brian11373
New Member
- 1
Hi All,
My mom has a Genworth policy for LTC which we are in the process of filing a claim for. It first started after a hospital stay a couple of months ago for blood pressure where based on a couple of incidents while there, cognitive tests & strength tests were given. That led to a recommendation of 24 hour care.
Genworth has approved an assisted living facility near us and we have since moved her in, which was a policy requirement, prior to the health evaluation. My question is prompted by the fact that we are exercising the claim based on the cognitive clause and not the 6 physical activities (of which she has difficulty but not to the point she can't absolutely do them). Her cognitive issues and her safety will be purely based on her complete lack of ability to handle her medications (along with smaller items like getting lost while driving, leaving a burner on once, paranoia). We had a formal memory test where she was officially diagnosed with Mild Cognitive Impairment with Memory Loss, and again a recommendation of 24 hour care was given. Her primary has also give that same recommendation. She has her Genworth nurse visit this Friday, August 8th.
My questions are:
1) The policy specifically says "Severe Cognitive Impairment", whereas her diagnosis says "Mild". Is that a concern regarding approval?
2) Since the policy requires she be in the facility already, if she is denied do we have any way of recouping the costs that will come out of her pocket for her short stay?
3) Is Genworth's reputation for approval good or bad?
4) What are our options if Genworth denies her claim and what is the likelihood of eventual success?
Any expert feedback/advice is much appreciate. Thanks!
Brian
My mom has a Genworth policy for LTC which we are in the process of filing a claim for. It first started after a hospital stay a couple of months ago for blood pressure where based on a couple of incidents while there, cognitive tests & strength tests were given. That led to a recommendation of 24 hour care.
Genworth has approved an assisted living facility near us and we have since moved her in, which was a policy requirement, prior to the health evaluation. My question is prompted by the fact that we are exercising the claim based on the cognitive clause and not the 6 physical activities (of which she has difficulty but not to the point she can't absolutely do them). Her cognitive issues and her safety will be purely based on her complete lack of ability to handle her medications (along with smaller items like getting lost while driving, leaving a burner on once, paranoia). We had a formal memory test where she was officially diagnosed with Mild Cognitive Impairment with Memory Loss, and again a recommendation of 24 hour care was given. Her primary has also give that same recommendation. She has her Genworth nurse visit this Friday, August 8th.
My questions are:
1) The policy specifically says "Severe Cognitive Impairment", whereas her diagnosis says "Mild". Is that a concern regarding approval?
2) Since the policy requires she be in the facility already, if she is denied do we have any way of recouping the costs that will come out of her pocket for her short stay?
3) Is Genworth's reputation for approval good or bad?
4) What are our options if Genworth denies her claim and what is the likelihood of eventual success?
Any expert feedback/advice is much appreciate. Thanks!
Brian
