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LifePlans has been providing expert long-term care underwriting and claims services for more than 20 years. Our combination of outstanding underwriting experience and claims services including state-of-the-art risk management tools make LifePlans the choice of more than 75 long-term care insurers across the U.S. and Canada.

Designed to deliver seamless integration with your operation, our flexible systems are built around your needs:

  • Customized processes that support your business process outsourcing needs
  • Seasoned underwriters, claims and care management staff
  • Efficient time and cost management
  • Rapid turnaround
  • Fluency in English, French and Spanish
  • Agent call center availability
  • Real-time reporting availability

LifePlans will perform a wide range of services to assist you in the issuance of your insurance product and the adjudication and management of your claims. These services can be outsourced long term or accessed on a periodic basis during peak volumes or unexpected emergencies. We will customize a program of services that best meets your needs including but not limited to:

  • Review of application for automatic declination
  • Triage applications
  • Coordinate ordering and review of requirements according to your protocols
  • Determine underwriting acceptance or declination
  • Report underwriting decisions with summarization of findings for support
  • Track all work in progress and report weekly and monthly
  • Following strict protocols and using our proprietary assessment tools, our trained clinicians Ė who have completed over 3 million assessments Ė complete all evaluations either telephonically or in the clients' homes. Our assessment technology focuses on the following:

    • Instrumental Activities of Daily Living (IADLís)
    • Mobility
    • Activities of Daily Living (ADLís)
    • Cognitive Screening
    • Medical history, significant symptoms and medications review
    • Living environment, physical and social activity
    • Clinical observations and summary

    Upon completion, the assessment interview is returned to our home office and reviewed by an in house clinician. A complete report is sent to the insurer within two (2) business days of receipt.

    LifePlans' experienced clinical adjudicators are a dedicated team working on a comprehensive software platform that matches requirements to meet clients' needs. With the flexibility and scalability to co-source for overflow capacity and detailed policy reviews that identify areas of opportunity for additional attention, LifePlans' adjudicators provide clients personal, customizable service and consistent quality results.

    Underwriting and claim audit services can be performed on-site or remotely. Detailed case information will be supplied along with a comprehensive report outlining results and recommendations and can include measurements against industry standards.

    Find out how LifePlans Underwriting and Claims Adjudication and Management services can help Long-Term Care, Critical Illness, Disability and Life Insurers deliver better health and business outcomes. Please contact:

    Denise Liston
    Vice President Long Term Care Services