Editorial: Protecting the aged

Friday, Oct. 5, 2007 | 7:29 a.m.

Information suggesting that a number of long-term care insurance companies aren't properly handling policyholders' claims has a top-ranking member of the Senate Finance Committee demanding answers.

Sen. Charles Grassley, R-Iowa, has asked nearly a dozen insurance companies to explain what he described as "troubling data" collected by the National Association of Insurance Commissioners, an organization made up of state insurance regulators.

State regulators say that complaints about long-term care insurance claims increased 92percent from 2001 to 2006 and that a majority of complaints involving denial of claims resulted in the reversal of decisions in favor of the policyholders - a trend, the report says, that is not typical of other kinds of health insurance policies.

Grassley has asked the nation's 11 largest long-term care insurers to provide information on how they handle claims and denials - including details on certain practices such as whether employees are rewarded for preventing claims from being paid.

In asking for the information, Grassley cited a story by The New York Times this year in which it was reported that long-term care insurers routinely enact procedures that make it virtually impossible for policyholders to collect on their claims.

Grassley also cited a Times story last month that revealed residents' treatment at a significant number of the nation's nursing homes - where long-term care policyholders typically seek services - had deteriorated after the homes were purchased by private equity companies that created layers of ownership to make it difficult to hold anyone responsible for poor care.

Adults who are in the position of needing others to look after their basic needs are not typically in the position to fight large insurance companies to obtain benefits for which they have paid and to which they are entitled. It is absolutely wrong for companies to routinely deny claims and pay only after people complain. This is no way to treat aging Americans in their time of need.