Some long-term care carriers price coverage around the “average” claim — a few years, then done. The real claims data tells a very different story, and if a client’s coverage is built around an average, that’s exactly the plan that fails the client whose care need runs long.
Key takeaways
- The commonly cited “average” LTC claim length (3.7 years women, 2.2 years men) hides the real risk: the longest, most expensive claims.
- Largest-claim data from seven carriers shows multi-million-dollar, decade-plus claims for both men and women.
- Clients whose coverage is built around an average are exactly the clients a long claim will bankrupt.
In five of the seven carriers tracked, the largest male LTC claim ran as long as, or longer than, the largest female claim — even though pricing assumptions favor women needing more care.
The problem with planning around “average”
The commonly cited average length of an LTC need is 3.7 years for women and 2.2 years for men. That statistic often gets used to justify shorter, cheaper benefit periods, on the logic that most people won’t need care much longer than that.
An average describes the middle of a range, not the edges — and the edges are where long-term care claims get expensive.
What the largest claims on record actually look like
The American Association for Long-Term Care Insurance tracks the largest LTC claims paid by carrier. Looking at the largest claims paid through December 2018 across seven leading carriers tells a very different story than the averages suggest. In five of those seven cases, the largest male claim ran as long as, or longer than, the largest female claim — even though the “average” narrative assumes women need care longer:
- Carrier 1: 14 years, 2 months (male), $2,276,381 — vs. 16 years, 6 months (female), $2,329,333
- Carrier 2: 19 years, 3 months (male), $2,205,800 — vs. 15 years, 4 months (female), $2,636,417
- Carrier 3: 16 years, 2 months (male), $2,091,083 — vs. 9 years, 10 months (female), $1,727,594
- Carrier 4: 15 years, 8 months (male), $1,700,000 — vs. 14 years, 6 months (female), $2,000,000
- Carrier 5: 14 years, 3 months (male), $1,461,256 — vs. 11 years, 7 months (female), $2,012,385
- Carrier 6: 15 years, 4 months (male), $1,413,934 — vs. 15 years, 6 months (female), $1,499,601
- Carrier 7: 13 years, 2 months (male), $1,179,502 — vs. 18 years, 1 month (female), $1,316,417
Source: American Association for Long-Term Care Insurance, largest claims paid through December 2018.
Every one of those claims topped $1 million. Several ran past 15 years. None of them would have been fully covered by a policy built around a two-to-four-year average.
Why the outliers matter more than the average
Conditions like Alzheimer’s and Parkinson’s don’t follow a predictable timeline. A client diagnosed in their early 60s can need care for well over a decade. Planning around the average length of a claim ignores exactly the cases that do the most financial damage — the ones that go long.
That’s the case for looking past the shortest, cheapest benefit periods and considering options like a Continuation of Benefits rider or a lifetime benefit period — particularly for clients with a family history of cognitive decline, or clients who would rather pay more now than risk running out of coverage later.
Frequently asked questions
Is the average length of an LTC claim a good number to plan around?
Not on its own. It’s a useful baseline, but the largest claims on record run into decades and well past $1 million — numbers a policy built around the average simply won’t reach.
Do men need shorter long-term care coverage than women?
Not necessarily. While women have a longer average claim length, the largest individual claims on record show men meeting or exceeding the longest female claims in five of the seven carriers reviewed.
What’s the alternative to a benefit period based on averages?
Look at Continuation of Benefits riders or a lifetime benefit period, which remove the cap entirely and protect against the claims that run far longer than expected.