Sacramento Long Term Care Insurance Claims Lawyer
Skilled Long Term Care Insurance Claims Attorneys Serving Sacramento, CA
When you or a loved one is facing the daunting decision to get long term care, having long term care insurance coverage is a wonderful resource to help meet the extensive expenses you are facing. Unfortunately, long-term care insurance companies have the right to deny coverage and often do so even with valid claims. This when you need the help of an experienced Sacramento long term care insurance claims lawyer.
You have diligently paid your premiums over the years for this very time in your life, and it can be overwhelming when the insurance company doesn’t meet its obligations. At Pillsbury & Coleman, LLP, our team of Sacramento long term care insurance claims lawyers are here to help you get the benefits you deserve under the terms of your policy.
When Do You Need Long Term Care Coverage?
As we witness the aging of America, we are also seeing the increased need for long term care. For most long-term care insurance, it will cover certain types of care when you need help with two of the six Activities of Daily Living (ADL), or have experienced cognitive impairment. These include:
- Personal hygiene
- Dressing
- Eating
- Toileting
- Transferring
- Ambulating
Consequently, a long-term care policy can help pay for:
- Adult daycare programs
- Assisted living
- Nursing home care
- Dementia care
- Hospice
Unfortunately, although long-term insurance is a valuable resource, it is only as good as your ability to get benefits when you need it. When your insurance company fights you each step of the way, you need the help of an experienced Sacramento long-term care insurance claims lawyer to hold them accountable.
The For-Profit Nature Of The Insurance Industry
In the vast world of insurance coverage, long-term care is extremely expensive. In California, the average cost of one year of long-term care has been estimated at $137,240 per year, as of 2020, and increases annually. And it is not only the elderly who need that care. Over 35 percent of individuals requiring long-term care are between the ages of 18 and 64.
Insurance companies, however, are for-profit businesses, and, as any for-profit enterprise, they strive to keep costs low. But what happens when there is a conflict between their profits and their contractual obligation to pay claims? This is what many people face each day when they have been unfairly denied coverage for a life situation that they counted on being covered for.
Why Was Your Claim Denied?
Long-term insurance companies have a litany of reasons they use to deny coverage. They may:
- Allege you missed a payment
- Claim the facility is not an eligible care provider
- Claim that you had no prior hospitalization
- Claim that they do not provide for some services, such as “personal care”
- Claim that you are able to perform some limited activities of daily living
- Claim there are conflicting medical opinions
- Claim that your condition has improved and you no longer qualify
- Claim that your medical condition is excluded
When your insurance company denies or resists paying benefits, our skilled team of Sacramento long term care insurance claims lawyers will aggressively advocate for you. Even if you have been denied benefits, you have the right to appeal that denial. Whether you have been denied benefits or are just embarking on a claim, we can help.
Getting The Help You Deserve
At Pillsbury & Coleman, LLP, we have helped countless individuals in the Sacramento area and throughout California get the benefits that they paid for and deserve.
The last thing you should have to do when considering long-term care is to fight with the insurance company that you trusted to be there when you needed it. Our Sacramento long term care insurance claims lawyers have worked with all major insurers in the state and understand the tactics of the industry. Contact us today to see how we can help you get the long-term care benefits that you deserve under your policy terms.