Jennifer Meagher RN is the owner of Senior Life LLC, Advocates and Consultants. Meagher founded and oversees the Better Business Partners Serving Seniors. She is on the Alzheimer’s Advocacy Committee and has specialized in geriatrics since 1998. She is called on by doctors, attorneys, and financial advisors to care for their clients and their families. Contact Jennifer at www.SeniorLifeGCM.com.
I enjoy reading your page. I am learning so much. My question is about Long Term Care Insurance. My father has dementia and my mother wants to keep him home. She wants to use the insurance for his home care bills. The insurance company turned down our request. How can they do that? They said he doesn’t need enough assistance with “ADL’s.” They said that’s “Activities of Daily Living,” like eating and using the toilet. It doesn’t make any sense to us. Can we appeal their decision? Isn’t it our insurance to use? Why have we been paying into it if they won’t let us use it?
We are pretty upset. I hope you’ll respond.
First, thanks for your kind words. Now, about Long Term Care Insurance. The representative is correct. In order for your father to qualify to place a claim against his insurance, he must need significant assistance with 2 out of 5 ADLs. They are:
Again, the requirement is that your father needs standby or hands-on assistance.
Remember: to successfully place a claim, your father must meet the criteria of assistance in at least two of these categories. This requirement for claim is clearly stated in the original agreement which your father signed.
Keep reading for more information.
THE LONG TERM CARE INSURANCE (LTCI) CLAIM PROCESS
Your LTCI policy has key ingredients:
1. QUALIFICATIONS FOR THE CLAIM.
2. WHAT CARE IS COVERED
3. CLAIM REQUEST PROCESS
4. ELIMINATION or WAIT PERIOD
5. DAILY PAYMENT RATE
6. TOTAL COVERAGE AMOUNT OR COVERAGE DAYS.
By John Sproul
World War I started in July 1914 when which of these famous people was assassinated?
A. Kaiser Wilhelm II
B. Tsar Nicolas II
C. Archduke Franz Ferdinand
D. Otto von Bismarck
The correct answer is C.
Franz Ferdinand, archduke of Austria (and heir to the Austrian throne), and his wife Sophie were riding in an open car in Sarajevo in June 1914 (a territory of the Austro-Hungarian empire), when they were assassinated by 19-year-old Gavrilo Princip. He was a member of The Black Hand, a group that was trying to gain independence for the states annexed by the empire. World War I started two months later when Austria sent its final warning to Serbia, and entangling alliances quickly involved other nations. The US didn't enter WWI until 1917. The war finally ended on Nov 11, 1918 (Armistice Day).