If you received a letter, a phone call, or a denial notice that mentioned CareScout and you own an old Genworth long-term care policy, you may be a bit confused. If you're one of the roughly one million policyholders still covered under a legacy Genworth Privileged Choice, Classic Select, or Cornerstone long-term care policy, understanding where Genworth ends and CareScout begins shapes how your claim gets reviewed, how fast it gets paid, and how hard you may have to fight for what you're owed.
Is CareScout the Same Company as Genworth?
Genworth stopped selling new individual long-term care policies between 2016 and 2019. Since then, the company has managed its roughly one million existing LTC policyholders as what the industry calls a "closed block." No new premium dollars come in from new sales — the block only pays out, which is a very different financial position than an insurer actively writing new business.
In October 2025, Genworth's CareScout Insurance Company subsidiary launched a new standalone LTC product called Care Assurance. As of February 20, 2026, it was active in 40 states, with more approvals pending. Care Assurance is a separate policy from a separate legal entity — buying one doesn't upgrade your existing coverage, and CareScout Insurance Company has no role in deciding your existing claim.
That distinction matters because a closed block and a brand-new product face opposite financial pressures. Care Assurance needs to price conservatively and attract healthy buyers from day one. The legacy block has no new premium coming in to offset rising claims costs, which is a dynamic that drove Genworth's rate-hike strategy for over a decade.
The Rate Hikes Behind the Denials
Legacy Genworth policyholders have lived through more than a decade of steep premium increases — some well over 100% in a single filing. The company has faced multiple class-action lawsuits over how it handled and disclosed those increases, including Skochin v. Genworth and the separate Haney v. Genworth case, which required Genworth to offer policyholders new elections, disclosures, and in some cases reduced-benefit or cash options in place of accepting a rate hike.
Genworth has also settled lawsuits with its own shareholders. In 2016, the company paid $219 million to resolve a securities class action alleging it misrepresented the adequacy of its long-term care reserves in 2013 and 2014 — before revealing it needed to add $531 million to those reserves, which sent its stock price down drastically. That particular case was about disclosures to investors, not a policyholder dispute, but it's part of the same story: a business unit that has struggled for years to price and reserve for its legacy obligations accurately.
The pressure hasn't let up. As of mid-2024, Genworth confirmed in its own SEC filings that it was in active litigation with two state insurance departments that had refused to approve rate increases the company considered actuarially justified.
None of this implies something directly for any individual claim, but it explains the incentive structure a legacy policyholder is up against — a fixed, aging pool of policyholders, rising long-term care costs, and a company that has repeatedly turned to premium increases rather than smoother claims payment to close the gap.
What CareScout's Rollout Means If You're Filing a Claim
CareScout isn't only Genworth's new sales channel — it's also the group that has handled assessments on legacy claims for over twenty years, rebranded. If you're working through a claim right now, the nurse or care advocate reviewing your ADLs is likely working under the CareScout name, even though your policy predates CareScout by decades.
Genworth has also extended CareScout's Quality Network to its roughly one million existing LTC policyholders, explicitly as a way to manage claims costs on the closed block. That could be a genuine benefit if a provider in your area participates. It is not a substitute for confirming what your specific policy actually covers, and using an in-network provider doesn't insulate an existing claim from being reassessed.
Some legacy policyholders have reported that a CareScout review of an already-approved, active claim resulted in benefits being cut off — in at least one publicly reported case, following a records-based audit rather than a new in-person evaluation, for a condition that hadn't improved. A degenerative diagnosis that stays the same, or worsens, isn't a valid basis for reversing an approved claim.
Were Your Genworth Long-Term Care Benefits Reduced or Terminated?
If your benefits were reduced or terminated after a reassessment, that determination can be challenged — it isn't automatically the last word. Speak with our legal team today about your policy.
Common Reasons Legacy Genworth Claims Get Denied
Every insurer denies claims on eligibility grounds — failing to show you need substantial assistance with two Activities of Daily Living, for example. Genworth's legacy-block denials tend to cluster around a few patterns tied directly to the pressures above:
- Elimination period disputes. Genworth's elimination period counting has drawn repeated criticism for excluding days of family-provided care or days it deems "unverified," stretching a 90-day waiting period toward 150 days or more.
- Reassessment-driven benefit cuts. An active claim gets flagged for a CareScout review, and benefits stop or shrink based on a paper review rather than a new in-person evaluation.
- Provider network pressure. Claims examiners push policyholders toward CareScout Quality Network providers, questioning the credentials of a family caregiver or a long-standing home health aide who isn't in-network.
- Documentation loops. Requests for the same records multiple times, or claims that a submitted form was never received — a pattern longtime LTC claimants and their families have described for years, not something new to CareScout.
Should You Consider Switching to a New CareScout Policy?
This is a common question. The answer is "Probably not", and definitely not without legal and financial advice first. If you have an in-force legacy Genworth policy, surrendering it to buy a new Care Assurance policy means re-underwriting at your current age and health status — which, for most policyholders dealing with a claim dispute or who might need to make claims in the near future, means either a much higher premium or an outright decline. A legacy policy you've paid into for fifteen or twenty years, even one facing rate pressure, still represents benefits you've already qualified for. Don't let a denial or a rate increase push you into giving that up before talking to someone who can evaluate your options.
What to Do If Your Genworth LTC Claim Is Denied
- Request the full denial letter and your claim file in writing. You're entitled to know the specific policy language and evidence the denial relies on.
- Don't assume an appeal is your only option. Whether to appeal internally or move straight to legal action depends on your policy's language and your state's bad faith laws — that's a case-specific call, not a form response.
- Get your treating physicians' records in order now. Office visit notes, ADL assessments, and functional capacity evaluations carry more weight than a prescription list.
- Track every communication. Genworth's documentation loops are easier to fight when you can show exactly what was submitted and when.
- Talk to a long-term care insurance attorney before signing anything — including a settlement offer, a policy exchange, or a new CareScout application.
Frequently Asked Questions
Is CareScout the same company as Genworth?
CareScout Insurance Company, which underwrites the new Care Assurance product, is a separate legal entity from the companies that manage legacy Genworth policies. But the CareScout name also covers Genworth's long-standing claims assessment team and its provider network, both of which do interact with existing policyholders. Your existing policy isn't a CareScout policy, even though CareScout plays a real role in how your claim gets reviewed.
Can CareScout deny or reduce a Genworth claim that was already approved?
Yes. A CareScout reassessment of an active, already-approved claim can result in reduced or terminated benefits if the reviewer concludes you no longer meet your policy's eligibility criteria. That determination can be challenged, particularly when it's based on a records review rather than a current in-person evaluation, or when your underlying condition hasn't improved.
Will my Genworth premiums keep going up?
Should I just let my policy lapse instead of dealing with this?
Talk to an attorney first. A lapsed policy forfeits benefits you've already paid for over many years, and a denial or rate increase doesn't necessarily mean your claim isn't valid — it may mean the claim needs to be fought.
Contact Sandstone Law Group Today
If Genworth has denied, delayed, or cut off your long-term care claim — or you're trying to decide whether a rate increase or a CareScout reassessment changes your options — talk to a long-term care insurance legal expert before you respond. Call Sandstone Law Group at (602) 615-0050 or reach out online to schedule a free case evaluation.