Long-Term Care Insurance Policyholder Wins Suit Against Company for Hiking Premiums

Estate Planning, Wills And Trusts

A long-term care policyholder has successfully sued her insurance company for breach of contract after the company raised her premiums.

At age 56, Margery Newman bought a long-term care insurance policy from Metropolitan Life Insurance Company. She chose an option called “Reduced-Pay at 65” in which she paid higher premiums until she reached age 65, when the premium would drop to half the original amount. The long-term care insurance contract set out the terms of the reduced-pay option. It also stated that the company could increase premiums on policyholders in the same “class.” When Ms. Newman was 67 years old, the company notified her that it was doubling her premium.

Ms. Newman sued MetLife for breach of contract and fraudulent and deceptive business practices, among other things. In its defense, the company argued that the increase was imposed on a class-wide basis and applied to all long-term care policyholders over the age of 65, including reduced-pay policyholders. A federal district court dismissed Ms. Newman’s suit, ruling that the contract permitted MetLife to raise her premium. Ms. Newman appealed.

The U.S. Court of Appeals for the Seventh Circuit reversed the lower court’s decision and held that MetLife breached its contract when it raised Ms. Newman’s premium (Newman v. Metropolitan Life Insurance Company, U.S. Ct. App., 7th Cir., No. 17-1844, Feb. 6, 2018). According to the court, reasonable people would believe that signing up for the reduced-pay option meant that they were not at risk of having their premiums increased. The court also allowed Ms. Newman’s fraudulent and deceptive business practices claim to proceed, ruling that she showed evidence that the company’s marketing of the policy was deceptive and unfair.

To read the court’s decision, click here.

For further information, call me for a consultation.

Share:

Share on facebook
Share on twitter
Share on linkedin

More Posts

Jakob Legal helps a senior couple with Health Care Directives sitting together on plaid at sandy beach.

Its Medicare Advantage Season

Now is the annual opportunity to change medicare coverage. From Oct. 15 until Dec. 7, enrollees can shop Medicare’s marketplace for the prescription drug and Advantage plans offered by commercial insurance companies. They can also switch between fee-for-service original Medicare and Advantage.
And they will have plenty of choices: Next year, the typical Medicare enrollee will be able to choose from 57 Medicare prescription or Advantage plans that include drug coverage, according to the Kaiser Family Foundation.

Senior man and woman couple embracing at sunset or sunrise on a deserted tropical beach. They relay in Jakob Legal for Probate

Seniors Starting Businesses for their Contemporaries

Many entrepreneurs are successfully navigating new opportunities in serving their own peers.

Specifically, the article discusses the new career of “Patient Advocates” for the Elderly who are helping the adult or “sandwich generation” children navigate the complex and, sometimes horrific, medical system.

13 Estate Planning Terms You Need to Know

Estate planning is not just for the wealthy, it is something every adult should do. Estate planning can help you accomplish any number of goals, including appointing guardians for minor children, choosing healthcare agents to make decisions for you should you become ill, minimizing taxes so you can pass more wealth onto your family members, and stating how and to whom you would like to pass your estate on to when you pass away.

The Future of Eldercare is Bright

An organization called Hogeweykh is spreading the initiative to support all elderly individuals in living their best lives “with and despite their limitations due to dementia” with their care concept.

Please Contact Me

Skip to content