Quote:
Originally Posted by Wild Coyote
Hi BirdDancer, 
You and your siblings have been doing quite well with all of the demands and stress. Many families cannot get along with one another at all.
After you'd posted this, I'd had a dream of you sitting beside my bed, telling me more about your concerns with the issues of the LTC coverage. 
I am very sorry your dad's policy excludes anyone with a history of alcohol use/abuse. I have never seen alcohol use, including alcoholism, used as a reason for terminating coverage. I have seen "injuries resulting from alcoholism" listed as an exclusion; yet, I am not sure of what that means exactly. That said, I have no idea of the legal exclusions allowed in your state.
You may already know the following info. If so, please please forgive me.
If you/your siblings/your dad wonder if this type of an exclusion legally terminates coverage, you can contact the State Insurance and Banking Commissioner.
In your state, there is an insurance ombudsman available to assist individuals/families with understanding policies, understanding the state laws/regulations governing the policies, determining if a policy is in compliance with state regulations, assisting with the filing of inquiries and/or the filing of complaints.
The Office of the Insurance Ombudsman
Telephone: 1-800-446-7467
FAX: 609-292-2431
E-mail: ombudsman@dobi.nj.gov
The basic guide for LTC policies in your state, is quite interesting and can be found here:
Ombudsman's Office - What You Should Know About Long-Term Care
I hope something here is somehow helpful in some way.
I have always had excellent outcomes whenever I have involved an insurance ombudsman in inquiries/disputes/complaints.
I hope all works out for the best!
Love and Prayers ~  |
Thank you so much, Wild Coyote, for all of this helpful information.
I will share this with my sister. So you know, we do plan to hire a lawyer to help with a number of matters regarding my father. I will be sure we bring up this topic to the lawyer, as well, and see if he can help us with it or if we should pursue it on our own.
I believe it was the LTC insurance's assumption that our Dad's injuries were as a result of alcohol. Even some of the doctors at the hospitals he was in were saying this, but honestly I am not so sure this is the case. Hopefully the neurologist and psychiatrist my father will go to in a couple of weeks will have proper insight into this.
I can't be sure if the alcohol affected him cognitively or if his cognitive and psychiatric state were the culprits. My husband and I even believe his heavy drinking was not so much the cause of everything, but a symptom of life-long psychiatric issues and perhaps early stages of some neurological issue(s). You know...Which came first? The chicken or the egg? To my knowledge, my father's drinking issues did not even start until he was in his early 60s. The worst of it didn't even start until he was already in his 70s. I find that abnormal when it comes to addiction. That is something I wish to bring up in the letter I write. So often when there is addiction, it is portrayed as if it's been a lifelong problem.