LTC Eligibility Review Process

LTC Eligibility Review Process

Genworth Guide to Making a Claim

A claim associate will be assigned to evaluate your claim. The associate will work directly with you, or your personal representative, and care providers, to gather all required documentation, which may include, among possible others:

  • Onsite Functional Assessment Interview
  • Authorization to Release Information

During the eligibility review process, a claim associate will evaluate the type(s) of Long Term Care Benefits you wish to access and the policy or certificate’s coverage limits. The associate may also consider your medical records, assessment interviews, and provider information.

Genworth usually makes a claim decision within 30 days of receiving all required information needed to complete the evaluation process. However, if the claim associate is unable to reach a decision, or if additional information is needed, you will receive periodic communication outlining the remaining information required to complete the review.

You can help the eligibility review by ensuring Genworth has complete and current information, and by being available for questions.

After reaching a benefit eligibility determination, the claim associate will contact you, or your personal representative, by letter or telephone to discuss the decision made and to answer any related questions.

206401E1C3 04/02/19