Transamerica Long Term Care Insurance Reviews

We appealed and it was denied again. I submitted our concerns to the Minnesota Attorney General, the Minnesota Department of Commerce, and their state representative and senator. I also submitted this issue to the Better Business Bureau. I will be contacting these agencies again. After reading other peoples' reviews, I am very concerned that, if the need to enter a care facility arises, their claim will not be approved for that either. This is nothing less than organized theft!

5. After they claim they cannot reach one source of info after trying ONE time, they CLOSE the case! Without notifying the policyholder.

I'm going to get a lawyer to deal with this now. After 3 months of delay tactics and gas lighting. Crazy! Please stay away from TA.

We had another assessment in December with another rude nurse, surprisingly Mom was finally approved. But wait.... Let's drag our feet and tell us that you didn't get our paperwork we sent in several times, and the address where you claimed you sent documents was forwarded back to you even though when we called you the address was correct in your system. It was all excuses to drag your feet with hopes that Mom would die before you would send the first check. Finally, 3 months later the check came the day she died. It disheartens me to know that they worked so hard to be protected until their time of death and all Transamerica did is take their money and took advantage of our vulnerable parents. Do not spend your money with this company!

TransAmerica seems to be contracting out its services. The doctor who wrote her denial letter works for Illumifin. There is a different company that does some other part of their eligibility process. It is impossible to know how to move complaints up the chain. Here is link to an article written by the Illumifin CEO: **. Seems clear there is an active strategy to not pay claims. Very frustrating and damaging to patients and families. I'm sad to see that I am far from the only person to have bad experiences with TransAmerica.

There have been many hours on the phone made to expedite his approval. Documents sent were never received. We sent emails along with every mailed and faxed document only to be told that it was an old email that had been discontinued. For every submittal, a letter stating that additional information is required comes back.

Documents are faxed so we see the received fax notice. Documents that are mailed are verified. Once we provide proof of mailing, we are told that it takes 10 days to process letters and 20 days to submit an email. We are constantly asked for the same information (doctor reports) over and over. The stall tactics to keep from paying out on long-time people who have honestly paid into their plans is abhorrent. Their reasons for the delay are not consistent, and there is no way to have a case manager for continuity. We have sent documents from the doctors at his facility that were incorrectly entered by Transamerica were denied because of the date of entry only to be told that we should have highlighted the dates to make sure they were legible. TransAmerica is doing everything possible not to pay out after 20 years of receiving their payments. I encourage folks to file a claim with the Insurance Review Board in their state.

There have been countless phone calls made by my sister and me to facilitate this process. Every time we send the "required" documents to TransAmerica, we receive a letter stating that additional information is required. We send everything verified mail because they tell us the documents we HAVE SENT are not there. Once we provide proof of mailing, they tell us, "Oh, the documents arrived the day after we sent the letter," which is not true because the mailings were sent weeks before the letter.

I don't know how much information the California Department of Labor requires for complaints, but I could write a novel with all of the dates, times, and misinformation given to us by TransAmerica. You never speak to the same person twice when you call the claims department. And they consistently give different info. One person will tell you of a document needed. The following person will say to you the document was received weeks ago. On November 1, 2023, I spoke to a "team lead" who told me they had received "everything they need and that the claim was approved and would be sent to the claims processing department for payment." We then received a letter stating they needed the direct deposit info with a canceled check. We had sent these documents three times, the last certified mail. Today, I called them and once again was told that the letter was sent one day before the documents were received.

THEN, TODAY, they told me they didn't have all of the billing invoices from the LTC facility and couldn't pay until they were received. This is a total lie. Four people at TransAmerica told me in early November that they had received these documents from Brookdale. (the assisted living facility) TransAmerica is doing everything possible not to pay this claim. I am so frustrated. My Dad has been paying out of pocket for over a year now. Again, he is 94 years old. I honestly think they are just waiting for him to die to avoid paying out. FYI, my mother died this past May. We went through the same horrible experience with TransAmerica and her claim. It took almost 8 months for her payments to begin, and then she died. Something very dishonest is happening at TransAmerica. We have spent a fortune on mailing and faxing the same documents over and over again. I don't know what else to do. Please, please help. Thank you."

Appeal filed with TA, and they continue to slow-walk this claim, as Mom’s condition continues to decline. No LTC benefits have been received and 8 months since claim filed. Good luck trying to call their customer service as others have said. If you do get thru to LTC, they pretend they cannot look at file or give any update to status of claim. In summary…avoid this pathetic company! I feel sorry for all those seniors who paid thousands for LTC insurance, and will experience the same nightmare we have experienced. Where is the Iowa Insurance Commissioner and what are they doing to shut this company’s bad faith practices down?

My best advice (per my experience) for those of you fighting for reimbursement: Contact your State Insurance Commissioner (I was able to begin the process online). Filing complaints with the commission was the ONLY move I did that led to progression of payment. They held TA accountable, demanded responses from TA within a fair timeframe, cited laws and let them know they could be fined if a timely reply and action were not met within the required time parameter set by the Commission.

I will also add that I had THREE separate complaints/issues that were resolved because of the State Insurance Commission. I won't hesitate to reach out to the Insurance Commission again should I need to. Keep a log (I did an excel spreadsheet) of all your phone calls to TA including the call reference number, questions and responses and name of representative you spoke with. Sign up for Direct Deposit (so those 'checks' they claim they mailed can't get 'lost'). You must request the Direct Deposit form from TA; they will send it snail mail so anticipate two weeks to receive it. Submit your bills/claims and required documents via FAX. Snail mail 'might get lost'.

Keep ALL correspondence from TA! They charged for an annual premium AFTER benefits had been invoked for over six months. They claim the insured stopped utilizing benefits for over 30 days. They demanded annual premium be paid in full or all benefits already used would be rescinded and no future benefits would be paid out. I did pay it to not lose any benefits. The dates they claimed that the insured wasn't using benefits had actually already been paid by TA! I sent all of the EOB's (explanation of benefits) showing TA had already approved and paid these dates of service to the commissioner as proof. The insurance commission backed me up and I was awarded my premium back with interest. I KNOW I would have never received any of that premium back without the assistance of the insurance commission.

I am sharing in the hopes it may help some of you having difficulty with TA. They are unethical in my opinion. Our elders PAID for the insurance! It is OWED to them! Best wishes!

Original Review: I am experiencing the same as many have said before me. They don't want to pay! There is always a "hitch", and their communication is HORRIBLE. You never get the same representative. Answers from most are contradictory. Mailings from TA are received weeks out from date of letter. When I asked for something to be faxed to my home care provider, they agreed but said "a fax can take up to five days to send". Things like this are commonplace. MY BEST RESOURCE IN GETTING PAYMENT (among other assistance needed) has been filing a complaint to my State Insurance Commissioner via their website. This has been a tremendous help in receiving payments.

In addition to complaints regarding payments, I have reached out to the Commissioner for other processes (TA saying they never received the report(s) from independent companies that review the client's needs, billing me for policy premiums AFTER benefits have been invoked, not letting me speak to a supervisor). If you are having issues reach out to your state Insurance Commissioner! Still be prepared to spend a lot of time on the phone with Transamerica.

I also highly recommend making a call log that includes, date, time, your question(s), response received from representative, and call tracking number. I have forwarded my call log to my State Commission, who I believe forwarded to TA with my most recent complaint (I'm on my 3rd filing with the Insurance Commission). I must say that the Commission has provided HUGE assistance and sanity for me! Please try it if you're having difficulty with TA! The beneficiaries PAID for this product! They deserve what they invested in for their elderly years/needs!

After 4 months of phone calls (January 2023), and no one knowing the status, they told me the case manager closed the case due to not having the documents. After a loud, abusive, angry phone call they miraculously found the docs. We have started the process over. It is agonizingly slow because of "a new system change over that requires 2 weeks with no ability for processing claims. On 2/6/23 the new system was considered "changed over." Always an excuse. Two weeks later, still no answer. Now they say they cannot refer to a supervisor. Deny, deny, deny, delay, delay, delay. All the while I have had to make 3 quarterly payments.

When my mom moved into an assisted living facility, costing $5300/month, we followed all the requests given by TransAmerica to meet the policy requirements for claim approval. Today the claim remains rejected, after an appeal, because the inadequate assessment and opinion of the TransAmerica nurse that visited my mom trumps the doctor's assessment as well as the assessment given by the assisted living facility that spent months monitoring my mom.

Part of the TransAmerica claim process is to send a nurse to do a physical and mental assessment. During that assessment, the nurse noted that my mom needed help bathing because she could not reach her feet. She went on to explain that she had patients that could not properly wash their feet and had serious problems involving hospitalization. The assessment also involved assessing my mom’s ability to get dressed and her memory. The nurse asked my mom questions about getting dressed but did not watch her perform those tasks. She also asked my mom to remember a few words over a couple minute time span, which my mom, at the time, was able to do.

In response to the TransAmerica assessment, along with the assessments done by her primary care physician and the assisted living facility nursing staff, it was obvious my 96 year old mom does not have the flexibility to properly care for her feet. With that, we started paying the assisted living facility to help my mom shower and get dressed – mainly putting on socks, pants and shoes of to avoid a fall. The need for this type of help clearly meets her policy requirements. TransAmerica, however, claims that although their nurse said she needs assistance showering, the nurse did not say she needed help getting dressed, even though she was adamant that my mom could not reach her feet.

Apparently, the nurse does not realize the need for socks and shoes, or putting on a pair of pants. And the metal assessment did not show the nurse that my mom gets easily confused and forgets things that happened less than 30 minutes prior – yet the nurse felt my mom's mind is fine. And that inadequate assessment cost my 96 year old mom $67,000 and is leaving her with the responsibility of paying $5300 every month of her remaining years – or until our money runs out.

My goal here is to educate. If you read this far and still have doubts about my story, email me at **. I can send you my mom's policy contract, the letters sent by me and TransAmerica and the Doctor's assessment. This is real, and the time to prepare for end of life is not at the end of life, because there is no recourse. The money is theirs, no matter where you have to go when the rest of your money runs out.

Long waits on hold, long senseless conversations with phone puppets, promises to send needed paperwork by snail mail, requesting faxes and mailed forms, saying they haven’t received proper forms, sometimes they email, but say they don’t, caregiver timesheets that are unbelievably difficult to navigate and impossible for most caregiver educations, seriously elder abusive for the 90 + year old trying to get reimbursed for there crystal clear need to be cared for. We have tried to start this process a few times to only be driven into discontinuing the exorbitant amount of forms and lies because of the stress it causes. Next stop is an elder law attorney. Anyone have a suggestion or experience suing this dirt ball company to get deserved funds paid? We are in contact with the California Insurance Commission fraud department. Their response is slow but they are researching complaint. HELP!

Due to her "change in condition" and her move to a new room, I was initially told that a "new" claim would need to be filed and APPROVED by the eligibility department. Documentation was also required by the facility. Then an assessment was required which took nearly a month to have someone come in to see Mom. The individual had MANY papers to fill out detailing out Mom's medical history (which they already have!) My mother has dementia and could not remember details of past surgeries much less the town she lives in. The assessment even included a "test" of memory that has been done by her neurologist. Her memory is failing! Therefore, her move to Memory Care.

I was told by one representative that once they had the assessment they could expedite the claim. The next representative told me they could not. We are still waiting on the check. I have spoken with Thomas, Adrian, Matthew, Omartalia and Nessa over the past 2 months. One told me that Transamerica has to make sure the facility is an approved one. It is the SAME facility!!

The latest news was from Thomas who said on 11/18 that the assessment has been received and is now being reviewed. It could take up to 10 business days BEFORE approval. He then asked me why it was taking so long? Did we not tell them? He was putting the blame back on us. We had no idea that we had to let Transamerica know that she was moving rooms within the same facility. I called when we only received a partial check for the month of August and was told a letter had been sent to us notifying us to start paying her premium again while the policy was under review. Thomas did finally agree to send an email to the eligibility department to ask if they can speed the process up for us.

The original letter from Transamerica stating their need for documentation from the facility was supposedly mailed on September 29. However, the letter we received was actually dated October 11. We now have a new letter saying the premiums must be paid up to date by January. We are still waiting. Meanwhile, the burden lays on the family to pay her monthly bill for memory care. Mom paid for YEARS on her policy assuming she would be financially able to receive the care she needs.