Long Term Care Law Office Blog

Restoration of benefits: The golden-ticket to extended benefits?

Written by Kelsey Dunn in category 
December 7, 2016

Some people have lifetime polices, which essentially never “expire”-as long as the insured keeps the policy active by paying the premiums. The majority of people though, have limited-time policies. In order to maximize these limited-time policies, it is crucial to understand how to utilize and maximize their features in order to fully benefit the policyholder.
One of the most crucial yet overlooked policy features is called restoration of benefits. Perhaps the most important characteristic of this “restoration of benefits” feature is its ability to essentially transform a limited time policy into a perpetual policy, when used properly.


Policies do vary, but essentially if a policyholder goes 180 consecutive days without receiving “covered care” the policy benefits will restore to the original amount. There are many variables to consider depending on the specific policy language. However, this is a critically important provision and must be fully understood in order to be able to reap the benefits. That is why it is important to have someone with experience to review the policy in order to receive the proper advice on how to manage this very important provision.

Throughout my time as a long-term care attorney, I have seen many people fail to understand the advantages of this feature and just let their benefits dwindle. They rarely utilize the restoration benefit, because they assume that once they reach the end of their claim period, their policy benefits are maxed out. While this is understandable because the contractual language is very tricky (especially for an untrained eye), it is a grave misunderstanding, because the insured is losing out on care that they are entitled to under their policy.

I strongly urge anyone with a limited-time policy (or their loved ones) to familiarize yourselves with the restoration benefit feature to ensure it is being used to the utmost advantage of the insured.

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