LTC Insurance Claims: Latest Report

• Long term care insurance companies paid $6.6 billion in claims to over 200,000 individuals in 2011.
• The largest long-term care insurance claim ever paid to date totaled $3 million.
•  The largest claim still being paid has exceeded $1.7 million in paid benefits.  (In this particular case, the claimant is a woman who purchased coverage and began receiving care three years later.  She has been receiving care for nearly 15 years.)
• Caims paid increased 8% in 2011 over 2010.
• Nearly two-thirds (65%) of new claims opened during 2011 over 2010.
• About one in four (24.1%) of new claims commence between ages 70 and 79.
• 65.5%  of all claims start after the policyholder reached age 80.
• About 10% of all claims start when policyholders are in their 50s or 60s, with accidents being a major cause.
• Alzheimer’s disease was the leading cause for claims in a nursing home or assisted living community. 
• Cancer was the top cause for claims that begin at home.
• Care at the residence of the claimant accounted for about 50% of new claims.
• Women receiving benefits for home care accounted for 32 % of new claims.
• Men receiving benefits for home care accounted for 18% of new claims.
• Less than one-third (31%) of new claims begin with the policyholder receiving care in a nursing home.

With each passing year, we learn more and more about how people use their LTC insurance policy.  These findings help carriers price their contracts realistically and help producers increase their expertise in designsing coverage that is most likely to cover their client’s needs while staying within an individual’s and a family’s budget.