Bankers Life and Casualty Company sells long-term care insurance policies that promise to pay for care again if a policyholder recovers or develops new care needs after a prior claim closes. But when elderly policyholders try to collect on that promise, Bankers Life has repeatedly argued that almost any ongoing care — even for a completely different condition — disqualifies them from ever receiving benefits again. Two federal courts told Bankers Life that argument was wrong. The company settled both cases quietly and kept right on doing it.
What the Complaint Alleges
Ms. Zeichner paid premiums for over two decades before submitting her first claim. For years, Bankers Life acknowledged she was a chronically ill individual entitled to benefits and paid accordingly. When her prior benefit period reached its maximum, she developed new care needs — including injuries from multiple falls and severe knee arthritis — and filed new claims in 2024 and 2025.
Bankers Life denied both. According to the complaint, the company characterized her new care needs as a continuation of the prior claim rather than a separate qualifying event, applying an interpretation of its “Any One Period of Expense” provisions that would make benefit restoration nearly impossible for any long-term policyholder who continued to need any care at all.
The complaint further alleges that after each denial, Bankers Life told Ms. Zeichner she “may want to end her coverage” — providing cancellation instructions before describing her appeal rights. When she did request cancellation and then rescinded that request within a week, Bankers Life initially refused to reinstate the policy.
This Wasn’t the First Time
What makes this case distinct is what was already on the record before it was filed. In Kasoff v. Bankers Life & Casualty Co., the Ninth Circuit found that the same policy language at issue here was ambiguous and had to be construed in favor of the insured’s reasonable expectations. In Goodman v. Bankers Life & Casualty Co., the Central District of California reached similar conclusions. Bankers Life was a party in Kasoff. It had actual notice of what the court found.
The complaint alleges Bankers Life settled those cases in ways designed to remove the adverse rulings from public effect — then continued applying the same interpretation to other policyholders, including Ms. Zeichner.
Why This Matters
If you have a Bankers Life long-term care policy and they’ve denied your claim — or told you your coverage isn’t worth keeping — you have options. The law is on your side, and these denials can be challenged.
Sandstone Law Group represents policyholders nationwide in long-term care and long-term disability insurance disputes. We handle cases against insurers who deny, delay, or use policy language to avoid paying benefits that policyholders have earned. If you believe your claim has been wrongfully denied, contact us for a free case evaluation.
Contact Sandstone Law Group at (602) 615-0050 or online to discuss how professional legal guidance can help protect your rights and maximize your chances of obtaining the benefits you may be entitled to under the law.