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Capitol Health Call
November 14, 2007

Long-term Care Insurance Probed

JAMA. 2007;298(18):2129. doi:10.1001/jama.298.18.2129-c

Long-term care insurance providers have been asked to submit documentation about how they process claims because of reports of improper rejections of claims by policy holders.

In letters sent on September 27 to 11 of the largest long-term care insurance providers, Sen Chuck Grassley (R, Iowa), the ranking minority member on the Senate's Finance committee, quoted statistics from the National Association of Insurance Commissioners (NAIC) that showed a 92% increase in the number of long-term care complaints nationally from 2001 to 2006. The NAIC also found that there was a 74% increase in the number of claim denial–related complaints between 2003 and 2006 and that more than 70% of claim denials are overturned in favor of the policy holders upon appeal, Grassley said.

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