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Bankers Life & Casulty Long-Term Care Insurance

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Michael of Park Ridge , IL November 9, 2009

I purchased a Long-Term Care Policy from Banker’s Life & Casualty in 2001 at the age of 51. Banker’s Life has raised the annual premium to policyholders in my group by over 82%. As an alternative to paying the full increasing premium adjustment, Banker’s has offered to proportionately reduce the contracted benefits. Due to the drastic change in premiums and benefits, Banker’s also offers all policyholders to cancel the policy without a refund of the paid premiums!

The basic premise by the insurance company to buy a long term care at such a young age was that I would be “locking” in a lower annual premium to receive three years of inflation indexed care benefits. This is a policy purchased for old age nursing home care coverage. If you’ve ever talked to a company about buying such a policy it’s not to different from a discussion about a whole life insurance policy.

My original annual premium was 1,868.71 it is now 3,405.79. So much for locking in the premium and locking in future care benefits. To date I have paid 19,663.69 in total premiums.

To date Banker’s has successfully unilaterally raised premiums and reduced benefits based on a paragraph on page 3 of the 14 page contract which reads: Renewal Premium We may change the premium rates for this policy. We can change the premium only if we change it for all policies like yours in your state on a class basis. We’ll provide you with written notice of any change in the premium in the time required by your state. This clause was never discussed prior to purchasing the policy nor was I required to initial such an important clause.

I have subsequently learned that the insurance company has twice raised the premium because they made an error in calculation the actuarial loss ratio when they sold me the policy, again in 2007 and again in 2009. Banker’s Life is increasing the premiums so that I can pay for their error in forecasting claim losses. They can continue raising the premium to cover additional losses and I have the same lousy choices: pay the higher premium, accept lower benefits and still a higher premium, cancel the policy and forego the 20,000 in premiums paid to date. As individual policyholders are forced to cancel the policy because we can’t afford the excessive premium increases, Banker’s enjoys a windfall.

Common sense would say that nobody would intentionally enter into such an onerous policy. Unfortunately, not only Bankers Life but State of Illinois Department of Insurance who is mandated to protect consumers from unfair business practices and bad business behavior, has refused to look beyond the revised calculations submitted by Banker’s Life required by State statute to support the higher premium. They ignore the unfair business practice and clear exploitation of policyholders.

The long and short is that I’ve written everyone from Banker’s Life, our Governor, the State consumer protection departments, the States Attorney’s office, all our Senators and Congressman and the Tribune Op-Ed Editor … with everyone ignoring me or saying it’s not their concern or they can’t do anything. It is my opinion that all these government employees are complicit in the unfair business practices of Banker’s Life. If they aren’t willing to fight for the consumer they should not hold a position with just that mandate.

I have proposed to Banker’s Life, the State Department of Insurance and all government officials that a fair resolution would be any of the following: Re-instate the original premiums and benefits without future increases as represented to policyholders when we purchased the policy. Cancel the policy with a full refund for premiums paid to date. You’ll note an argument by Banker’s and the State that a refund is not appropriate because if I filed a claim in the last 7 years I would have received the benefits. The fallacy here is they ignore the basic premise of selling me an old age care policy at the young age of 51 where neither they nor I intended to need for 15 or 20 years from purchase. I can send all prior correspondence to document my long battle in seeking fair restitution. Additionally all individuals seeking long term care insurance should be warned that this undisclosed premium device is not limited to Bankers Life. I would appreciate a response … good or bad. Thank you for your time and I am available to discuss any details.

Sue of Farmington, AR October 30, 2009

I have had the same experience as Kay of Spirit Lake, IA dated October 12, 2009. I am writing this complaint with the hope that I can help someone. I don't want you to experience what my Mother and I did with Bankers Life and Casualty Company.

For all elderly people who buy a "long term care policy" from Bankers Life: You may think you are insuring that you will not have to go to a nursing home but you are certainly insuring that whoever cares for you will be in a living nightmare of paperwork and frustration. If you don't have a lawyer in the family who works for free, I would strongly suggest you stay away from this long term care policy.

I started calling BL in March while my Dad was still in the hospital. Every time I called I got a different person with different, conflicting information about what was covered, who and how I could hire for help, when and what the policy would pay. The first thing I would tell anyone who has a claim is: The elimination period does not start until you hire a CNA or other licensed caregiver. The elimination period is not just a period of time but the period of time you have been paying out "covered" expenses. You need to know what constitutes "covered expenses" or they will not pay no matter how obvious the need.

The "specialist" will not tell you up front whether an expense is covered or not. BL may require that you hire through an Agency. However, BL won't tell you before you hire someone whether you can hire direct or if you must hire through an Agency. If you are approved to hire a licensed caregiver direct, you can have them come as little as an hour a day until the elimination period is up. I wish I had known this back in March when I first started filing claims.

The policy states that they will provide an agent and a plan coordinator to help file claims. I repeatedly asked for both by phone and mail. I did not get either an agent or a plan coordinator. The agent that sold the policy to my Mother and Father was long gone. I had no help. I promise you that edlerly people who are sick and in the "condition" as required by the policy to be eligible for claims could not even get through the automated phone system let alone ever get a claim paid.

I have been caring for my Dad in my home since March 27 and still cannot get the claims paid. My Dad died last week and so far we have received two checks. The first check BL sent they immediately put on a "stop pay". If any lawyer ever takes a "class action" against BL, I hope they let me know.

My Dad was supposed to be covered for 560. per week for in home care. Since Bankers Life would not pay the claims, I could not continue to hire caregivers. I filed over 7,000 in claims and so far BL has paid 880. They say they have sent one more check but I have not received it. They stopped the payment of one check I received in September and it was taken out of my Dad's bank account. If Bankers Life would have paid the claims, I could have hired more caregivers and family members would not have been so stressed.

Kay of Spirit Lake, IA October 12, 2009

My Dad has a long term care policy... like the all the ads you here are pushing for your retirement... what a joke... my parents bought these with the greatest of intensions... but the agent and company not so upfront... they were never told that is a government agency pays that the policy would not... so they have paid this policy for all these years for nothing... because my dad is a WWII vet and they are now helping to pay some homehealth aid ... the insurance company will not pay... they said it was in the policy... but these are older people and they should have been told this by the selling agent...

I will tell everyone I know not to waste their money on any long term care policy... because when you need it ...is when you find the loop holes in it that know one seemed to mention when it was purchased...I feel that this is an injustice to the older population ... they are just taking advantage of their willing to trust if a licensed insurance agent... They should of been told that up front... not to have to read this big policy and try and to figure it out for themselve... I read the policy now to see if I could find that clause ... I could not... I had to call the company and they had to point out were it was in the policy... I sold insurance a few years back and I could not see it until it was pointed out to me.. now you tell me how any older person would ever see that... it is a in justice to our older citizens...

Joseph of Upland, CA January 18, 2009

My Aunt has a Long Term Care policy with Bankers Life and Casualty. One year ago I started helping my Aunt with her Financial affairs and this year have taken them over. One year ago I contacted Anthony and explain that the latest increase from 2007 to 2008 was quite large, he explained that this was the first one in a very long time and it is not a common occurance. This year I took over my Aunt's financial affairs and moved her in with my family and I found that their were regular increases every year. And this year the increase represented 38%.

One more year it will be above her Social Security check that she receives and thus will be living on only her 600 USD/month retirement check... How can these individuals sell such an insurance policy when they know that in a few years the individuals will not beable to afford the payments on them, it almost seems like a con game preying on older senior citizens that believe what these con artists are saying.

Buying into a insurance policy for longterm health that ineffect she pays during eight years and then can no longer afford when she possibly could need the insurance.

Dr of Portland, OR November 7, 2008

I had to change In Home services due to terrible service from "Right at Home Seniors" a national franchise. I switched my policy over to Guardian Angel Caregivers of Portland Oregon (503-698-2020)in early August 2008 and Bankers Life, my insurance company that pays for this service, told us it would take a month and a half at the most to switch over service and start sending checks.

Steve M, President of Guardian Angels, mailed all the required documentation during the month of August to the above business address for Bankers life. Since then, both I, Khin A and Steve M have made many attempts to get an update on the progress of the transition. Each time either of us called, we get the same rehearsed answer, "nothing more is required of you, do not worry about it, it is being processed". It has now been over two and a half months and we still have no answer from this company.

Steve M went to Phillip, a banker life rep in Portland Oregon to help resolve the problem on Oct 15th 2008. Phillip called his company in Chicago and stated that the company has 72 hrs to approve or disapprove a new in home service so he requested that I fax him my state and federal business ID to help (even though Bankers Life stated these documents wern't needed) since the company hasn't realized that a transition even took place. He said they have all my paper work, including my original application with new IN Home service request, but no one has looked at it yet.

Both of us have called Phillip the bankers Life Agent several times since then and now he also isn't returning our calls to help hold Bankers Life accountable for no action. I called Bankers Life in Chicago today, Nov 7th, and they stated the same rehearsed line to just give them another week. We both have been hearing that for over a month. At this point we decided to stop service because of lack of payment to Guardian Angel Caregivers who has been providing service for 2 1/2 months. This leaves my husband, Dr Tin A at risk since he needs someone to be with him because of his health condition.

Banker life representatives are elusive and take no accountability for their non-action and no one person seems to be in charge when a problem exist. Since they didn't fulfill the 72 hr approval time for the new in home service (Guardian Angel Caregivers) we are left confused and without one payment from Bankers Life for a policy I purchased years ago to cover the needs of my husband. I need Help with these issues I am having with Bankers Life because no one in their organiztion will except accountabilty or follow up. My husband is now out of service because the time has exceeded two and a half months with no effort from Bankers Life to pay for the service that has been provided. This new Agency has provided excellent service compared to the last agency I had but they can't keep providing service without payment. Thanks for any suggestions on how to resolve these issues with Bankers Life.

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