Filed Under:Health Insurance, Ltci

Plaintiffs' lawyers analyze possible LTCI case triggers

Some conflicts may involve the definition of
Some conflicts may involve the definition of "residence." (AP Photo/Wally Santana)

Legal disputes involving U.S. long-term care insurance (LTCI) coverage are much more likely to focus on how an insurer is interpreting the policy terms than on whether the insured needs care.

Corinne Chandler and Glenn Kantor, partners at Kantor & Kantor who have represented LTCI policyholders, give that assessment in an article published in a recent issue of Trial, a magazine published by the American Association for Justice.

In the article — which appeared alongside an article on assisted living facility cases — the lawyers say insurers often question whether the facility or the home health care provider providing the care really is an eligible provider.

Other common triggers include disputes about policy lapsation and disputes about whether an insured has met the policy conditions, such as minimum hospital stay requirements, for qualifying for LTCI benefits, the lawyers say. 

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