John Hancock faces a putative class action lawsuit over allegations that the life insurance company refused to pay room and board fees that should have been covered under a long-term care insurance policy.
The John Hancock class action lawsuit was filed Tuesday on behalf of plaintiff Grace McElwee of New Jersey who is represented by her son Andrew McElwee Jr. because she is no longer capable of handling her affairs on her own.
According to the John Hancock insurance class action lawsuit, Grace McElwee purchased a long-term care insurance policy in 2002 just in case she eventually became in need of “substantial assistance.” Since purchasing the policy, the plaintiff has reportedly paid more than $83,000 to John Hancock.
Under the terms of her John Hancock care policy, both nursing care and custodial care charges are covered after 100 days of being declared to need “substantial assistance” with everyday activities or cognitively impaired. The John Hancock class action lawsuit claims that the insurance company expressly states that room and board charges are covered under the long-term care policy.
According to the class action lawsuit, “nursing care” is defined by John Hancock as services performed by or under the continual, direct and immediate supervision of a registered nurse on-site for 24 hours per day at a facility which is “licensed or certified and operated to provide nursing care for a charge (including room and board).”
In 2012, McElwee allegedly became in need of assistance with daily living while she was confined in a nursing home and an assisted care living facility where she received nursing care and custodial care. The John Hancock insurance class action lawsuit claims that the company is required to pay for McElwee’s nursing and custodial care charges including room and board but has refused to do so.
According to the John Hancock class action lawsuit, in 2014 while residing at an assisted care facility McElwee fell and fractured her leg. Since the accident John Hancock has allegedly refused to pay any portion of her nursing home or assisted care living charges verbally stating that because she received Medicare payments since her fall, she is not entitled to any payments under their policy.
The John Hancock insurance class action lawsuit claims that the company did not provide any breakdown of charges covered by Medicare making it “impossible” to determine if McElwee received the insurance benefits for which she is entitled.
McElwee is suing John Hancock for breach of contract and bad faith practices alleging that the insurance company deliberately misinterprets records or policy language so they can avoid coverage.
If approved, the John Hancock insurance class action lawsuit would be open to all New Jersey residents who have been denied coverage for room and board expenses with respect to John Hancock’s plan for long-term health insurance. The John Hancock class action lawsuit also seeks to represent individuals who have been improperly denied claims for long-term care charges that were allegedly covered by Medicare and those who have been denied all or a portion of their right to payment or have received delayed payments as a result of John Hancock’s bad faith practices.
McElwee is represented by Kenneth L. McElwee.
The John Hancock Insurance Coverage Class Action Lawsuit is McElwee v. John Hancock Life Insurance, Case No. 3:15-cv-07398, in the U.S. District Court for the District of New Jersey.
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13 thoughts onJohn Hancock Hit With Long-Term Care Coverage Class Action
The Long Term Care division is an absolute scam. I have been trying for months to get my mother the money to which she is entitled. Every phone call is met with “Oh, we’ll take care of this in 3-5 business days,” and nothing every happens. I have hired an attorney to get my mom’s benefits, but I can’t believe this company can get away with this. It’s breach of contract, at the very least. It seems to me the only way to rectify this is a class action lawsuit. This could bring relief to the hundreds of people Hancock has scammed.
My experience very similar to these class action clients. Premiums thus far paid 235K
A provision in John Hancock’s long term health care policy says the firm will prorate coverage if the insured’s stay at the health care facility is “interrupted” more than 60 days a year. We assume “interrupted” refers to long term treatment at another facility, not weekend visits w/ family and friends, vacation, etc. Anyone else have experience with this policy provision?
I started policy for LTC with John Hancock over 30 years ago thru my employer,AT&T plus have automatic paymenta. Now at almost 75 years old I need help. Live alone in a nice Senior apartment building that is for 55 years and older. I have had Two strokes and in need of assistant – however John Hancock LTC is dragging it’s feet and Not helpful and seems they are SCAMMERS…..,
My wife and I have been paying John Hancock over $4500 per year for the last 18 years. I am wondering how we will be protected, should we ever need to file a claim.
Any useful information that you can provide would be gratefully appreciated.
Just be organized and have all your records, use your PCPhysician, and be sure that the company you place on the form to care for your beneficiary, is trustworthy and will acommodate your needs.
I wish you luck. My Godmother paid roughly 60k+ for her long term care policy. She lived 10 days past the required deductible period. This means they owe her estate $1,500. They are refusing to pay and trying to drown me in paper work so I will give up. I ha e sent them all the receipts multiple times.
My husband and I have been paying for about 10 years for our policies with another company. We are considering dropping them. It’s all just a big scam.
Never pay again
Consider it lost money.
They will never pay out.
My mom passed 4 mths ago . We have been trying to claim since 2020 they have not paid a dome. Road blocks , denials due to technical issues. I cant see anyone over 65 being able to accomplish reimbursement from JH due to the lengthy legal web of BS. Scammers of the biggest kind. Join in a class action suit and maybe your children after you go will get something.
After paying about $5K per year for 12-years for our John Hancock LTC policies, I filed a claim for my legally blind wife. (She cannot read, drive, unfamiliar surfaces without assistance … and numerous other sight-related issues.
After considerable runaround (lost files, non-returned calls, etc.) and a nurse’s review, the claim was denied. I subsequently re-filed an appeal on the basis that the ADL’s were being so narrowly interpreted by John Hancock, that one would have to be virtually bed-bound and unable to feed themselves – in order to qualify. I’m interested in joining a Class Action lawsuit – and understand there are several.
I’m having the same type of problem with John Hancock long term care. I filed a claim this service investigator came and talk to me then I get a letter being refused my money that is at $80,000 plus interest at 5%, Then dropped two 3.5%, then again, dropped to 2.9%!
This brings much more Money to my account. Which yes usable at $257. I day for five years.. This is my money and being made to beg for Payments for in home care .
I Purchased this long term care, so are at 87 now, can’t stay in my home after, two mini strokes,.. iCan care for myself, physically at this time. But I need housekeeping and transportation and errands. I have hi problems macular degeneration, and hearing loss. There will. Come a Time when I will need physical help., But not now just daily living chores.
Please contact.
My husband was also turned down!
I even brought him home and had to have round the clock care because he
Was bed ridden and I couldn’t pick him up! The claims were sent in but they said they never received them!
I had to pay out of pocket! His benefits
Rolled over to me but I need assistance now!
I missed a payment and tried to call back to get my account reactive and they would not!
I opened and account in 2008 and probably lost at least 80k :-(
Hello, So what happened with the John Hancock lawsuit? My father paid for John Hancock Long Term Care Insurance for like 40 years and when I filed a claim they turned it down. He was also in a facility and needed 24 hour care