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What Consumer Protections Apply to Long-Term Care
Insurance Sold in California?
California has a long list of consumer protections,
some of which are listed here.
. Renewability: Every individual long-term
care policy must be either guaranteed renewable or non-cancelable.
. Guaranteed Renewable means that
the insurer may not cancel your coverage unless you do not pay premiums
on time. Your coverage may not be cancelled because of your age or your
health, but the company retains the right to increase premiums if the
Department of Insurance approves the increase.
. Non-cancelable means that the insurer
cannot cancel your coverage or increase your premiums, as long as you
continue to pay your premiums on time. No company currently offers this
type of coverage in California.
. Group Coverage Renewability: If
you purchase a long-term care certificate through a group, you have
the right to either continuation or conversion if your coverage terminates.
. Continuation means you maintain
the same coverage if you continue to pay the premium on time.
. Conversion means you will be issued
an individual policy containing identical or equivalent coverage regardless
of your health or your age. The premium will be calculated on your age
at the time the group certificate was issued.
. Duty of Honesty, Good Faith and Fair Dealing:
Every long-term care insurer and insurance agent owes every applicant
and policyholder a duty of honesty, good faith and fair dealing. Among
other things, this duty means that advertisements and other marketing
materials may not be misleading. Applicants must be given fair and accurate
comparisons of policies. No excessive insurance or inappropriate replacement
policies may be sold. High pressure tactics are expressly forbidden,
and insurance agents must receive special training in order to sell
long-term care insurance.
. 30-Day Free Look: Purchasers of
individual long-term care insurance (except purchasers through employer
groups or trade associations) have the right to review the policy or
certificate for 30 days after they receive it. If they decide not to
buy the insurance, for any reason, they may return the policy to the
insurer or the agent without explanation, and all the money they paid
will be refunded to them. (Note: Always keep a record of the date you
receive the policy and the date you return it, or return it by certified
mail.)
. Outline of Coverage: An outline
of coverage is a summary of the terms of a policy or certificate that
you can use to compare different policies. An Outline of Coverage must
be delivered to you at the time of an insurance agent's first presentation.
If you are purchasing insurance through the mail, then the Outline of
Coverage must be delivered to you at the time you receive the application
or enrollment form. You do not need to fill out an application in order
to get the Outline of Coverage. An agent or insurance company should
be willing to give you an Outline of Coverage. If a company or an agent
refuses to give you one, do business with someone else.
. Changing Your Benefits: If you find
that you cannot afford to continue paying the same amount of premiums
for the coverage you bought, you have the right to reduce your benefits
in return for a lower premium. Companies must, at a minimum, let you
reduce the daily benefit or change the number of years the company will
pay benefits so the lower premium is an amount that is more affordable.
Long Term Insurance
| Bluecross Long Term |
California Long Term Insurance
| Kaiser Long Term |
Long Term PPO plans|
Long Term Medical plans | Long
Term Dental Insurance |
Long Term Group
Insurance | Long Term Blueshield
| Long Term Health Insurance
|
Long Term Health
plans | Long Term Health net
| Long Term Pacificare |
