Oregon Has New Regulations on Appealing a Denial on a Long-Term Care Insurance Claim

Long-term insurance is a way for people to ensure they have someone to take care of them when they get old and too sick to take care of themselves.

Oregon Insurance Division  claims that at least 70% of people over age 65 will need some long-term care services. However, as mentioned in a  Kaiser Health News article, not everyone thinks about long-term care before they get older, and even if they do, the process of payments can get complicated. More specifically, some insurance companies are slow to pay and can even deny payments all together.

The article brings up the example of Jim Chenoweth, who had to call to the Oregon insurance commissioner’s office recently to get a claim paid. It also explains the long process his daughter had to go through trying to get help for her father, and that she ended up hiring someone else to take care of him.

Oregon along with other states such as Kansas and Alabama, are adopting new regulations to help fulfill the needs of insured people.

For instance, Oregon adopted new rules of appealing a denial on a long-term care insurance claims. In the past  a denied consumer had to go to court for the appeal, which can be problematic for an elderly person.

Cheryl Martinis, with the state’s consumer services department, claims:

“In the past with long-term care insurance, consumers haven’t had the same rights that they have had with other health insurance, … and that is to have an undisputed claim paid within 30 days, and so now that is a right in Oregon. And also, we haven’t had an appeals process in the past, and now we do.”

Now, the Oregon Insurance Division helps to negotiate wrongly denied claims which makes the process easier for elderly people because they don’t have to go through the court system.