Over 150.000 insurance professionals and consumers come to the Insurance Forum every month. Click here to register for FREE


Go Back   Insurance Forums > Insurance Agents and Brokers Forum > Long Term Care Insurance Forum

Reply to Long Term Care Horrible Experience W/Allstate     
Old 06-08-2017, 01:08 PM   #21
Guru
 
Join Date: Jun 2012
Posts:338
State: walthamny is an Insurance Agent from Massachusetts
Long Term Care Horrible Experience W/Allstate Re: Long Term Care Horrible Experience W/Allstate
Some tips for hiring an attorney in this case.

It helps if the attorney has experience with insurance contract law. Most civil attorneys law about their state contract law but most of the time insurance company will fight these because they will claim there is a different statue for insurance contracts law and they will bring up obscure insurance contract case law decisions from over 100 years ago.

You also need to hire an attorney who is mean, someone you really dislike, (&^%$# personality. You can hire a nice, gentle attorney and make your father happy but cases like this really shine for the type I mentioned.
------------------------------------
  Reply With Quote to Long Term Care Horrible Experience W/Allstate

Old 06-09-2017, 07:38 AM   #22
New Member
 
Join Date: Jun 2017
Posts:10
State: Badandy1 is an Insurance Agent from
Long Term Care Horrible Experience W/Allstate Re: Long Term Care Horrible Experience W/Allstate Badandy1 is the thread starter for: Long Term Care Horrible Experience W/Allstate

Thanks for all the great advice! Our attorney feels this may have Class Action potential !!
------------------------------------
  Reply With Quote to Long Term Care Horrible Experience W/Allstate
Old 06-09-2017, 12:18 PM   #23
Guru
LGilmore on Long Term Care Horrible Experience W/Allstate
 
Join Date: Jun 2007
Posts:3,989
State: LGilmore is an Insurance Agent from Washington
LGilmore is a member of 1000 posts VIP club
Long Term Care Horrible Experience W/Allstate Re: Long Term Care Horrible Experience W/Allstate
"Allstate tells me that they "used " to pay Assisted Living, but have now changed their minds. Coincidentally, they changed their minds when they recieved my Fathers claim. "

This is what I meant by make sure you're working off the same policy language. Insurers change policy offerings every so often and in those changes, new definitions or features come on or drop off. The thing is these changes should only apply to new business.

They will have to go by the contract language in your dad's plan. They don't get to change it to something else. This can be a good or bad thing depending on the option we're talking about.

I would go through your dad's policy and call them and make absolutely sure you are both working from the same policy plan.

As I said before I had a similar problem over wavier of premium on my life policy taken out about 30 years ago. The definition of disability and how the waiver applies had changed two times since I purchased. First two customer service reps kept telling me something that wasn't in my policy. I had to point out the series I was working from, not what is currently for sale. Asked for a third customer service rep who knew the old policies.

Then it was a snap to take care of. Remember customer service reps are not versed in policy language, they read back what the screen says to you. They may have only been working there 6 months.

Make sure everything is on the same page. If they still disagree, ask for them to put it in writing and then submit to your OIC for them to work on.

make triple sure. But also understand they may have given you the wrong information because of what I just wrote as well. The big thing is make sure everybody matches.
"
------------------------------------
  Reply With Quote to Long Term Care Horrible Experience W/Allstate
Old 06-09-2017, 04:20 PM   #24
Guru
 
Join Date: Nov 2008
Posts:1,851
State: Mr_Ed is an Insurance Agent from New Jersey
Mr_Ed is a member of 1000 posts VIP club
Long Term Care Horrible Experience W/Allstate Re: Long Term Care Horrible Experience W/Allstate
Originally Posted by LGilmore View Post
"Allstate tells me that they "used " to pay Assisted Living, but have now changed their minds. Coincidentally, they changed their minds when they recieved my Fathers claim. "

This is what I meant by make sure you're working off the same policy language. Insurers change policy offerings every so often and in those changes, new definitions or features come on or drop off. The thing is these changes should only apply to new business.

They will have to go by the contract language in your dad's plan. They don't get to change it to something else. This can be a good or bad thing depending on the option we're talking about.

I would go through your dad's policy and call them and make absolutely sure you are both working from the same policy plan.

As I said before I had a similar problem over wavier of premium on my life policy taken out about 30 years ago. The definition of disability and how the waiver applies had changed two times since I purchased. First two customer service reps kept telling me something that wasn't in my policy. I had to point out the series I was working from, not what is currently for sale. Asked for a third customer service rep who knew the old policies.

Then it was a snap to take care of. Remember customer service reps are not versed in policy language, they read back what the screen says to you. They may have only been working there 6 months.

Make sure everything is on the same page. If they still disagree, ask for them to put it in writing and then submit to your OIC for them to work on.

make triple sure. But also understand they may have given you the wrong information because of what I just wrote as well. The big thing is make sure everybody matches.
"

if this was a group policy, then his father would only have a certificate and the benefits could have been changed without his father's knowledge or consent.

That's why I asked if it was a group policy or if it was purchased as an individual.

I think the OP used the phrase "certificate" to describe his father's policy which leads me to believe it is a group policy.
------------------------------------
  Reply With Quote to Long Term Care Horrible Experience W/Allstate
Old 06-09-2017, 05:16 PM   #25
Guru
LGilmore on Long Term Care Horrible Experience W/Allstate
 
Join Date: Jun 2007
Posts:3,989
State: LGilmore is an Insurance Agent from Washington
LGilmore is a member of 1000 posts VIP club
Long Term Care Horrible Experience W/Allstate Re: Long Term Care Horrible Experience W/Allstate
Originally Posted by Mr_Ed View Post
if this was a group policy, then his father would only have a certificate and the benefits could have been changed without his father's knowledge or consent.

That's why I asked if it was a group policy or if it was purchased as an individual.

I think the OP used the phrase "certificate" to describe his father's policy which leads me to believe it is a group policy.

Could be, then it would be year to year. Same point applies, they need to make sure everything matches on both ends, so they can move forward. The first information the OP got could have been what was incorrect to. It will depend on the policy language inforce at the time.
------------------------------------
  Reply With Quote to Long Term Care Horrible Experience W/Allstate
Old 06-15-2017, 06:56 AM   #26
New Member
 
Join Date: Jun 2017
Posts:10
State: Badandy1 is an Insurance Agent from
Long Term Care Horrible Experience W/Allstate Re: Long Term Care Horrible Experience W/Allstate Badandy1 is the thread starter for: Long Term Care Horrible Experience W/Allstate

I wanted to let everyone know how this ended up. I submitted a complaint to Indiana Department of Insurance , called and spoke to my "complaint consultant" . She became very intrigued when I explained the denial reason was , "We Changed our Minds" !
When I then told her I had documented all the phone calls ( Stating that Assisted Living was covered) and Allstate told me they would not release the phone calls with out a subpeona, she was really intrigued.
My "Problem Counselor" Called Allstate that day and requested the phone call transcripts.
Interestingly enough, The Vice President of Claims phoned me that afternoon to say " They would pay the benefits as an Accommodation only, ( meaning this is a negotiated deal) and she reminded me that our policy is "a nursing home policy only. (It is not!)
We have several Attorneys interested in a Class Action Lawsuit. If you know of consumers with policies such as this, please let me know!
------------------------------------
  Reply With Quote to Long Term Care Horrible Experience W/Allstate
Old 06-26-2017, 07:38 PM   #27
New Member
 
Join Date: Jun 2017
Posts:1
State: NeedHelpForGrandpa is an Insurance Agent from
Long Term Care Horrible Experience W/Allstate Re: Long Term Care Horrible Experience W/Allstate
Badandy1, so glad to hear that this ended well for you. We are going through the EXACT same thing with Allstate now. Grateful for your posts and follow-up. Crossing our fingers for a similar outcome!
------------------------------------
  Reply With Quote to Long Term Care Horrible Experience W/Allstate
Reply to Long Term Care Horrible Experience W/Allstate 

  Insurance Agent Forum > Insurance Forums > Insurance Agents and Brokers Forum > Long Term Care Insurance Forum




Similar Threads with Long Term Care Horrible Experience W/Allstate
Thread Thread Starter Forum Replies Last Post
Is anyone going to the Convention (National Agents Alliance) (NAA dvd493 Life Insurance Forum 1591 11-17-2016 10:24 AM
Long Term Care Update for February 2014 - News You Can Use Lets Get Down to Business Steve Savant Long Term Care Insurance Forum 25 09-08-2014 01:18 PM
Long Term Care Update Steve Savant Long Term Care Insurance Forum 0 04-02-2014 05:53 PM
Affordable Long Term Care trishaatorga Long Term Care Insurance Forum 0 01-07-2014 12:15 PM



All times are GMT -5. The time now is 05:20 PM.

Forum enabled with vBulletin®
Copyright ©2000 - 2017, vBulletin Solutions, Inc.


Join the Forum - It's FREE

Share This Page



Weekly Poll

Where do we go from here? POLL
Nothing - No ACA fixes - status quo
29.82 %
HHS Rulings and band aid bills
17.54 %
Hail Mary repeal and/or replace bill
17.54 %
A bipartisan bill to fix ACA
35.09 %

Voters: 57. This poll is closed