HomeInsuranceWhy are long-term care insurance rates going up in NC?

Why are long-term care insurance rates going up in NC?


Insurance companies attribute rate hikes over the last two years to people living longer and higher health care costs. One company requested a 550% increase.

BELMONT, N.C. — People who bought insurance decades ago to cover their potential need for long-term care one day are seeing their premiums skyrocket now that they’re retired and are on fixed incomes.

A WCNC Charlotte investigation found long-term care rates in North Carolina alone have increased by more than 30% on average over the last two years. Public records show some companies have tried to convince the state to raise premiums as high as 550%.

“This is just ridiculous”

Smitty and Gail Hanks of Belmont spent the last two decades preparing for their years after retirement. In their mid-50s, the business owners invested in long-term care in the event, during their golden years, they could no longer care for themselves.

“We bought the best policy we could afford at the time,” Smitty Hanks said. “We expect to live for a while. You never know, but we planned for it.”


Now that they’re in their late 70s and retired, the couple’s insurer recently told them it planned on hiking their premiums by 25%, which is the equivalent of more than $2,000 combined over the course of the next 12 months. That’s just the first year. The company is planning additional 25% increases every year for at least the next three years.

“This is just ridiculous,” Smitty Hanks said. “25% a year compounded is a lot of money, especially on a fixed income.”

Paperwork shows Smitty’s monthly premium jumped from $260 to $325 a month on August 18. By, August 18, 2027, his premium will exceed $640. By then, his wife’s monthly premium will eclipse $1,000.

“All we have (for income) is Social Security and our savings,” he said. “That’s it, so it’s a real concern.”

In letters to the couple, the insurer noted that due to trends in the industry, “the Company may need to increase (their) premiums again.” Hanks’ own policy paperwork states the most premiums can increase, based on when they bought them, is 90%.

When questioned by WCNC Charlotte, the company that bought the Hanks’ policies several years ago, Continental General Insurance Company, refused to comment. In letters sent to policyholders, the insurer blamed the increases on people living longer coupled with the much higher cost of long-term care.

“They expected me to die before I ever drew a dollar,” Hanks said. “I feel like what we’re getting is wrong and I don’t know how to fix it.”

Public records show Hanks and his wife are among 25,000 people in North Carolina left with little choice in recent years but to pay increasingly higher long-term care premiums. State data shows companies’ requests are getting larger and larger.

Continental General Insurance Company asked for the highest rate hikes so far in 2024 — more than 260%, according to the data. Records show in 2023, Continental Casualty Company requested the largest increase at 550.50%.


“I question the protection that the North Carolina Insurance Commission is providing for its residents,” Hanks said. “I think it’s a farce to think that the insurance commission is protecting us.”

“A tough market”

Mike Causey is the North Carolina Department of Insurance’s commissioner.

“The consumers we spoke to don’t feel like you’re protecting them,” WCNC Charlotte said to Causey.

“Well, I have been,” he replied. “It’s a tough situation. It’s a tough market.” 


Causey told WCNC Charlotte unforeseen industry circumstances have resulted in fewer companies left to shoulder the cost of a larger group of people filing more expensive claims. He said he continues to use what limited authority he has to push back against rate increases but says state law requires he ensure rates are “adequate” enough to pay out claims.

“I do feel for the consumers facing those increases,” Causey said. “It’s a mess. It’s really no fault of the consumer. It’s just a terrible spot to be.”

Causey said North Carolina caps increases at 25% per year but allows companies to spread out rate hikes higher than that over several years. State records show the commissioner has approved the full amount requested a little less than half of the time.

“(Insurance companies have) received a very small percentage of what they’ve asked for,” Causey said. “My main focus is helping consumers and I’m fighting every day, pushing back on insurance company requests to do the best I can do for the consumer.”

Causey spent most of his career in the insurance business. Up for re-election this year, campaign finance records show he’s received a fraction of his donations from people in that sector so far in 2024.

“A certain level of accountability”

WCNC Charlotte shared its findings about recent rate increases with state Rep. Terry Brown (D), Mecklenburg County. The lawmaker sits on the House Insurance Committee. Rep. Brown has since asked questions of NCDOI and said there will be more.

“Our office is going to be continuing to reach out,” Rep. Brown said. “I want to make sure that we’re doing everything we can to deliver for the people.”


Rep. Brown said he’s since learned state law lets companies ask for these types of increases every year if they choose. He believes the problem may warrant legislation during the next session to better space out rate hike requests over longer periods of time.

“We want to make sure that everybody who’s been doing the right thing, been diligently planning for their future, been working hard, is being taken care of,” Rep. Brown said. “Nobody should be forced to have to make a cut between, do they want to get groceries or do they want to get their long-term care here in North Carolina? That’s completely unacceptable.”

WCNC Charlotte requested the justification insurance companies submitted to the state so far in 2024. In response, NCDOI said “all documentation supporting the request for rate change is claimed by the insurance companies as ‘Trade Secret Confidential’ for which NC Department of Insurance honors such status of trade secret confidential.”

As a lawyer, Rep. Brown said he’s sensitive to the proprietary nature of certain things, but said consumers deserve more transparency.

“There’s a certain level of accountability, when you’re paying into a system and when you’re paying for a service,” he said. “Even if you can’t give specifics, there should be some type of accountability, some type of justification there.”

He urges consumers to voice their feelings with lawmakers and NCDOI.

“I think the key thing is, are you comfortable with those increases? Are you comfortable with not getting that information?” Rep. Brown said. “If not, there are so many different ways to reach out to folks and express your displeasure.”

Commissioner Causey also said he wants consumers to reach out to him directly. He said his office can help consumers navigate some of the challenges.

“We do everything we can to help folks,” he said.

Causey shared his email address publicly:  Mike.Causey@ndoi.gov. He also said consumers can call his office (855) 408-1212 or file a complaint online.

“I don’t think a thing will change”


Smitty and Gail Hanks formally complained to Causey’s office about the insurance rate hike.

“I don’t think it’s right,” Gail Hanks said. “I think they’re taking advantage of people who are older.”

The couple has also escalated directly with the insurance company, but doesn’t have faith there will be any relief.

“I don’t think a thing will change and I hate it,” Smitty Hanks said.

Contact Nate Morabito at nmorabito@wcnc.com and follow him on Facebook, X and Instagram.

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