An 80-year-old woman in Wilmington, Delaware, was diagnosed with Alzheimer’s disease. When neither she nor her sons could take care of her daily needs any longer, she attempted to use her long-term care insurance provided by Genworth but was denied. Unsure how someone with diagnosed Alzheimer’s disease could be disqualified for long-term care, Attorney Emily Quirino challenged the denial by presenting convincing medical evidence of disability, including an in-home assessment by a licensed practitioner which confirmed she needed assistance to do her activities of daily living In the end, Genworth approved of the benefits.
Details of the LTC Alzheimer's Case
Even before our client was diagnosed with Alzheimer’s disease, an infamously severe progressive cognitive disease, she struggled with taking care of herself. At 80 years of age, she was diagnosed, and the difficulties in her day-to-day life were prominent. When it became clear that she and her sons were not equipped to take care of her needs, she tried to use her long-term care insurance policy that was provided by Genworth—but the insurer denied it.
Attorney Quirino could only conclude that Genworth was acting in bad faith because the medical evidence of her client’s disability was clear and not up to interpretation. In September 2024, her treating physician wrote that she was “incapacitated and currently unable to manage [her] property or business affairs.” Shortly after, a board-certified neurologist corroborated the physician’s findings by reaching the Alzheimer's disease diagnosis.
With her medical files, a few notes were particularly telling of her disability, including:
- She could not recall the day of the week.
- She could not recall her home state (or even respond to the question).
- She could not solve rudimentary math equations.
- She could not tell the time.
Although most claim evaluators would look at the medical information and cognitive assessments in our client’s file and determine that she needs day-to-day assistance, Genworth’s evaluators somehow said that she has no cognitive issues whatsoever. Even when a brain scan showed signs of Alzheimer's disease progression, Genworth falsely claimed that “there is no clinical evidence or standardized test results” that show her disability.
As part of the appeal submitted to Genworth, Attorney Quirino obtained an in-home assessment by a licensed practitioner who witnessed firsthand the help our client needed. This type of evidence is helpful, and often necessary, when an insurance company pushes back in a case like this.
Unaccepting what appeared to be an obvious show of insurance bad faith, Attorney Quirino challenged Genworth’s denial and promised to meet the insurance company in court if a reversal wasn’t granted without delay. Not wanting to face one of our firm’s reputable attorneys before a court, Genworth decided to approve the long-term care benefits for our client.
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Call the Dabdoub Law Firm to get experienced disability lawyers on your side. We can help with:
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