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TJ, Esq.
TJ, Esq., Attorney
Category: Legal
Satisfied Customers: 12404
Experience:  JD, MBA
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I have had calPERS term care insurance since i was 52. i am

Customer Question

I have had calPERS long term care insurance since i was 52. i am now 70.. i am disabled with a serious neck spinal stenosis which is compressing my spinal cord..I have been using my insurance 8 hours a day for 2 years to help me as i cannot walk and have minimal use of my arms and hands. calPERS now wants to reduce my benefits to 4 hours a day instead of 8.They think i am too independent...i am trying to be independent so i need less help and it is now like shooting myself in the foot! They say I am too independent! and dont need so much care. I will still have to use all 8 hours but with their reduction of benefits I will have to pay 4 hours myself which will cause me much financial distress. I will go broke!
JA: Because laws vary from place to place, can you tell me what state this is in?
Customer: California
JA: Has anything been filed or reported?
Customer: no
JA: Anything else you want the lawyer to know before I connect you?
Customer: The insuranse I bought says unlimited lifetime benefits
Submitted: 1 year ago.
Category: Legal
Expert:  TJ, Esq. replied 1 year ago.

Hello and thank you for the opportunity to assist you. My name is ***** ***** I will do my very best to help if I can. Please bear with me a few moments while I review your question, conduct any necessary research, and type a response. Thank you.

Expert:  TJ, Esq. replied 1 year ago.

Hello again. Thank you for your patience.

If your contract with the insurance company states that you have unlimited lifetime benefits, and those benefits include 8 hours per day, then the insurance company has no choice but to honor that contract.

I assume that you have already complained to the insurance company. If not, then you should do so immediately since it is possible that the insurance company will do the right thing on its own. However, if it does not, then you can file a complaint with the California Department of Insurance.

In order to file a complaint with the California Department of Insurance, you should click here:

At the website, you will see a link for filing a complaint online.

If you file the complaint and the California Department of Insurance is of no help, then you can sue the insurance company for breach of contract. That of course, is a last resort, and will probably be unnecessary once you file a complaint.

Does that answer your question? Please let me know if you need clarification, as I am happy to continue helping you until you are satisfied. Also,please remember to provide a positive rating via the stars(and note that your positive rating is the only way that I'll get credit for helping you, so it is much appreciated!). Thank you. :)

Expert:  TJ, Esq. replied 1 year ago.

Hello again. I didn't hear back from you, so I'm just checking in to make sure that you don't need more help on this issue.