My mother purchased a Long Term Home Health Insurance Policy on April 12, 2002, from Agent Kip **. Since then she has become legally blind and they refused to pay for care. In August 2012, I traveled to Washington to help take care of my mother as she had become a danger to herself. Being there 24/7, I realized that she was having periods of confusion/paranoia. These became severe enough that she was diagnosed on January 9, 2013 with Dementia. I could no longer take care of her, so we moved her to Patriots Landing Assisted Living. She had to have help bathing, being taken to meals, dressing, given medications and so on.
I contacted Banker's and asked what they needed for me to file a claim. They gave me a list, reminding me that this was supposed to be a home policy and therefore they would only pay the amounts for the services themselves, not the "room and board charges." I assembled everything they asked for in a packet and sent it to them. They continually requested the same information from me and her doctor and Patriots Landing numerous times, then denied the claim. I contacted Kip, the agent, who said he didn't know why they would deny it and that he had also sent a copy of the info to them. Since then, the Claim Dept has told me to file for an appeal, as my mother's Dementia has progressed to the point where she could not stay in Assisted Living (she attacked other residents) so she was sent to Highline Medical Hospital's Specialty Campus, where she was evaluated again for a two week time period with a final diagnosis of Dementia and Alzheimer's.
Since Patriot Landing had no opening in their Memory Care wing, she was transferred to Emeritus @ Harbour Pointe, in Ocean Shores, WA. My sister had built a house there, and would be able to visit with her there. I filed and sent all the paperwork again, this time as an appeal. After weeks, I called to be told they wanted it filed as a new claim since she was at a new facility (meaning we would not be reimbursed the amounts they should have paid from February 2013 on). And finally, we get to today, when I received a call telling me the claim was denied. Emeritus hadn't sent the documentation to prove Dementia, nor other statements of itemized billing and their Facility License, and that even if they had, we need to go to a different company called "Personal Service Providers" at ph (360) 538-1540.
The claim was denied. I have been around and around with this company, supplying the paperwork time after time, and they are still taking money every month for this policy they refuse to pay on. I can't be the only one they are doing this to, and I am ready to do whatever it takes to get them to honor their contract or refund all monies they have collected from my mother, with interest calculated at the 2002 rates.