Long Term Care Insurance

Exploring Fraud in LTCI: Risks, Realities & Collaboration Opportunities

Long-Term Care Insurance (LTCI) plays a critical role in our evolving health care landscape. As the U.S. population continues to age, there is growing concern about how to fund the escalating costs of chronic and ongoing care needs. Although only a small portion of individuals are prepared with private LTCI coverage—either through stand-alone policies or hybrid plans—the pressure on public and private systems is mounting. States like Washington are beginning to implement their own initiatives to offset future burdens on Medicaid, signaling a shift in how society approaches long-term care planning.

At John Hancock, a renewed focus on fraud, waste, and abuse within LTCI has unearthed previously overlooked vulnerabilities. Senior Director of the Anti-Fraud Team, Shannon Perschy, and Kristina Mulholland, Director of Global Investigative and Forensic Services, will guide attendees through the fundamentals of LTCI, prevalent fraud schemes, and emerging trends. Through real-world case studies, the presenters will illustrate key risk areas and the importance of shared accountability across sectors.

This session will also explore how greater collaboration between LTCI carriers and health insurers can enhance fraud prevention efforts. By identifying crossover fraud opportunities and aligning investigative strategies, stakeholders across the care continuum can strengthen their defenses and improve outcomes for all.

Shannon Perschy, LICSW
Senior Director, Long-Term Care Anti-Fraud
John Hancock

Kristina Mulholland, CFE, CAMS
Director, Global Investigative and Forensic Services
John Hancock