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Long-Term Care Insurer Faces Lawsuit

Our Chicago nursing home abuse lawyers appreciate that our nation’s seniors often face mistreatment on a wide range of fronts. Elder abuse in assisted living facilities and nursing home are one of the most talked about forms of mistreatment-but there are many others. As we’ve discussed consistently, financial exploitation of these groups remains prevalent. With some studies suggest one or two seniors out of every ten face some sort of financial abuse, quite a few have begun referring to the issue as an epidemic.

Financial exploitation of the elderly comes in many forms. Sometimes it involves elaborate scams pulled by con artists who convince unsuspecting seniors that they need repairs on their home or who otherwise “sell” something, take money, and fail to provide anything for the victim. In many other cases the abuse is perpetrated by one who is in some position of control over the senior’s finances. This could be a nursing home aide who helps with bills, an at-home caregiver who performs services for the senior, or even a family member who has access the elder’s bank account and checkbook,

Other financial mistreatment is much more sophisticated, conducted by purportedly reputable enterprises. However, the harm to the unsuspected seniors (and their families) is just as real as if the mistreatment was conducted by a scam artist.

For example, the L.A. Times reported this weekend on a new lawsuit filed by a consumer watchdog group against a long-term care insurance company. The crux of the lawsuit is simple: policyholders paid claims for years only to have the insurance company wrongfully deny or delay coverage when needed. More specifically, the lawsuit suggests that the provider sometimes ignored claims submitted by policyholders or willfully delayed the process. At times a range of unnecessary paperwork was required by the company or excessive medical examinations were requested. Similarly, the insurance company apparently told policyholders that the caregivers they used had to have certain licenses-even though this went against state law and company policy.

As the consumer watchdog group president noted, the insurance company was “preying on the elderly.” One plaintiff, a 78-year old man, dutifully paid premiums on his policy for sixteen years. When he finally needed the extra care, the insurance company engaged in a wide range of stall tactics and claim denials. In the end, the company denied 80% of his claims. This forced him to lose all of the assets he had built up over a lifetime-the very outcome he wanted to avoid by purchasing the insurance in the first place.

Our Illinois nursing home abuse lawyers firmly believe in the power of the justice system to help correct all cases of mistreatment perpetrated against our senior community. That is particularly true when those wrongdoers are large businesses-like nursing home chains and insurance companies. When trying to fight the company alone, many residents feel overwhelmed. However, the court system can be a great equalizer. All those involved, including the big interests with the deep-pockets, are forced to explain their actions. Please get in touch with our office if you know one who has been hurt by nursing home neglect, financial exploitation, or similar misconduct.

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