The insurance industry uses tricks of the trade to boost its bottom line, even though it has trillions of dollars in assets and makes average profits of over $30 billion a year. Some of the best-known companies that spend enormous amounts of advertising money to gain your trust are the worst at trickery.
One of their tactics is simply to deny valid claims. If they don't pay a legitimate claim, they make more money. Some have rewarded employees who got away with denying claims and replaced employees who wouldn't issue denials. Too many companies routinely delay accepting claims as legitimate, knowing that many claimants will get tired and give up.
Long-term care insurers know that if they delay payment long enough, a certain number of their policyholders will die, and the claims will go away. This is a particularly shameful use of the delaying tactic. Some health insurers have taken to retroactively cancelling or rescinding policies when their policyholders' health conditions have become expensive to treat. And some have even offered bonuses to employees who meet "cancellation goals." At their most vulnerable, cancer patients have been stripped of their insurance.
Another dirty trick of insurance companies is the use of confusing terms or language in policies. Although most states now have laws requiring that contracts be written in everyday English instead of legalese, some companies persist in pulling the wool over policyholders' eyes. A good example occurred after Katrina when the companies used "anti-concurrent" clauses to deny payments to people who thought they had hurricane coverage. Who knows what an anti-concurrent clause is? That's the point. If you are confused by an insurance company or are tired of its delaying tactics, don't give up. Get legal help. I can't guarantee a lawyer can win your case, but it's guaranteed that you'll be a lot closer to having a level playing field.