I know that, Bill.
But there are a lot of other policies out there right now that would pay a claim in the manner in which the original poster is desiring.
sao
Does Genworth Negotiate Changes to Policies in Claim Status
- Thread starter george bolder
- Start date
I know that, Bill.
But there are a lot of other policies out there right now that would pay a claim in the manner in which the original poster is desiring.
sao
- 657
True Scott, but the OP was referring to a Genworth policy.
Arthur Rudnick
Guru
- 1,652
Scott,
Are you saying that a company which specifically states they will not pay family members WILL pay family members, or are you just stating that there are policies available on the market that allows for family members to provide care?
Are you saying that a company which specifically states they will not pay family members WILL pay family members, or are you just stating that there are policies available on the market that allows for family members to provide care?
Given that a reimbursement policy will not allow compensation to family members in caretaker status, would it be possible to switch to a cash benefit policy where there is no such restriction? Since a cash benefit policy is more expensive at the same benefit level, lowering the benefit from $3000/mo to $2000/mo may be close in premium. Just offering a suggestion... wanting to know, not providing an answer.
The big question in my mind has to do with "on claim status". I would think once someone is on claim status that there would be no room to negotiate. But then, I'm a student, not the professor.
The big question in my mind has to do with "on claim status". I would think once someone is on claim status that there would be no room to negotiate. But then, I'm a student, not the professor.
I'm saying:
1) There are policies that are available for purchase today that do exactly what the OP is wanting. Obviously, it's too late for them to switch policies, but for those to whom it is important to be able to pay a family member, that is a common feature in many of the top policies today.
2) Although Gen has never offered such a policy, and they exclude family members (except when a family member is working through a home health agency), wouldn't it make sense for the claims dept. to consider this offer under the "alternate plan of care" benefit which is included in most Gen policies?
Arthur Rudnick
Guru
- 1,652
Retread............
You post:
"The big question in my mind has to do with "on claim status"
Not only can't a policy be changed while a policyholder is on claim, but unless there is specific wording in a contract allowing for specific alternative benefits, nothing can be changed in a contract, other than reducing benefits.
If paying for family members was an important issue then a policy paying a cash-benefit, or cash-alternative should have been purchased up front. A 100% reimbursement policy is not the answer.
Scott,
On your point #2; I'm not sure if any wording in an Alternate Plan of Care" will allow for it to directly contradict a specific exclusion in the policy. Would it make sense? Possibly, but I'm not sure any carrier wants to start a precedent.
You post:
"The big question in my mind has to do with "on claim status"
Not only can't a policy be changed while a policyholder is on claim, but unless there is specific wording in a contract allowing for specific alternative benefits, nothing can be changed in a contract, other than reducing benefits.
If paying for family members was an important issue then a policy paying a cash-benefit, or cash-alternative should have been purchased up front. A 100% reimbursement policy is not the answer.
Scott,
On your point #2; I'm not sure if any wording in an Alternate Plan of Care" will allow for it to directly contradict a specific exclusion in the policy. Would it make sense? Possibly, but I'm not sure any carrier wants to start a precedent.
If the clients child went to work for the home health care agency with the stipulation that his/her only client would be her mom, GNW will have no choice but to pay for the person's care since it was provided by a licensed caregiving agency. No one researches the actual caregiver in that case. Its just a $17/hour line item.
Any debates on that? The name of the caregiver was not always on my mom's invoice when the caregiver came over. Even if it was, the daughter could have a different last name.
Not trying to cheat the system here......just saying how it might work. Not sure if the child actually lives in the home or not though.
Any debates on that? The name of the caregiver was not always on my mom's invoice when the caregiver came over. Even if it was, the daughter could have a different last name.
Not trying to cheat the system here......just saying how it might work. Not sure if the child actually lives in the home or not though.
- Thread starter
- #18
george bolder
New Member
- 4
the policy was issued 5 yrs ago. and it does not allow a family member to be the caregiver. Is it possible that genworth would consider a one time cash buyout? this would allow the insured to compensate her daughter for looking after her in the remaining years of her life. genworth would save money by allowing the cash buyout so is this not a win-win situation?
- 657
You will have to ask Genworth Claims that question. They are the only ones that can answer it.
Arthur Rudnick
Guru
- 1,652
George,
Is a cash buy-out a win-win situation?
NO.............
You said that your policyholder has a $3,000/monthly benefit. You didn't mention the benefit period, but let's use 3 years as an example. If she was reimbursed for 100% of that $3,000 each month for 3 years, she would have been paid a total of $108,000. (36 months x $3,000/month)
Let's say that you want a buy-out and you feel that $54,000 is a fair number (50%).
If your client went on claim January 1st, and died on February 1st, Genworth would only have been responsible for $3,000, not $54,000.
Who wins in that case?
An insurance contract is not subject to negotiations by the policyholder & a company representative. It is a legal, binding contract.
A car lease is a legal contract. Can you call up your leasing company after paying 2 years of a 3 year lease and ask to turn in your car 1 year early for a lump-sum 6 month payment? Don't think so.
If you have a $1,000 deductible on your auto insurance, can you call the company immediately after an accident and negotiate a $200 deductible if you tell them you'd be willing to stick with the company for another 3 years?
Don't think so.
Herman;
Genworth's policy states:
"No payments will be made for any expenses paid to an immediate family member unless:"
1) The immediate family member is a regular employee of the organization that is providing services, and
2) Such organization receives payment for the services, and
3) The immediate family member receives no compensation other than the normal compensation for employees in his or her job category.
And, under the definition of the home care benefits it states that they will not pay benefits to anyone who normally does not live in the policyholder's home.
Now, is there a way around that? I guess............
But I'm not sure if that's what George & his client had in mind. I think they wanted to make a deal after-the-fact and have her daughter come in on her own and be paid directly. For that, Genworth was the wrong company.
Is a cash buy-out a win-win situation?
NO.............
You said that your policyholder has a $3,000/monthly benefit. You didn't mention the benefit period, but let's use 3 years as an example. If she was reimbursed for 100% of that $3,000 each month for 3 years, she would have been paid a total of $108,000. (36 months x $3,000/month)
Let's say that you want a buy-out and you feel that $54,000 is a fair number (50%).
If your client went on claim January 1st, and died on February 1st, Genworth would only have been responsible for $3,000, not $54,000.
Who wins in that case?
An insurance contract is not subject to negotiations by the policyholder & a company representative. It is a legal, binding contract.
A car lease is a legal contract. Can you call up your leasing company after paying 2 years of a 3 year lease and ask to turn in your car 1 year early for a lump-sum 6 month payment? Don't think so.
If you have a $1,000 deductible on your auto insurance, can you call the company immediately after an accident and negotiate a $200 deductible if you tell them you'd be willing to stick with the company for another 3 years?
Don't think so.
Herman;
Genworth's policy states:
"No payments will be made for any expenses paid to an immediate family member unless:"
1) The immediate family member is a regular employee of the organization that is providing services, and
2) Such organization receives payment for the services, and
3) The immediate family member receives no compensation other than the normal compensation for employees in his or her job category.
And, under the definition of the home care benefits it states that they will not pay benefits to anyone who normally does not live in the policyholder's home.
Now, is there a way around that? I guess............
But I'm not sure if that's what George & his client had in mind. I think they wanted to make a deal after-the-fact and have her daughter come in on her own and be paid directly. For that, Genworth was the wrong company.
