We’re here when
you need us
Long Term Care Insurance
Claims Processing
Underwritten by
Claims Processing
Trust Our Experience
When Excellence
Makes a Difference
71% of Genworth’s long term
care insurance claims started
with home health care.*
At the time of the initial claim,
our youngest claimant
was 27 years old and oldest
was 103 years old.*
50% of all claim dollars are
paid to claimants with mental
disorders, including Dementia.*
$4.3 million paid in long term
The Life of a Claim
** It always helps, especially at what could be an unsettling and challenging time, to be informed. Over the years, we have worked hard to make our claims process simple and efficient. That means an easier claims process for you. In general, here are the steps in our claims process:Open a Claim
Anyone can begin the claim process on behalf of the Insured as long as they have the Insured’s identifying information. To initiate a claim, call us at 800 876.4582
Mon – Thu 8:30 am – 8 pm ET Fri 9:00 am – 8 pm ET
A Claims Service Representative will help you open the claim and answer any questions you may have about policy benefits and eligibility
requirements. Please note that some privacy regulations may apply. Intake Nurse Calls You
After notifying us of a potential claim, the Insured or designated representative will be contacted by a Genworth Intake Nurse. The Intake Nurse will discuss the Insured’s care needs and review eligibility requirements. A claim packet will be sent directly to the Insured,
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and Care Coordination is initiated. If a claim for Home Care Benefits is being filed, the Insured will receive an in-home assessment, and a Plan of Care will be developed. If a claim is for Assisted Living Facility Benefits, an in-facility assessment will be prepared. Privileged Care Coordinator
Sets up a Home Visit†
Shortly after the intake call, a Care Coordinator will contact the Insured. The Care Coordinator is a nurse with access to a nationwide database of facility and licensed home health care agencies. The Care Coordinator will arrange for a local registered nurse to conduct a functional assessment with the Insured at his or her place of residence. Assistance with claim form completion is a part of the assessment visit.
Does not apply to Nursing Home claims
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Determination of Eligibility A Benefit Analyst reviews the assessment summary and the claim forms, as well as any additional information needed to determine benefit eligibility. When the Benefit Analyst has made an eligibility determination, a letter will be sent to the Insured, and if approved, the letter will be sent along with the customized Plan of Care. To receive policy benefits, both the Insured and the care provider need to meet the eligibility requirements of the policy. Benefit Payments Begin
When the Insured has been approved for benefits and is using an eligible care provider, the Insured can be reimbursed for covered services up to the policy maximum each month. Copies of invoices or billing statements for care services, including a detailed description of the services provided, can be mailed or faxed to Genworth.
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“ I always found it really
easy to call Genworth
and get somebody
on the phone who could
walk me through what
the benefits were and
how to put the policy into
effect. And it was really,
really easy. I have always
found them so helpful
and supportive and
always available.”
Diane P., speaking on herexperience with our claims team
Ongoing Support
Continuous Review and Ongoing Support
Your Privileged Care Coordinator will routinely call and monitor your long term care needs to be sure the Plan of Care is current and appropriate. As your long term care needs change, applicable adjustments will be made to the Plan of Care. You have the option to change care providers at any time, for any reason. The Benefit Analyst assigned to your claim will continue to review your benefit eligibility and determine the interval for any further on-site visits by the local Care Coordinator nurse, typically on an annual basis.
There When You Need Us
Our goal is to make the long term care claims process as easy as possible, every step of the way. Since we know this could be an especially difficult time, our goal is to always provide ongoing claims support with sensitivity and respect.
Keeping Our Promises A leader in long term care
O V E R
Y E A R S
insurance since 1974