Tool Sprawl Risk Audit — Long-Term Care Insurance

Signs of tool sprawl in Long-Term Care Insurance

• The claim cycle from notice-of-loss to first benefit payment is a multi-step, paper-and-medical-evidence-heavy workflow that runs months and frustrates the policyholder and family at the worst time.
• Reserves and assumption discipline (morbidity, mortality, lapse, interest) determine the long-term economics of a multi-decade liability book — and the assumption review cycle is data-and-model-intensive.
• Legacy admin systems and policy-processing infrastructure date to the 1990s-2000s and the modernization business case competes with the runoff thesis.
• Claim-fraud and care-eligibility verification (ADL triggers, cognitive impairment) is a clinical-and-investigative workflow that runs slow and inconsistently.