The Policy Interrogation
Liam Reilly
| 21-12-2025
· News team
Hey Lykkers, let's talk about a conversation many of us delay until it's too late. You're sitting with a trusted advisor, discussing long-term care. The brochure looks reassuring, and the agent is friendly. But that policy document? It's a small novel of complex terms. Signing based on a summary is like buying a house after only seeing the garden.
Your future security depends on the details hidden in the fine print. Today, let’s move beyond the sales pitch and arm you with the crucial questions to ask before you sign. This isn't just about getting coverage—it's about getting the right coverage that will actually work when you need it most.

1. "How is 'Needing Care' Specifically Defined?"

This is the single most important question. A policy is only as good as its triggering events. Does it require you to be unable to perform a certain number of "Activities of Daily Living" (ADLs), like bathing or dressing? If so, how many? The industry standard is typically 2 out of 6, but some policies require 3.
Expert Insight: "The definition of disability is the engine of the policy," says Jane Bryant Quinn, renowned personal finance commentator. "I’ve seen policies that only pay if you're hospitalized first, or that have restrictive definitions of cognitive impairment. You must understand the exact key that unlocks the benefits." (Source: AARP Bulletin)

2. "What is NOT Covered?"

Policies have exclusions, and you must know them. Pre-existing conditions are a common one, often with a "look-back" period. Does the policy exclude specific illnesses like Alzheimer's from certain benefits? Are there geographic restrictions on where you can receive care?
Probe Further: Ask: "Can you show me the 'Exclusions and Limitations' section? Walk me through it line by line."

3. "How Does the Inflation Protection Work, and Is It Realistic?"

A benefit that seems sufficient today may be woefully inadequate in 20 years. Does the policy offer inflation protection? Is it a simple 5% compound increase (the gold standard, but expensive) or a lesser option? Some policies offer "future purchase options," which can be risky if your health changes and you're no longer eligible to increase coverage.
Expert Insight: "Neglecting inflation protection is the most common and costly mistake in long-term care planning," warns Dr. Wade Pfau, Professor of Retirement Income at The American College. "You're not insuring today's costs; you're insuring the unknown costs of the future. Compound inflation protection is non-negotiable for anyone under 80." (Source: Retirement Researcher blog).

4. "What is the Elimination Period, and How Do I Satisfy It?"

The elimination period is like a deductible, but measured in days, not dollars. It's the number of days you must pay for care yourself before the policy starts paying. Is it 30, 60, 90 days? Crucially, do the days need to be consecutive? If you have a 90-day period but your needs are intermittent, you might never satisfy it.

5. "What is the Claims Process Really Like?"

This is where the rubber meets the road. Ask for a sample claim form. Who conducts the assessment to confirm you need care? Is it the insurance company's nurse or an independent party? How long does approval typically take? A smooth claims process is the ultimate test of a policy.
Final Authority: "A policy is a promise to pay. Your job is to investigate the integrity of the promisor," advises Scott Olson, an industry veteran and co-founder of LTCShop.com. "Ask the agent for the company's AM Best financial strength rating and their state's complaint index ratio. The cheapest policy from a shaky company is a worthless piece of paper." (Source: Industry interview on ThinkAdvisor).
Lykkers, think of this meeting not as a sales appointment, but as a due diligence interview. You are the CEO of your own life, hiring a financial safety net. Bring this list, take notes, and don't let any question go unanswered. The right policy can protect your savings and your family's well-being. But the right questions are what get you that policy. Now, go into that meeting not with anxiety, but with the quiet confidence of someone who knows exactly what they need to know. You've got this.