Q. Sometimes my clients ask claims questions such as how many people receive care at home and for what kinds of conditions. Can you provide me with information to respond?
Now that long-term care insurance has been around for a while, sufficient data has been accumulated so that we have a good grasp on claims. The industry is paying a very large amount of dollars in claims—some $6.6 billion in benefits was paid to about 200,000 individuals in 2011*—and we should be sharing that information with clients.
Here is an analysis of the more than 160,000 claims that a leading carrier paid by the end of 2011.
• $1.2 million is the largest single claim.
• 50 percent of all claim dollars are paid to claimants with mental disorders including dementia.
• 78.7 is the average age of claimants. At age 80, it’s approximately 26 percent of claims, age 85 it’s about 24 percent of claims and age 90 it’s 9 percent.
• Youngest claimant is 28; oldest is 103.
• Longest claim is 18.7 years.
• 71 percent of claims have been paid to female claimants.
• Married women tend to claim at an earlier age than single women and men.
LENGTH OF CLAIMS
• 43 percent of claims last less than one year due to a short recoverable illness, a sudden terminal illness or a single use of non-caregiving benefits.
• The average length of claims that last more than a year is 3.9 years.
• 15 percent of claims will last more than five years.
Of 100 people, 80 do not transition from where they receive their initial care.
WHO GOES ON CLAIM AND FOR WHAT—BY GENDER AND CAUSE
• Single women–38 percent of all claims
• Married women–27 percent of all claims
• Single men–11 percent of all claims
• Married men–24 percent of all claims
• Women–Dementia, Cancer, Fractures, Stroke
• Men–Dementia, Cancer, Stroke, Parkinson’s
Of all the claims, 59 percent died while on claim, 30 percent recovered and 11 percent exhausted their benefits.
(Source ‑ *AALTCI Source Book)