Summary of Long Term Care Insurance Claims Data

The largest long-term care insurance claim paid totaled $3 million while the largest claim still being paid has exceeded $1.7 million in paid benefits, according to a just-released report from the American Association for Long-Term Care Insurance the national trade group.

“Last year the nation’s long term care insurance companies paid $6.6 billion in claim benefits to over 200,000 individuals,” reports Jesse Slome, executive director of the Los Angeles-based organization.  According to the Association’s report, the amount of claim benefits paid increased eight percent compared to the prior year.

The Association reports that women accounted for nearly two-thirds (65%) of new claims opened during 2011.   About one in four (24.1%) of new claims commence between ages 70 and 79 while 65.5 percent start after the policyholder reached age 80.  “One in 10 claims start when policyholders are in their 50s or 60s,” Slome acknowledged, “often the result of an accident or illness.”

“The widespread question asked by individuals considering long-term care insurance is will I ever use it,” Slome admits.  “The best we can do is gather information on how people use their benefits.”

According to Association, Alzheimer’s disease was the leading cause for claims in a nursing home or assisted living community while cancer was the top cause for claims that begin at home.

Half of all new individual long term care insurance claims pay for home care services the Association’s research found.   New claims by women receiving care at home accounted for 32 percent of new claims with 18 percent of men receiving benefits for home care.  “Less than one-third (31%) of new claims begin with the policyholder receiving care in a nursing home,” Slome adds.

The Association study revealed that the largest claim still being paid at the end of 2011 had reached $1.7 million.  “There are a number of claims still being paid that have exceeded $1-million,” Slome notes.  “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.

The complete findings of the Association’s research are contained in the just-published 2012 Long-Term Care Insurance Sourcebook.    Copies will be mailed at the end of July to all members of the Association.  For additional information, call the Association at 818-597-3227.

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