Investigating and Litigating Long Term Care Insurance Fraud, Waste and Abuse

Long term care insurance claims are increasing and the claims arc is expected to increase for years to come.  Given the significant monetary benefits LTC policies pay out, often with no policy limits, fraudulent claims are a serious financial risk for LTC insurers.  Fraudulent LTC claims often start as legitimate claims, triggered by an accident or acute illness, but later become fraudulent when the insured lies about their recovery or condition to keep benefit payments flowing. 

A series of court opinions from the past few years has begun to carve out a body of law which insurers may use to address LTC insurance fraud, including in some instances providing for policy invalidation as a remedy for fraud, a crucial development since most LTC policies do not have express policy-invalidation or cancellation provisions for claim-fraud.

Drawing on our deep experience representing life, disability and LTC insurers in addressing insurance claim fraud, combined with lessons from recent LTC insurance court opinions, we provide a series of best practices (Do’s and Don’ts) that insurers’ inhouse attorneys, claims professionals, and FWA professionals may utilize when investigating and litigating LTC insurance claim fraud.

Speakers

• Andrew Azarmi, Partner
• Kelly Graf, Partner
• Seena Forouzan, Managing associate
• Alina Pavlova, Senior Managing Associate

CLE

CLE credit for the live webinars is being sought in Arizona, California, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Missouri, New Jersey, New York, Pennsylvania, Texas, Utah and Virginia. Credit for all other states must be applied for and submitted by individual attendees. Compliance with each state's MCLE requirements is the sole responsibility of the attendee. 

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