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Long Term Care Insurance
Long term care insurance companies don't sell policies without first determining what the probability rate will be that they will have to make good on the bet or in simple terms, what the prbability rate that you the policy holder will file a claim. This is the basic concept for any type of insurance and is called "underwriting". It just means the company evaluates your health before it will sell you a policy. Some companies follow "short-form" underwriting. On the application for coverage, you will be asked to answer a few questions about your health. Have you been in a hospital during the last 12 months or are you confined to a wheelchair? If you answer "no" to all of the questions, the long term care and health company believes you are a good bet to be a customer who will pay money in and not force them to pay out as much. The insurance sales person is then authorized to issue coverage as soon as you write a check.
Other healthcare companies are more selective. They will examine your current medical records and ask for a medical statement about your health from your doctor. Having current health conditions that are likely to require long-term care makes you a bad bet and will disqualify you with these insurance companies.
Always answer all the health questions truthfully as possible. If the insurance agent completes the form as you are asked questions, please be sure to change any entries that are not 100% correct before you give your signature confirming that everything is accurate to your knowledge. The reason is very simple. Once you make a claim you become just another statistic and the insurance company will not pay you a single penny if it later can claim that you were not trueful about your health when you signed up. If there is anything the care carrier can do to avoid paying it will and the long-term carrier will lament that it relied on the misstatement to grant long-term care coverage. Even though you "won" the bet and are entitled to long term care benefits, the carrier will rescind your policy and return the money you paid for your coverage. These care insurance companies do not investigate your medical record until you file a claim, and then they investigate it with extremely fine attention to every conceivable reason why they should deny benefits based on inconsistencies. This practice is called "post-claims underwriting." It is illegal in many states. Companies that do their underwriting studies at the outset and thoroughly check on your health before issuing a policy are not as likely to engage in post-claims underwriting.
Never guess when filling out one of those application. Don't answer questions unless you completely understand it. If you do not know that "pulmonary" refers to lungs, then you shouldn't be responding to any inquiries concerning "pulmonary" conditions, complaints or symptoms. Just because you believe you know what a word means, does not mean you understand it. This is not a matter of pride. If you do not know what a word means, ask.
Trying to remember every health condition you ever had and when you had it is not an easy task. It is a lot better to state that you believe you have had that medical condition but do not recall the exactd deatils. Add an asterisk [*] to every section of the application where you are not completely sure and at the place for explanations add an asterisk and the words "please see the records of Dr. Smith" or whoever can provide the necessary information. If you follow this advice, the company can never deny you benefits after the fact because you were honest in disclosing what you remembered and offered the carrier access to a specific doctor's records where the information could be found. If a carrier tries to deny coverage for a customer with this information in their application, the insurance company's lawyers will be facing a lawsuit not only for the damage caused by the company, but in addition punitive damages.
Many insurance companies will issue a policy if the current customer has relatively minor health problems, but will not cover those particular conditions for a period of time, usually six months or longer. A pre-existing condition is one for which you sought medical advice or treatment or had symptoms within a certain period before applying for the policy. Companies also vary in the length of time they will look back at your health status, and you will want to consider these variations as well. If the company discovers you have not disclosed a pre-existing condition on your application, it may refuse to pay for treatment related to that condition and perhaps terminate your coverage.
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