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Insurance Denials Have WWII Vet Fighting

Since breaking his hip two years ago, a 92-year-old Newport Beach resident has been fighting over long-term care coverage. Now, he's suing, alleging the firm routinely denies claims to senior citizens.

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    A 92-year-old Newport Beach man is suing a SoCal insurance company over their refusal to pay his long-term health care costs. Randy Mac reports for the NBC4 News at 6 p.m., Feb. 20, 2015. (Published Friday, Feb. 20, 2015)

    A World War II veteran says he’s truly in the battle for his life.

    Bill Crawford is suing the insurance company he’s paid premiums to for 20 years after they have repeatedly denied claims for care his doctors and caregivers say he desperately needs.

    The 92-year-old Newport Beach resident says he bought insurance to bring himself some piece of mind, but it’s brought him nothing but headaches in the last couple of years.

    "Well, I think they have treated me very badly," Crawford says of the Continental Casualty Company, a firm also known as CNA.

    Crawford broke his hip two years ago, limiting his mobility, and he is legally blind. He filed a long-term care claim with CNA, but it was denied.

    Crawford pays $3700 dollars in annual premiums, and he’s continued to file claims each week since breaking his hip in 2012. His doctors have certified he meets the policy’s criteria for long term care and yet each claim has been turned down.

    Meanwhile, life is catching up to the veteran. He’s outlived two wives, but he says his health is declining and his finances are dwindling.

    "Health-wise, I have some problems," he says.

    Volunteer caregiver, next-door neighbor and Vietnam veteran Bill Pavone says Crawford needs help with nearly all of his daily routine.

    "What are his needs? Oh going to doctors, shopping, physical therapy exercises that we do and other, you know just daily living activities," he says.

    Pavone says he’s upset that Crawford isn’t getting the care his doctors have signed off on.

    "You expect the right things to happen and it’s just not happening here," he says.

    Crawford feels the same way.

    So, now he’s suing CNA, alleging the insurance company’s handling of his claims “was not an isolated incident but rather a corporate practice” of denying and delaying legitimate claims for senior citizens.

    "You are really harming these people and that’s why we believe this company needs to be punished for what it does," says Sam Bruchey, Crawford’s attorney.

    In court filings, CNA denies any improper denial of benefits to Crawford while admitting they’ve received his claim submissions and doctors letters.

    Though CNA denied a request to be interviewed about the case, its spokesman released a statement saying "We do not comment on matters in litigation… We are committed to fair and proper claim handling for all our customers."

    Lawsuits like Crawford’s have the attention of the state’s insurance commissioner, whose investigators are fielding similar complaints.

    "We receive about 200 complaints a year (related to) long-term care issues," says Byron Tucker, deputy commissioner of the California Department of Insurance.

    While the litigation wears on, Crawford says he’s never been more determined to live. He says he is determined to finish what others could not.

    "I feel sorry for all the ones that die," he says. "Waiting for them to pay them."

    Anyone who has questions regarding insurance regulations for long term care policies can call the Department of Insurance Consumer hotline at 800-927-4357.

    For a complete list of  Long Term Care policies in California, visit the Department of Insurance Information website.

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