Long Term Care Insurance: "Conseco is a Comedy of Errors"

Philadelphia, PA"I am convinced that Conseco insurance company is unethical and they deliberately intend to drive people crazy and force them to give up," says Jane. "They do everything they possibly can so they won't have to pay long term care insurance benefits."

Jane's mother has been insured with Conseco since 1991 and her premiums were always paid on time. And with Conseco, her premiums continued to be paid even though she had an active claim--until one payment was late (a simple mistake) and that was enough reason for Conseco to deny benefits. Jane says that they did not receive the bill, nor were they given a late notice. "Obviously we would have paid it," she says.

"My mother was diagnosed with Alzheimer's disease and lung cancer and she started collecting benefits a few years ago," says Jane. "My mum has a full time care giver who gets her bills and sends them to my sister to pay, but in August she received a cancellation notice for non-payment." Jane called Conseco but it wasn't a matter of a simple phone call; she says that dealing with that company is a " bureaucratic nightmare" and she is convinced it is set up that way to deny coverage; "Nobody could design a system that unfriendly," she adds.

"I first talked to someone in customer service and explained my situation, that my mother had not received a bill or reminder notice," says Jane. "I explained that the bill is paid yearly and been paid faithfully, on time since 1991. I asked if I could just send a check because there has been a misunderstanding. 'No, we will just send it back to you,' she replied, 'because you have to go through a reinstatement process.'

I faxed the information they required but they wrote a letter to my mother saying I had sent in the wrong forms—my mother who has Alzheimer's! But they gave me the forms—that is just one incident of their absurdity.

I sent the forms back again and when they asked about my Mum's 5-year health history I asked them to contact her primary doctor. I also sent them my power of attorney requesting they communicate with me. But no, they insist on sending everything to the caregiver who in turn has to mail everything to me.

I asked to speak to someone in policy administration—they are the folks who make the reinstatement decisions. A long-term care customer service person told me they do not accept incoming calls! By now I am convinced that Conseco is a Comedy of Errors…

Then my mother got another letter from Conseco: it said they cannot contact her primary care physician, she has to contact her doctor. They are putting up deliberate road block after road block--they already have all her health information. Conseco has paid close to $150,000 on her policy and she has a lifetime tap of $250,000 but you must have a second diagnosis after the first $150,000.

I filed a complaint with the State of Florida Insurance Commission and they contacted Conseco but so far there is nothing they can do. It seems like my job is faxing—the doctors, the insurance company, the long term care agency. And last week my sister had to pay--out of her pocket-- $21,000 to the health care agency before they stopped my mother's 24-hour care. This insurance policy is my mother's lifeline between being independent and being in a nursing home, she needs to stay with this long term home care.

In any other business, if you pay late you might get a penalty. This is a nightmare that could have been avoided. How did I know this bill was due? They were always paid on time, all these years. The bottom line is we are still waiting to get her reinstated; Conseco insists they sent a bill and apparently they are able to document mailings of the premiums due to my mother's address. I will be surprised if they reinstate her."