Tipline Investigation: 101 year old fights with insurance company to stay in her home
SANTA BARBARA, Calif. - One of the toughest battlegrounds in the fight against COVD-19 has played out at senior living facilities. Outbreaks can sweep through killing dozens of residents. Yet, for many seniors they are at home where they feel safe. So, imagine the difficult situation they would face if their insurance company cancelled their long term care coverage in the middle of the pandemic under questionable circumstances.
Betty Meyer just turned 101 years old. She’s been living at the Samarkand Retirement Community in Santa Barbara for about 10 years. In June, TransAmerica Insurance sent Meyer a letter explaining it conducted an assessment and determined she no longer met the ‘eligibility requirement’ and therefore TransAmerica was terminating her Long Term Care coverage, the monthly benefit that allows her to live at Samarkand.
“They did not say it was a telephone interview, they said they sent somebody for an in-person interview. And in May, due to the COVID-19 pandemic Samarkand, the entire facility was on lockdown. Nobody could get in. I haven’t been able to see my mother since March,” said Ann Meyer, Betty’s daughter, who wanted to know more about that assessment.
The actual wording in the letter reads, ‘An onsite assessment completed on May 8, 2020 by an independent care coordination firm L-T-C-G indicates that you are independent with all the activities of daily living.’ The letter also states she scored 10 out of 10 in cognitive testing and based on other factors, TransAmerica gave Meyer just two weeks notice that it was ending her coverage.
“Once she was cancelled from her insurance it sent her for a loop and she’s totally depressed and you know scared, frightened,” said Ann Meyer.
She said her mother needs around-the-clock assistance, something Ann can’t provide because of her job and because she lives upstairs. Ann also said that Samarkand tried to help by filing appeals on her mother’s behalf, but that didn’t work, so she called the NewsChannel 3 Tipline.
The NewsChannel started looking into it and we wanted answers to some obvious questions. How did Betty qualify for coverage almost ten years ago, but now at 101 she doesn’t qualify? Also, we wanted to know more about this ‘onsite’ assessment. How did someone get into Samarkand to assess Betty Meyer when no one was allowed inside the facility due to COVID-19 health restrictions? We contacted Transamerica and L-T-C-G, the company that supposedly conducted that 'onsite' assessment. Both declined to talk about Betty’s assessment or why they did it in the middle of a pandemic.
“But they obviously know the timing of this," said C.J. Ward "Oh, they have to, one, whoever they quote, unquote sent to meet my mother couldn’t get in,” said Meyer.
To make matters worse, Ann Meyer said TransAmerica started billing her mother about $5,700 a month. The full amount for her care at Samarkand.
“They turned around and are now billing her. We’ve cut you off and now we’re going to bill you,” said Meyer.
That’s when NewsChannel 3 got involved and started calling around trying to get answers. TransAmerica Life Insurance did not return our calls, but a company spokesman did send us an email that reads, "Thank you for contacting us. Due to customer confidentiality, we are unable to provide information to you, but we have reached out to our customer directly to address their concern."
Transamerica did contact Betty Meyer and reversed its decision to terminate her coverage. She gets to stay at Samarkand where she wants to be.
“Since you contacted them, she was reinstated with her insurance and they actually even paid her for the month they had cancelled and so she got all of that back. She’s back on track able to stay at Samarkand. It’s wonderful. We just can’t thank you enough. We love you and adore you,” said Meyer.
Ann Meyer said she spoke with officials at Samarkand and there is no indication that anyone from the insurance company or LTCG went inside the facility for the assessment in May.
The NewsChannel contacted LTCG to get a comment for this story, but our emails and phone calls were not returned.