Aged, Frail and Denied Care by Their Insurers

[WillyT]

<snip>

CONRAD, Mont. — Mary Rose Derks was a 65-year-old widow in 1990, when she began preparing for the day she could no longer care for herself. Every month, out of her grocery fund, she scrimped together about $100 for an insurance policy that promised to pay eventually for a room in an assisted living home.

On a May afternoon in 2002, after bouts of diabetes had hospitalized her dozens of times, Mrs. Derks reluctantly agreed that it was time. She shed a few tears, watched her family pack her favorite blankets and rode to Beehive Homes, five blocks from her daughter’s farm equipment dealership, content that she would not be a financial burden on her family.

But when she filed a claim with her insurer, Conseco, it said she had waited too long. Then it said Beehive Homes was not an approved facility, despite its state license. Eventually, Conseco argued that Mrs. Derks was not sufficiently infirm, despite her early-stage dementia and the 37 pills she takes each day.

After more than four years, Mrs. Derks, now 81, has yet to receive a penny from Conseco, while her family has paid about $70,000. Her daughter has sent Conseco dozens of bulky envelopes and spent hours on the phone. Each time the answer is the same: Denied.

Tens of thousands of elderly Americans have received life-prolonging care as a result of their long-term-care policies. With more than eight million customers, such insurance is one of the many products that companies are pitching to older Americans reaching retirement.

Yet thousands of policyholders say they have received only excuses about why insurers will not pay. Interviews by The New York Times and confidential depositions indicate that some long-term-care insurers have developed procedures that make it difficult — if not impossible — for policyholders to get paid. A review of more than 400 of the thousands of grievances and lawsuits filed in recent years shows elderly policyholders confronting unnecessary delays and overwhelming bureaucracies. In California alone, nearly one in every four long-term-care claims was denied in 2005, according to the state.

<snip>

Link: http://www.nytimes.com/2007/03/26/business/26care.html?hp

OK... time to TRULY regulate the entire insurance industry!

Assholes!

:nuke:

[Monkeyman]

1. Assholes is not the words I use the blanks

[PDJane]

2. I have a stack of these stories.......

And if the insurers will not pay the claims, why the hell do they take the money?

It is past time for them to be regulated.

[aquart]

6. No. Single payer national health. Eliminate the corrupt middle man.

[PDJane]

9. That's a much better solution.

It is the solution. However, the corporate machine that dictates what the government does won't allow that easily. Steps.

[Erika]

3. We need to start screaming and voting

Can you imagine any of our congress paying for such?

[sandnsea]

5. John Cornyn actually sued them

When he was AG of Texas. Apparently, this has been a problem for a long time. People are having their premiums go up 50%. Long term care insurance is really expensive to start with. Sounds like another case of the media just not telling us what's going on.

http://www.oag.state.tx.us/newspubs/newsarchive/2001/20010731conseco.htm

[babylonsister]

8. WOW! I'm shocked; he's my ineffective, blow-hardy senator. nt

[sandnsea]

10. Almost makes you think you missed something

What's the catch? Have to be missing something if it looks like Cornyn did the right thing once. :silly:

[babylonsister]

12. Series! I honestly think he has exhibited

brain-deadness, so this really shocks me. He sounds so dumb most of the time, pledging allegiance to the C(riminal)IC.

[lovuian]

4. Universal health would take care of it

it has to be

[babylonsister]

7. My heart hurts at this. nt

[LiberalHeart]

11. Makes me happy my mom has Genworth.

It costs a bundle -- $6,500 a year. But looks like it might be worth it.

[AwakeAtLast]

13. As soon as I read the word "Conseco" I knew it was bad.

Hate, Hate, HATE that company! Just look up Stephen Hillbert if you want an idea of how they run. :grr:

[Thothmes]

14. Insurance

This does not surprise me in the least. I am amused that it surprises anyone. The purpose of health insurance companies is their profit, not their policy holders health.

[mainegreen]

15. Nationalize.

Seize their assets. This is an area private ownership has no business.

[Omaha Steve]

16. I have never used this type of language before on the DU!

WTF? This really pisses me off. My mom is 83 & 1/2. This hits home hard. Where is the government that needs to step in and end this? Now I'll return to a more family friendly use of words.

[lonestarnot]

17. Run the son of a bitches out of business after all of their assets are seized!