The long-term care insurance community relies on us for complicated litigation, regulatory compliance and other challenges.

We have a depth of experience successfully defending LTC insurers in dozens of coverage actions for more than 15 years. We have successfully resolved numerous LTCi class actions and many individual claims and other lawsuits. Over the last 10 to 15 years, we have had multiple LTCi lawsuits and other engagements running at all times. We keep a detailed database of all active LTCi cases around the country and closely monitor this litigation. It is no exaggeration to say that we do more LTCi work, and are more informed on these issues, than any other law firm in the country.

In addition to our robust litigation background, our LTCi practice is also differentiated because our work is much more than litigation. We represent LTC insurers in a myriad of regulatory and compliance issues in which we have devised and helped our clients implement procedures calculated to ensure compliance with evolving regulatory requirements.

We have established relationships with many state insurance departments and other regulatory agencies, which enable us to gain insight and obtain informed opinion on statutory/regulatory interpretation and other emerging compliance issues.

Long-Term Care Insurance

Our recent regulatory and compliance projects include:

  • New product development, counseling, and rollout
  • Policy drafting
  • Development and implementation of anti-fraud compliance plans
  • Review and revision of claims policies and procedures to ensure compliance with current legal requirements
  • Premium rate increase counseling, including development of over-arching strategy, as well as the manner, method, time and substance of communications with insureds, producers, and regulators, all of which have been focused on providing excellent customer service to the insureds, building trust with the field, and insulating the carrier from the risk of class actions or other significant litigation – to date, none of the more than half dozen clients we have counseled on rate increase issues have faced any significant litigation.
  • HIPAA, HITECH and GLB privacy and security compliance, including initially conducting audits of companies’ use and disclosure of personal information about insureds/applicants, then drafting privacy and security compliance plans, policies, procedures, privacy notices, authorizations, business associate contracts (and conducting related negotiations with business associates), preparing and providing training, and after the initial compliance effort, conducting periodic reviews/audits of ongoing compliance, updating policies and procedures, providing refresher training, handling breach and other issues, and related insurance coverage issues (i.e., assisting carriers to ensure that they have the right insurance protection in place against the risk of data breaches and other privacy and security problems)
  • Stem-to-stern compliance audits to assure compliance with applicable legal requirements
  • Claims audits to assure compliance with policy language, applicable legal requirements (including, e.g., prompt pay) and prudent litigation risk mitigation
  • Counseling with regard to combination products such as life insurance/LTCi hybrid to evaluate how such products fit within LTCi regulatory frameworks and, if so, how best to bring them into compliance without adversely impacting the life operations of the issuing company
  • Assisting companies to address extraterritorial jurisdiction issues
  • Claims training to ensure compliance with the current law and to learn lessons from recent LTCi claims litigation
  • Addressing genetic testing issues, including the use of genetic testing and/or family history information in underwriting LTCi

Related Capabilities