Oregon Suit Alleges Bankers Life Denies LTC Claims

April 05, 2013

By David Dankwa

InsuranceNewsNet

A Portland-based law firm, Williams Love O’Leary & Powers, has filed a class-action lawsuit in a federal court in Oregon against Bankers Life, alleging that the insurer has a habit of denying long-term care benefits to the elderly.

The law firm claims Bankers Life has a history of raising premiums, delaying payments and denying legitimate claims.

In a statement, the firm cited the case of a 79-year-old woman, Katherine Fallow, who used an in-home caregiver after being hospitalized in 2009. The family hired a state-certified home health aide and began submitting the bills to Bankers Life.

“What followed were several months of wrangling over aides’ qualifications, long delays in communications and denials of payments,” according to the law firm.

Bankers Life allegedly paid out just $11,388 of the $51,667 cost the family incurred on Fallow’s in-home care.

Portland attorneys Mike Williams and Christopher Cauble said they have filed the suit on behalf of four individuals that have made claims as representatives of the class. The lawyers estimate “there are hundreds, perhaps thousands, more elderly Oregonians and their families who could join the suit.”

According to the law firm, the Oregon Department of Consumer and Business Services’ consumer complaint index ranked Bankers Life 19th out of 19 in 2011. The insurer allegedly has ranked worst for consumer complaints every year from 2005 to 2011.

In 2008, Bankers Life’s parent company, Conseco, now CNO Financial Group, was named in a multi-state investigation into consumer complaints that resulted in a $2.3 million fine and $30 million in claims-handling improvements and restitution by the company. Oregon was not part of that multi-state action.

Last year, the states involved in that action found that Bankers Life was not complying with the terms of the settlement and a $3.2 million penalty was levied against the company, according to the law firm.

David Dankwa is a longtime business reporter with significant experience writing about the global insurance industry. Contact him at [email protected]

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