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They've been paying on the long term care insurance for well over 10 years. Hopefully there is a way to get their insurance reinstated through the court system. Thank you.
To follow up on that previous post, according to the article I linked to, apparently policies issued before HIPAA in 1996 only had to offer a 30-day grace period ... after HIPAA, they're required to offer a 5-month "grace period" in which the policy can be reinstated if the policy lapsed because of the policyholder's failure to pay due to a cognitive impairment or because he or she needed help with "activities of daily living." Some insurers allow up to 7 months, and whether they start counting from the day the policy lapsed or the day when the premium was first due is the question, and varies by company.
I am SO sorry to hear this happened, Garcia10 ... first, gladimhere is right; it is worth checking into whether there was anyone listed on the policy as being an alternate person that the insurance company should notify in the event premiums were not being paid. I know that my parent's (small) LTC policy DOES have such a notification clause within it, and that I was listed as that person.
Second, for any others who are reading this ... yes, Jeanne is right; it is a VERY good idea to have all insurance premiums, ESPECIALLY this one, automatically paid from your checking account. My parents had this premium set up to be paid from their checking account automatically for many years. About a year and a half ago, as my Dad's dementia symptoms grew worse, I had those automatic payments transferred to my own checking account instead (and just asked him to write checks to reimburse me), because I was concerned about the potential danger of him accidentally overdrawing his checking account or being taken advantage of financially in some way that would cause this particular insurance premium to go unpaid even though it wasn't a check he had to remember to write. I'm actually amazed to hear the company in question here would let the policy go unpaid for six months before canceling ... I'd assumed any insurance company in this position would cancel within a month or two, tops, and be looking for any excuse to do so. :-(
It's definitely worth talking to a lawyer to see if anything can be done ... but yes, try to resolve with the company first. Do you have a copy of your parents' policy? Have you looked through it to see if they named an alternate contact (and provided contact info) for the company to reach out to if premiums were not being paid? It's possible that the law requires the company to ask insureds for such information, and to honor the notification request if it is provided, but not to do so if it is not ... For that matter, if they bought the policy through an agent, the agent should have been notified. Do you know if there was an agent, and if so, who that person (or agency) was?
I just searched the Web and found this article:
It is somewhat encouraging in that it specifically refers to one woman managing to get her mother's policy reinstated after persistently trying for a year (the mother had apparently canceled the policy sometime after developing Alzheimer's) ...
This may well be a case in which being persistent -- polite, but persistent ... and willing to involve a lawyer ... and absolutely, past-due premiums would have to be paid ... might, might, might get you where you need to be ... my fingers are very much crossed for you and your parents. Good luck!
Wow. This is really sad all the way around. Dementia really does first start showing as neglecting mail and acting irresponsibly in ways not at all common before. And these can be very hard for someone not living with them to detect. So what your in-laws did is not surprising. And that you didn't catch it is not surprising. None of you are bad people.
That the insurance company needs to get its premiums every period is not surprising. A six-month grace period with lots of over-due notices, is behaving responsibly. They are not a bad company.
So there are no bad guys in this scenario (except dementia) but there sure is a bad outcome!
I think if it were me I'd make one more attempt to contact the insurance company, in writing. Explain, briefly, why your in-laws did not pay the premiums, and why you did not know they were not meeting their various financial obligations. Now that you are aware of the situation you are trying to set matters right. Offer to pay the 9 months missing premiums and beg them to reconsider reinstating the policy. It was purchased for precisely this need; appeal to their sense of community service.
If that does not get favorable results, I'd go with Jinx's suggestion of visiting a lawyer.
I am certainly glad that my long-term insurance and all other insurance premiums are paid automatically from my account. I set it up that way for my convenience, but now I can see it as a safety measure, too!
At the very least, demand return of the premiums paid. Get a lawyer's advice, and write to the newspaper or TV consumer help reporter, and write to the Insurance Commissioner of your state.
We've spoken with the insurance company. The last payment they made was Feb. 2013. Past due notices went to their home along with a cancellation notice after 6 months of non-payment. They simply gave up opening their mail unaware to the rest of the family. The ins. company naturally claims that they did what was required of them to be legal.The rapid onset of dementia is playing a huge part here. Thank you for responding.
I hate this. My mom also had a long term care policy that she probably paid into for 20 years. Who was listed on the policy with them, that person should have been notified when premiums were not paid. I think this happens frequently and may be one of the first signs of dementia. Mom took out the policy when she was of sound mind because of the cost of the nursing home my grandma was in. A very responsible decision since mom did not want her life savings paying for health care, she wanted something left of an inheritance.
How many of these policies lapse each year only to find out later that the insured has developed dementia?
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Second, for any others who are reading this ... yes, Jeanne is right; it is a VERY good idea to have all insurance premiums, ESPECIALLY this one, automatically paid from your checking account. My parents had this premium set up to be paid from their checking account automatically for many years. About a year and a half ago, as my Dad's dementia symptoms grew worse, I had those automatic payments transferred to my own checking account instead (and just asked him to write checks to reimburse me), because I was concerned about the potential danger of him accidentally overdrawing his checking account or being taken advantage of financially in some way that would cause this particular insurance premium to go unpaid even though it wasn't a check he had to remember to write. I'm actually amazed to hear the company in question here would let the policy go unpaid for six months before canceling ... I'd assumed any insurance company in this position would cancel within a month or two, tops, and be looking for any excuse to do so. :-(
It's definitely worth talking to a lawyer to see if anything can be done ... but yes, try to resolve with the company first. Do you have a copy of your parents' policy? Have you looked through it to see if they named an alternate contact (and provided contact info) for the company to reach out to if premiums were not being paid? It's possible that the law requires the company to ask insureds for such information, and to honor the notification request if it is provided, but not to do so if it is not ... For that matter, if they bought the policy through an agent, the agent should have been notified. Do you know if there was an agent, and if so, who that person (or agency) was?
I just searched the Web and found this article:
It is somewhat encouraging in that it specifically refers to one woman managing to get her mother's policy reinstated after persistently trying for a year (the mother had apparently canceled the policy sometime after developing Alzheimer's) ...
This may well be a case in which being persistent -- polite, but persistent ... and willing to involve a lawyer ... and absolutely, past-due premiums would have to be paid ... might, might, might get you where you need to be ... my fingers are very much crossed for you and your parents. Good luck!
That the insurance company needs to get its premiums every period is not surprising. A six-month grace period with lots of over-due notices, is behaving responsibly. They are not a bad company.
So there are no bad guys in this scenario (except dementia) but there sure is a bad outcome!
I think if it were me I'd make one more attempt to contact the insurance company, in writing. Explain, briefly, why your in-laws did not pay the premiums, and why you did not know they were not meeting their various financial obligations. Now that you are aware of the situation you are trying to set matters right. Offer to pay the 9 months missing premiums and beg them to reconsider reinstating the policy. It was purchased for precisely this need; appeal to their sense of community service.
If that does not get favorable results, I'd go with Jinx's suggestion of visiting a lawyer.
I am certainly glad that my long-term insurance and all other insurance premiums are paid automatically from my account. I set it up that way for my convenience, but now I can see it as a safety measure, too!
How many of these policies lapse each year only to find out later that the insured has developed dementia?