Regulators Defend Record On LTC Oversight

April 05, 2007 at 06:00 PM
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State insurance regulators are promising to look into allegations that some long term care insurance policyholders have had trouble collecting on claims.

A reporter wrote about the allegations in an article published March 26 in the New York Times.

Wisconsin chairs the senior issues task force at the National Association of Insurance Commissioners, Kansas City, Mo.

Members of the task force will discuss the allegations in the Times article and then decide whether to consider changing the NAIC's Long Term Care Insurance model act, according to Eileen Mallow, assistant deputy commissioner at the Wisconsin Department of Insurance.

Pennsylvania, one of the states mentioned in the Times article, already is investigating one LTC insurer, says Randy Rohrbaugh, Pennsylvania's acting insurance commissioner.

Rohrbaugh declined to name the insurer.

"Where there is noise, we look," Rohrbaugh says.

The NAIC's market analysis program helped the Pennsylvania department decide where to look, Rohrbaugh says.

California is another state discussed in the Times LTC insurance article.

"In California alone, nearly 1 in every 4 long term care claims was denied in 2005," the Times reporter wrote in the article.

Officials at the California Department of Insurance did not return telephone calls seeking their comments on the article.

An official in another West Coast state, Washington Insurance Commissioner Mike Kreidler, expressed keen interest in the Times article.

"Without question, we will be looking at this at the NAIC," Kreidler says.

Up till now, LTC insurance pricing and sales practices have tended to get more regulatory attention than LTC claims problems have received.

Some companies entered the LTC insurance market without a sound understanding of the underwriting that would be needed, and many LTC insurance complaints deal with rate increases rather than with claims problems, Kreidler says.

Meanwhile, managers at some LTC insurance carriers seem not to know how sales reps are selling the products, and Washington state is "in heartfelt discussions" with one such LTC carrier, Kreidler says.

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