Recently in Long Term Care Insurance Category

By David Share L.L.B.

President, David Share Associates, Lawyers

 The next time you see one of those feel-good ads on TV, in a newspaper or on the radio for a insurance company, don't forget that it really is all about the money for insurance companies.   Okay, lawyers work for money too, but we earn it based on the results we get for our clients in pursuing claims against large insurance companies.

A recent case, illustrates just how much money gets thrown around by insurance companies in their efforts to grab further market share.   The Ontario Superior Court released its' decision in Sun Life v. Metropolitan Life, 2010 ONSC 558 (CanLII) on January 22, 2010.   This case is a reminder of the type of stakes involved when one insurer acquires another.   In July, 1998, The Mutual Life Assurance Company of Canada (which changed its' name to Clarica and was then purchased by Sun Life in December 2002), paid $2.2 billion dollars to Metropolitan Life for its' Canadian life insurance related businesses.

The case is about one insurer alleging that they are entitled to further reimbursement or indemnification from liabilities flowing from policies issued by Metropolitan Life prior to its' takeover by Sun Life.    The concern that Sun Life has is that they do not wish to be stuck with the cost of fixing the cost structure of certain policies that Met Life had issued in the past, where their allegations of misrepresentations about the cost of these policies to the end individual policyholders. 

The ins and outs of this particular case will not matter to you if your claim has been denied, be it for long term disability benefits, life insurance or critical illness, but it certainly does reinforce the notion that money really does matter to insurance companies.    Does anything else matter to them?   Absolutely, just nothing matters more than money.

 

 

By David Share L.L.B.

President, David Share Associates, Lawyers

What sort of insurance product would you market to the Canadian public when you read about the aging demographic and the gap in health care services?   Long Term Care Insurance may be the answer, and in theory this type of coverage seems to make a lot of sense.

This type of insurance is supposed to provide protection if you need to enter a long term care facility or will require special medical care at home, for services, such as the following:

  • nursing care
  • rehabilitation and therapy
  • personal care (help with activities of daily living like dressing, eating etc)
  • homemaking services (meal preparation, cleaning, laundry)
  • supervision by another person

The big question, though is will it come through when you need it?  

Many claims will no doubt be paid, but where there is a question about entitlement, or where a level or interpretation or analysis is required to decide on whether benefits will be paid, the ambiguity and fine print in the insurance policy or contract will come into play, and there will be claim denials.

The bottom line for Canadian consumers is to get good advice on whether such insurance makes sense for you, and in the event that you have it and your claim is denied when you most require the financial support such policies are supposed to provide is to find lawyers with the expertise to assist you and your family recover what you are entitled to.

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This page is an archive of recent entries in the Long Term Care Insurance category.

Litigation is the previous category.

Long Term Disability is the next category.

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