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Portland-area senior sues Mutual of Omaha over repeated denials

Despite frequent falls, dementia and other concerns, the insurer has denied coverage of assisted living, according to the suit
November 2, 2023

Mutual of Omaha is one of only a few companies still offering long-term care insurance. But for Multnomah County resident Garris Leisten-Gregory, it hasn’t worked out.

Through her legal representative, Leisten-Gregory has filed a lawsuit in U.S. District Court in Portland claiming the insurance giant denied her valid claims since early 2020.

According to the suit, that’s when Leisten-Gregory’s doctor said she needs the supervision of a local assisted-living facility in light of her failing kidneys, repeated falls and advanced dementia.

Mutual of Omaha did not immediately respond to a request for comment.

Lawyer Megan Glor filed the suit, which seeks more than $340,000 in damages plus attorney fees.

Leisten-Gregory had paid her premiums to Mutual of Omaha since 2011. In January 2020 she moved into Touchmark, a local assisted-living facility, after a visiting home health nurse told her doctor that her “living situation was unsafe, and that she had not been taking her medications correctly,” according to the suit. “In addition, due to confusion from vascular dementia, she had taken expired medication and had taken medication irregularly, and consequently, her kidneys were not functioning properly.”

To obtain her benefits of $8,865.00 per month, she and her physician provided the insurer with information documenting the need for the move, noting that she also “requires stand-by assistance for showering, and has fallen numerous times. At least one time, Ms. Leisten-Gregory has required hospitalization as the result of a fall, and her falls have become more frequent,” according to the suit.

In October 2020, Mutual of Omaha denied the claim, and then denied a revised claim with more information in February 2021, according to the suit. In April 2021, her attorney filed an appeal, but the insurer rejected it, saying Leisten-Gregory did not fit its definition of “chronically ill.” 

Another appeal was filed in August 2022, which the insurer denied the following April.

You can reach Nick Budnick at [email protected] or at @NickBudnick on X.