Long-Term Care Claims

If you have questions about what type of information to include with your appeal, contact Patrick Mause for a free consultation on the types of information you might want to include when you appeal an insurance company’s denial of your long-term disability claim.


Frequently, disability insurance companies would cross-sell “long-term care” insurance policies. These policies, similar to a long-term disability insurance policy, pay a monthly benefit to the insured; often several thousand dollars a month. Unlike a disability policy, however, long-term care insurance pays benefits if the insureds are unable to care for themselves. These policies typically require the insureds to show they require assistance with “Activities of Daily Living” or “ADLs,” or that they have a cognitive impairment and need someone to help keep them safe.

Also similar to disability insurance, some long-term care insurance companies are facing huge financial difficulties with their policies. Unfortunately, some of those companies have decided to address their financial difficulties not by tightening their belts or paying lower dividends to their investors but by deliberately shortchanging their insureds. Fortunately, most long-term care insurance policies are not subject to ERISA. These claims are therefore usually subject to Arizona bad faith law, and an insured whose long-term care benefits were wrongfully denied may be able to seek full compensatory damages and punitive damages.

Like disability claims, long-term care claims require a dedication to understanding not only the insurance policy issues, but also a dedication to understanding the insured’s medical issues, how they affect the person, and how they impact their insurance coverage. Through his nearly two decades of experience, Patrick has developed the knowledge required to investigate and pursue these cases.

If you believe you have been treated unfairly by your long-term care insurer, contract Patrick today for a free consultation.