Long-Term Care Insurance: Filing a Claim

Summary

This practice note addresses the considerations that must be addressed and the process of filing a claim for benefits under a long-term care insurance (LTCI) policy. It is vitally important to do this correctly as it is a condition precedent to an insurer's obligation to pay benefits. As with all insurance policies, the purpose of filing a claim under an LTCI policy is to access policy benefits. The insurance policy will specify the procedure to be followed, but critical steps are required that do not exist in other kinds of insurance claims. The practice note will also discuss the claim filing and claim evaluation process from the long-term care insurer's standpoint. The substantive and procedural aspects of LTCI disputes and litigation are beyond the scope of this practice note.