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May 29, 2007

California Health Care Advocates Launch Investigation of Long-Term Care Insurers' Claims-Handling Policies

The House Energy and Commerce Committee last week sent letters to long-term care insurers Conseco and Penn Treaty American to request documents as part of an investigation into the business practices of such companies, the San Francisco Chronicle reports. The committee launched the investigation in response to a March New York Times article that examined issues related to long-term insurance (Colliver, San Francisco Chronicle, 5/26).

In the article, the Times reviewed more than 400 complaints and lawsuits filed against long-term care insurers and found that some of the companies have developed practices to limit the ability of policyholders to receive claims payments (Kaiser Daily Health Policy Report, 3/26). Bonnie Burns, training and policy specialist for California Health Advocates, said, "Seven, eight, nine years later they are looking at claims and saying, 'gee whiz, is there anything on that application we can use to deny this claim,'" adding that the investigation "will shed light on practices that have been going on far too long without any regulatory response."

In a statement, Penn Treaty officials defended company business practices and said the company "sees this as an opportunity to highlight the value of long-term care insurance to America's seniors." Conseco officials in a statement said, "We agree that every long-term care policyholder deserves assurance that their claim will be handled timely and in accordance with the terms of their contract," adding that the company seeks a "thorough and fair" investigation.

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Posted by healthinsurance at May 29, 2007 07:21 PM