JCS-twelve
New Member
- 2
Purchased a policy in 1995 for my mom from a well known provider and I have kept it current for the last 27 years. The policy was inflation adjusted with a 3 year benefit period. My mom entered assisted living on 3/1/2022 and I filed the initial claim on 3/2/2022. The claim was approved but the 'claim effective date' was back-dated to 2/1/2021.
I've asked why and the vague response has been 'internal clinical documentation from the initial evaluation'. I've asked to have the claim effective date adjusted to 3/2/2022, but they have refused.
I have concerns that the benefit window will expire a year before the maximum benefit payout is achieved. Some online information says that the benefit window is not a finite amount of time - the maximum benefit amount is what's key. That said, I feel not having the effective claim date adjusted to reflect the actual date when the claim was filed leaves me potentially at risk.
looking for guidance on next steps.
I've asked why and the vague response has been 'internal clinical documentation from the initial evaluation'. I've asked to have the claim effective date adjusted to 3/2/2022, but they have refused.
I have concerns that the benefit window will expire a year before the maximum benefit payout is achieved. Some online information says that the benefit window is not a finite amount of time - the maximum benefit amount is what's key. That said, I feel not having the effective claim date adjusted to reflect the actual date when the claim was filed leaves me potentially at risk.
looking for guidance on next steps.