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Editor: Gerry W. Beyer
Texas Tech Univ. School of Law

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Thursday, August 22, 2013

Insurance Company Denies Claim To Pay For Caregivers

InsuranceIn February, a suit was filed on 91 year old Janice O'Brien's behalf because her insurance company, CNA Financial, would not pay her home care despite the fact that she had paid her premiums for years. The case is now set to go to federal court. CNA representative, Jennifer Martinez-Roth said "We do disagree with her assertions and we will defend ourselves against this lawsuit."

The suit alleged that CNA did not accept the advice of three medical doctors, including a CNA doctor for processing medical claims and bills. O'Brien had paid her bills since 1996. In 2011, doctors stated she should not live alone. Her family hired caregivers but CNA refused to pay for the cost. Mediation has been unsuccessful to settle the case. The family says they will go to trial if the insurance company will not be fair.  

See Phillip Molnar, Long-Term Care Insurance Battle Mediation Fails in Case of Pebble Beach Women,  San Jose Mercury News, Aug. 14, 2013.

http://lawprofessors.typepad.com/trusts_estates_prof/2013/08/insurance-company-denies-claim-to-pay-for-caregivers.html

Current Affairs, Disability Planning - Health Care | Permalink

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