Our ranking of the worst long-term care insurance companies in the US helps consumers avoid making a costly mistake.
Long-term care insurance (LTCI) is meant to provide financial security when people need extended care, such as assisted living, nursing homes, or in-home help.
However, over the past two decades, several major insurers have developed poor reputations for skyrocketing premiums, financial instability, and problematic claims handling.
While no single company can be definitively labeled the “worst,” there are several that have repeatedly faced criticism from policyholders, regulators, and consumer advocates for their long-term care practices.
Why Some Insurers Struggle With Long-Term Care
The long-term care insurance sector has faced structural problems since its inception.
Many insurers underestimated how many policyholders would file claims and how long they would live, resulting in massive underpricing of early policies.
In addition, years of low interest rates eroded investment returns, leaving insurers with fewer resources to meet growing benefit obligations.
As a result, several insurers have drastically raised premiums, sometimes by double or triple, even for long-term customers who were led to believe their rates would stay stable.
Claims delays, denied benefits, and complex eligibility requirements have also compounded frustrations, especially for elderly or disabled policyholders relying on coverage during vulnerable stages of life.
Genworth Financial
Genworth Financial is one of the largest names in the long-term care insurance market — and also one of the most criticized.
Thousands of policyholders have reported massive premium hikes, in some cases exceeding 100% over a few years.
Genworth has defended the increases as necessary to keep policies sustainable, but many customers who purchased plans in the 1990s and early 2000s say the company failed to deliver on expectations of affordable long-term coverage.
The company has also faced scrutiny for delays in processing claims and for its financial position. Credit rating agencies have downgraded its long-term care insurance unit in the past due to growing liabilities and uncertain profitability.
While Genworth remains in operation and continues to service policies, its history underscores how risky the long-term care market can be when actuarial assumptions fail.
CNO Financial Group (Formerly Conseco)
CNO Financial Group, previously known as Conseco, once sold a large volume of long-term care policies through its subsidiaries.
In the early 2000s, the company suffered significant financial losses tied to its LTC division.
Policyholders reported issues ranging from denied or delayed claims to confusing language regarding benefit triggers and daily coverage limits.
While CNO has since restructured and stabilized financially, consumer complaints over long-term care products have persisted, largely due to substantial rate increases and policy changes that have eroded the value of older contracts.
The company’s history serves as a reminder that even large insurers can mismanage risk, leaving customers paying more for less protection over time.
Penn Treaty Network America
Perhaps the most dramatic collapse in the industry came from Penn Treaty Network America Insurance Company.
After years of financial strain, regulators placed the company into liquidation in 2017, making it one of the largest insurance failures in U.S. history.
Tens of thousands of policyholders were left uncertain about their coverage, as state guaranty associations were forced to take over obligations.
The Penn Treaty case highlighted the perils of inadequate pricing, lax regulatory oversight, and over-optimistic assumptions about care costs and longevity.
For many consumers, it became a cautionary tale about trusting smaller or less financially robust insurers in the long-term care space.
What Consumers Should Watch For
If you have long-term care insurance — or are thinking about purchasing it — several warning signs can help you avoid trouble:
Premium Increases:
Even long-standing policies may see significant hikes as insurers try to offset past mispricing. Always ask for a history of premium changes before buying.
Financial Strength:
Check an insurer’s current credit rating. Downgrades may indicate the company is under pressure from rising claim costs.
Claims Handling:
Research complaint ratios and customer reviews. Delays, excessive paperwork, or frequent denials may signal systemic issues.
Policy Complexity:
Understand triggers for benefits, elimination periods, inflation riders, and any exclusions. Many consumers only discover gaps when they try to make a claim.
The Industry’s Broader Struggles
The long-term care insurance market as a whole is shrinking.
Many major insurers — including MetLife, Prudential, and Unum — have scaled back or stopped offering traditional LTCI altogether.
Those that remain, like Genworth and Mutual of Omaha, continue to adjust rates to stay solvent, often at the expense of older policyholders who can’t afford higher premiums but also can’t replace their coverage.
Experts say the industry’s troubles stem from a mix of underestimated longevity, low investment returns, and rising care costs that have made the original business model unsustainable.
As a result, many financial advisors now recommend hybrid policies that combine life insurance with long-term care benefits, or alternative strategies like self-funding through savings and investments.
Final Thoughts on The Worst Long-Term Care Insurance Companies
Long-term care insurance can still play a valuable role in financial planning — but it’s not without significant risks.
Consumers should treat insurer stability and claims reputation as seriously as price and benefit structure.
The experiences of Genworth, CNO Financial, and Penn Treaty serve as reminders that even established names can stumble badly in this complex, unpredictable sector.
For those holding older policies, it’s vital to stay informed, review annual rate notices, and consult financial professionals before accepting any premium increase or policy modification.
Ultimately, the “worst” long-term care insurance company is the one that fails you when you need it most — which is why vigilance and due diligence are your strongest protections.
