Recent claim studies from carriers and industry groups have indicated that most LTC claims are now being initiatied for home and assisted living communities.  Policies sold today usually have clear policy language indicated what benefits will be paid in those settings.

However, for those policyholders who have older policies the benefits will vary.  This was indicated by a recent lawsuit filed against CNA for denying assisted living claims. The complaint indicated that back in 2008 CNA was paying claims for certain assisted living facilities on group policies, but changed those policies recently.  Here is a link to the article http://seniorhousingnews.com/2014/01/02/long-term-care-insurer-gets-sued-for-excluding-assisted-living-claims/ .

The takeaway?  If you or your client have an older LTC policy, doing a periodic policy review is key.