Long-Term Care Insurance Claims: The Basics – Part 6 – What Is This Assessment Thing?

“Long Term Care Insurance Claims

– The Basics”

Long Term Care Claims help

What Is This Assessment Thing?

If the long term care claims documentation process wasn’t enough to give you chills, there is one last step that you must clear. The long term care insurance carrier will send out an assessor to interview the claimant and make sure that the claimant really does have need for care and there isn’t any fraud going on. This sounds innocent enough, but it becomes complicated when we mix it with seniors who don’t want strangers to know how much help they are truly needing.

Most of us don’t want to look helpless or frail – especially in front of a stranger! So you have to be sure that when the assessor comes out you remind the claimant that s/he needs to be truthful about the level of need and not “put the best foot forward.”

And then – to top it off – there will be a re-assessment that happens at intervals of time forward (3 months,6 months, and a year are all possible). The long term care insurance carrier will send the nurse back out to do another assessment to verify that the claimant is still needing this level of care and hasn’t somehow improved. So you get to walk thru this again – the face to face assessment AND resubmitting a few documents to prove claim eligibility.


Some Additional Links to help you with your long term care claim journey


Leave a Reply