A decade ago

A decade ago, Gayle Presslaff-Keating and her entire family purchased long-term-care insurance policies.

Buying the policy at a younger age — she was 58 at the time — would mean cheaper premiums.

For 10 years, she made quarterly payments of $1,057.01 to Transamerica for the policy, with the most recent five years of payments being made electronically through her bank’s online bill pay system.

Then there was a payment mix-up, and the policy was canceled.

“I have been a client for 10 years paying approximately $40,000 in premiums and have never had an issue of payment not being received,” Presslaff-Keating said.

Transamerica, which said it could not comment on the case for customer privacy reasons, refuses to reinstate the policy, even though Presslaff-Keating has repeatedly shown proof from her bank that the payment was sent.

Here’s how it happened:

ONE MISTAKE, MANY CONSEQUENCES

Presslaff-Keating, a widow who lives in Toms River, said she made a mistake with her payment, which was due on Aug. 25, 2023.

She remembered sending the payment through online banking as she always did, but somehow the payment didn’t go through.

“I don’t know. Maybe I never hit the send button,” she said.

She didn’t realize the error until Sept. 25, when she received a letter from Transamerica.

It said it hadn’t received the payment, but her policy would remain in force if she paid the missed amount, along with the next payment that was due, by Nov. 4, 2023. It included an invoice that said the full payment was due on a different date — Nov. 25, 2023.

It also included a payment coupon for Transamerica with an address in Dallas.

Not wanting to lose the policy, she paid $2,114.02 through online banking on Oct. 19, long before the two different deadlines she was given.

Then she received another letter, dated Nov. 6.

Transamerica said it hadn’t received her payment, the grace period had passed and the policy was canceled.

She called the company several times, her handwritten notes show, but it insisted that it didn’t receive the payment.

So Presslaff-Keating got to work with her bank, which provided a document that showed the payment had been processed for $2,114.02 and sent on Oct. 26, and it showed Transamerica’s account and routing numbers.

Next followed a series of attempts to get Transamerica to accept the bank’s proof that the payment was made before the deadline, but the insurance company wouldn’t have it.

“Every time I spoke to someone, I was like, ‘Can’t I just give you the money and be done with it?’ ” she said. “And they wouldn’t take the money from me.”

Instead, she received a Dec. 27 letter from the company thanking her for her “recent reinstatement application,” instructing her to call in to do a phone interview as part of the process.

But she didn’t want a reinstatement under those conditions because she was 10 years older than when she first applied. She feared the company was looking for a way to hike her premiums, so she continued her efforts to get Transamerica to accept her proof of payment.

Then a discrepancy was noticed. The address listed on the bank document for Transamerica was in Plano, Texas, and it was an address the company didn’t use anymore, Transamerica said. The new address was in Dallas.

“But that makes no sense. It was an electronic payment so why does the address make any difference?” she said. “I’ve been paying for almost six years electronically. Why would I look at an address?”

Her subsequent phone calls yielded no results, she said, and she received two more letters from Transamerica. One said she had 14 days to do the phone interview for her “reinstatement application,” and the second said her application was closed.

“Why are they choosing to ignore this letter from the bank saying I paid?” she asked. “It should never have gotten to this point,” she said, and she asked Bamboozled for help.

DOES WRITTEN PROOF MEAN ANYTHING?

If you pay bills online, it’s important to know how your bank makes the payment.

While Presslaff-Keating believed her payment was made electronically, it was actually made with a paper check.

You see, while most businesses accept electronic payments, some don’t. In those cases, your bank will mail a paper check to the company, and in those cases, having the correct address is essential.

It’s also important to note that the average cost of a semiprivate nursing home is more than $11,000 a month.

It’s costly for insurance companies to pay those bills, and many want out of the expensive long-term care insurance market.

Given that new long-term care insurance policies cost more the older you are, it’s no wonder that Presslaff-Keating is fighting to keep her policy in force while Transamerica would want a higher premium, if it can get it.

We reviewed her documentation, including the proof of payment from her bank, and we asked Transamerica to reconsider the case.

It refused to discuss the details, citing consumer privacy.

But Presslaff-Keating received a call. She said the company’s argument hadn’t changed, and they went around in circles, with her asking for them to accept the proof of payment and the representative arguing that the wrong address was used. Her pleas noting that Transamerica had accepted all her past payments, made the same way for nearly six years, went nowhere.

The representative offered the phone interview, which would include a review of her health history, but she refused.

“This is not a new policy,” she said she told the representative. “I have had this for 10 years. I’m not going through another telephone physical exam.”

He then asked what she wanted him to do.

“I want you to accept the proof you have in front of you,” she said she told the representative.

The conversation ended without progress.

We asked the Department of Banking and Insurance (DOBI), which regulates insurance companies in the state, to review the case, and Presslaff-Keating filed an official complaint with the agency. She received a response that someone was on the case.

We’ll let you know what comes of it.

Karin Price Mueller, NJ Advance Media, [email protected]