Largest long term care insurance claims

The largest open long-term care insurance claim has reached $1.7 million in paid benefits, according to a just-released report from the American Association for Long-Term Care Insurance (www.AALTCI.org). The claimant, a woman, purchased coverage at age 43, paying an annual premium of $881. Three years later her long term care insurance claim began and has continued for almost 15 years. [Note: Payment of policy premiums ceases when an individual is receiving policy benefits.]

"Insurers paid some $6.6 billion in benefits to roughly 200,000 individuals last year,” explains Jesse Slome, Executive Director of the industry trade group that compiled the data from 10 leading long term care insurers. "Long-term care insurance claims can last for years and amount to hundreds of thousands of dollars.”

The association annually collects data on claims including the largest open claims (still being paid as of December 31, 2011). The second largest claim still open is for a male who purchased his long-term care insurance policy paying an annual premium of $3,374. Three years later his claim began and has continued for just over six years ($1. 2 million in benefits has already been paid for his care).

“Long-term care insurance is not the lottery,” Slome says. “A policy holder who paid $3,000 in premiums and received benefits exceeding $1.5 million is not a winner. But having this protection in place can certainly pay off and for thousands of Americans it increasingly is." According to the Association, just over 8 million Americans currently have some form of long-term care insurance protection in place.

One in 10 (10.4%) of new individual claims initiated during 2011 began before the claimant was age 70 the study revealed. "While most long-term care insurance claims begin at older ages, typically in ones late 70s or 80s, accidents and illnesses are also a common reason younger people need this care for extended periods," Slome notes. The five most common reasons for a long-term care insurance claim, according to the Association, are Alzheimer's disease, stroke, arthritis, circulatory issues or injury."

Largest "Open" Long-Term Care Insurance Claims As Of December 31, 2011
Data from leading national long-term care insurance providers.
Credit: American Association for Long Term CareInsurance.

COMPANY A: Largest open claim: $1.7 million
Female -- purchased insurance at age 43
Length of Claim: 14 years, 9 months
Insurance Policy Premium: $881-per-year
Time from Policy Purchase to Claim Inception: 3 years 0 months

COMPANY A: Largest open claim: $1.2 million
Male -- purchased insurance at age 45
Length of Claim: 6 years, 1 month
Insurance Policy Premium: $3,374-per-year
Time from Policy Purchase to Claim Inception: 3 years 10 months

COMPANY B: Largest open claim: $1.12 million
Female – purchased insurance at age 56
Length of Claim: 12 years, 5 months
Insurance Policy Premium: $4,520-per-year
Time from Policy Purchase to Claim Inception: 0 years 3 months