John Alden Long Term Care complaints

Company states; This letter is in response to the complaint you filed on behalf of your mother, alleging delays and unsatisfactory customer service. Under a long-standing agreement with John Alden Life Insurance Company ("Alden"), LifeCare Assurance Company ("LifeCare") provides all the administration services related to the policy, such as premium collection, sending annual reports and other correspondence, and payment of any claims submitted. Under that authority, LifeCare is writing now in response to the referenced complaint. Preliminarily, Alden and LIfeCare are very sympathetic to your mother's medical conditions, and we understand the stress you are under as a son. We apologize that the claim handling process and communication has not proceeded as quickly as you would like. However, we disagree that we are responsible for delays and do not return calls. Both Alden and LifeCare are committed to providing excellent customer service to Alden's insureds, which requires a complete, careful and thoughtful analysis of every claim. The claim adjudication process requires many factors to be considered in totality to properly evaluate if any benefits should be paid under the terms and conditions of the Policy. Your complaint implies that our adjuster has not been attentive to your inquiries into your mother's claim. We have consistently sent out status update letters throughout the processing of this claim and have been in contact with you. Our last two status update letters were sent out on 8/26/22 and 8/5/22. And our adjuster spoke with you on 8/18/222 to provide a status on the claim and to get provider confirmation. In our last status letter dated 8/26/22, we have determined that your mother does meet the eligibility requirements under the Policy provided she receives covered care and satisfies the elimination period. It is also stated in the letter that we have requested information from your mother's provider to determine if the facility meets the terms and conditions of the policy. We trust the foregoing resolves this complaint and this matter can be closed. Very truly yours, John Alden Life Insurance Company By its TPA,

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In a status update letter dated 7/21/22 we advised and notified you that it is unclear who completed the Attending Physician Statement (APS), the fraud notice was not signed, and you did not declare whether or not your mother was pursing a claim in home care or will be moving into a facility. It is difficult for your mother's claim to advance if we do not have these documents and forms filled out properly.We do apologize if you have still not received the 8/26/22 status update letter, but according to our notes the supervisor did read to you the contents of that letter on 8/31/22 over the phone. As the claim has progress since the last response to this complaint, we have sent out three status update letters. A status update letter dated 8/31/22 advised that we need your independent caregiver to fill out the preliminary paperwork and send in the necessary documentation as required by the Policy. In a status update letter dated 9/9/22, we have determined that your facility qualifies under the Policy but we need invoices and care notes from your providers. we have not received care notes from the provider & have not received documentation from your mother's independent caregiver.

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