SHIP Lawsuit Affects In Home Assistance for Elderly Near San Diego

SHIP Lawsuit Affects In Home Assistance for Elderly Near San DiegoLong-Term Care Insurance Company Sued For Predatory Business Practices

It’s no secret that in home assistance for elderly near San Diego is expensive. Many people facing their twilight years invest in a long term care insurance (“LTCI”) policy, ensuring that the costs of their medical and non-medical care from caregivers in San Diego County will be covered. This forward-looking action takes a huge burden off family members, both in terms of monetary expense and actual work needed to provide care.

In most cases, long term care insurance companies fulfill their obligations, but a lawsuit in progress against the Senior Health Insurance Company of Pennsylvania (SHIP) illustrates the disastrous results that occur when a company fails to do so.

This case also illustrates the importance of knowing how to file Long-Term Care Insurance claims.  We have written many articles about this topic, and about how to avoid LTCI companies’ attempts to delay or even avoid paying legitimate LTCI claims.

 Delaying Tactics

Many California residents, foreseeing the need for San Diego County caregivers, have purchased policies from SHIP in order to cover in home assistance for elderly near San Diego. One California man, frustrated by a mountain of unfair requirements, documentation requests, and other stalling tactics, has brought a lawsuit against the company for failure to honor his policy.

According to the lawsuit, SHIP arbitrarily added a large number of requirements that are not included in the original policy’s language, putting up a barrier that has made it impossible for the plaintiff to obtain the care that the policy promised him. Instead of benefiting from the policy, he has had to struggle with the added requirements while paying for necessary care out of pocket in the meantime.

Added Requirements for Coverage In Home Assistance for Elderly Near San Diego

 One of the most serious violations of the plaintiff’s insurance policy was a refusal to pay for home care by unlicensed caregivers. There is no stipulation in the original policy that caregivers be licensed, but when the California man submitted information on his care expenses, SHIP refused to pay based on the absence of licensing.

Obviously, it is illegal for an insurance provider to add this licensing requirement after a client has already been paying premiums on a policy.  Nonetheless, this is a common delaying tactic, in our experience, when families of LTCI policyholders attempt to file claims on their own without help from in-home care companies.

Predatory Business Practices

 Trying to avoid paying for in home assistance for elderly near San Diego is called a predatory business practice in the lawsuit. Because aging individuals already have a hard time filling out forms, submitting documentation, and meeting other requirements for insurance claims, it is unacceptable for a company to add confusing and overwhelming requirements that make it impossible for seniors to benefit from the services they have already paid for. Hopefully, the outcome of the lawsuit will reimburse the expenses of the plaintiff and discourage such unethical practices in the future.

Original article:

Tim Colling
Tim Colling

Tim Colling is the founder and President of A Servant's Heart In-Home Care, which provided in-home caregiving services in San Diego County, and also of A Servant's Heart Geriatric Care Management, which provided
professional geriatric care management services and long term care placement services in San Diego County. Tim has more than 30 years of experience in management in a variety of industries. He held a Certified Care Manager credential from the National Academy of Certified Care Managers. Tim is also a Certified Public Accountant (retired), and received his Bachelor’s Degree in Accounting from California State University at San Diego. In addition to writing blog posts here for the Servant’s Heart blog, Tim also is a regular contributor to and to as well as blogs of other eldercare services provider companies. Finally, Tim is also the president of A Servant's Heart Web Design and Marketing, which provides home care marketing as well as website design and online marketing for those who serve the elderly and their families.

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