When a parent reaches the point of needing long term medical or assistive care, sometimes a family member cannot locate the actual policy even if they know a long term care insurance policy exists. How do you get a copy of the policy? One tactic used by insurance companies is to delay everything – including the simple task of complying with a request for a copy of the policy itself. They also know that if the policy’s language (terms and conditions of coverage) is not consulted early on, damaging statements regarding the condition of the insured and the type of care needed are often made to the detriment of obtaining coverage for the insured.
Knowledge of and citation to the Florida statutes should help to get a copy of the long term care policy asap.
Florida law requires insurance companies to promptly communicate with policyholders: “acknowledge and act promptly upon communications with respect to claims.” Fla. Stat. § 626.9541(1)(i)3.c. In addition, another Florida statute requires the insurance company to represent policy provisions accurately and relate claim decisions to applicable policy language. See Fla. Stat. § 626.9541(1)(i)3.b and Fla. Stat. § 626.9541(1)(i)3.f, respectively.
If you combine both of these statutes together, an insurance company is required to promptly comply with a policyholder’s request for a copy of the policy. Here is the link to these very useful statutes:
For more information please see our Resource Page for Long Term Care Insurance Denials.