LTC Bullet: ILTCI 2026 Virtual Visit

Friday, April 3, 2026

Seattle—

LTC Comment: ILTCI ’26 was another successful industry convocation. This “virtual visit” to the conference is intended to give those who could not attend a sense of what it was like and to encourage them to consider attending in the future. It follows the ***news.***

*** HAPPY BIRTHDAY to the Center for Long-Term Care Reform. We completed our 28^th year on April 1, 2026. Check out the Center’s many state- and national-level policy studies here. Read dozens of published articles here. Speeches, here. Review hundreds of LTC Bullets, organized by topic and chronologically, here. This is how we announced our mission in “Center for Long-Term Care Financing Established; "LTC Bullets" Opening Salvo”: “The Center will advocate public policy that targets scarce public resources to the neediest, while encouraging people who are young, healthy and affluent enough, to take responsibility for themselves. We believe that private insurance and investment can guarantee quality long-term care for prosperous seniors and help to save the Medicaid long-term care program for the truly needy. The Center will offer a range of fee-for-service products to public and private clients including consulting, publishing, training and public speaking.” It’s been a great run and it will continue as long as we have your support and collegiality in our common mission to improve long-term care for all Americans. ***
 

LTC BULLET: ILTCI 2026 VIRTUAL VISIT

LTC Comment: The 2026 Intercompany Long-Term Care Insurance Conference convened March 8–11, 2026 in Orlando, FL at the Rosen Shingle Creek Resort. The meeting’s theme this year was "Dream… Design… Deliver: Reimagining the Future of LTC.” Conference chair, Gina Besz from “illumifin,” opened the proceedings. She told the 1000-plus attendees what to expect, thanked the organizers, presenters and sponsors, and disclosed (always a topic of great interest) the city hosting next year’s conference: Indianapolis, March 14-17, 2027. She also surprised us by sharing where the meeting will convene the following year: Houston, April 2-5, 2028.

Next came announcement of the ILTCI Recognition Award recipients for 2026. This award “honors the trailblazers, innovators, and lifelong contributors advancing long-term care insurance and shaping the future of aging in America.” Steve Serfass, Partner, Faegre Drinker Biddle and Reath, LLP, received the individual award. Two companies shared the organization award: Lincoln Financial and One America. Congratulations to these award recipients for their many years of dedication and hard work in our common mission to improve long-term care for all Americans.

Jeff Noel, a 30-year Disney Leadership veteran, sponsored by NGL, keynoted the conference. He's the author of “Mid-Life Celebration” and hosts the podcast “If Disney Ran Your Life.” Noel captivated the audience with stories and theories bearing on leadership excellence, employee engagement, customer service, brand loyalty, creativity and innovation. Always do “just a little more than what the customer expects.” Go the “extra inch” not just the last mile. Their standing ovation demonstrated the audience’s appreciation of his remarks.

The exhibit hall is a highlight of every ILTCI meeting. It is where attendees convene to eat, drink, visit exhibitors and network. I missed the opening exhibit hall reception Sunday night due to flight complications, but I attended the breakfast, lunch, and late-afternoon sessions on the remaining two days. To meet, greet, confer, pitch, negotiate and generally do business of any kind in the LTC insurance industry, there is nothing like the ILTCI conference with its exhibit hall and the ample opportunities to connect in the hallways as well. Be there next year in Indy if you can.

After Monday morning’s announcements and keynote address, the conference turned to breakout sessions. These included presentations on seven different subject tracks:

• Sales, Marketing, & Distribution: Focused on consumer engagement, expanding into middle-income markets, and distribution trends.
• Actuarial & Finance: Covered topics such as AI in actuarial work, asset-liability management, and in force management.
• Management & Operations: Addressed operational excellence, technology adoption, and call center evolution.
• Wellness & Aging in Place Solutions: Explored innovative services, technologies for aging in place, and AI/robotics in care.
• Claims & Underwriting: Focused on accelerated underwriting, electronic health records, and fraud detection.
• Legal, Compliance & Regulatory: Covered regulatory changes, compliance issues, and legal developments impacting LTC insurance.
• [Track Name Varies - General/Future Trends]: Covered broader industry topics, such as the future of LTC and caregiver crises. 

It seems like themes run through the ILTCI conferences for years at a time. I noted the focus on wellness in LTC Bullet: Virtual Visit to ILTCI 2023. Emphasizing wellness and doing more for policyholders than simply processing and paying claims remains a strong conference theme. But it seemed to me that at the 2026 program fraud identification, control, and mitigation took a new and bigger role. That topic especially interests me as fraud is soaring right now in public programs like Medicaid and Medicare. So you’ll see in what follows that I covered several breakout sessions aimed at the topic of fraud.

It’s worth noting that another theme, prominent in earlier ILTCI meetings, has disappeared. That is the public policy context in which the LTC insurance industry operates. Medicaid is the predominant payer for LTC in the USA. It crowds out private LTC insurance by desensitizing the public to LTC risk and cost leaving private LTC insurance with a small residual of the market. Yet Medicaid was barely mentioned at the 2026 conference. Even state experiments with public LTC financing such as WA Cares in Washington State and the latest proposal for a national LTC financing program, WISH, were mostly ignored. Of course, I wasn’t in every session, so maybe there was public policy content I missed, but with no track dedicated to the subject as in the past, its importance has clearly declined.

First Breakout Monday, March 9, 2026, 10:45am
Track: Legal, Compliance & Regulatory
Title: The Fraud Escape Room Experience: LTC Edition
Description: Step into the world of long-term care insurance fraud investigations—like you’ve never experienced before. This interactive session combines real-life case studies with an escape-room-inspired twist. Our expert panel will guide you through actual fraud investigations from across the country, highlighting the tactics and techniques used to uncover and stop bad actors. But beware: after each case, you’ll receive a cryptic clue left behind by a fictional mastermind who may be orchestrating these schemes. Are these cases truly unrelated, or is someone pulling the strings from the shadows? Work together to solve riddles, connect the dots, and uncover the truth before time runs out. Join us for a session that educates, entertains, and challenges your investigative instincts—because in this room, every detail matters.
Moderator:
Matt DeLong, illumifin
Presenters:
Tara Dickson, Cozen O'Conner
Adam Haque, John Hancock
Tom Kakos, illumifin
Matt Keeling, Unum
Comments: This program blew me away. I had no idea fraud was so rampant in private LTC insurance, nor did I know anything about the highly creative efforts carriers are employing to identify, prove, and control fraud that these speakers shared. They described three case studies, each of which was nearly beyond belief. They told of policy holders who claimed severe need, got approved, but were then shown to be fully capable of doing all the ADLs they claimed to be unable to manage. Arrogant and brazen, the fraudsters evaded being caught until they were shown to be out of compliance by clever methods described by these presenters. Such techniques included desktop investigation, searching social media, unmanned surveillance, tracking travel and many more.

Here’s just one of the anecdotes they shared. Married couple on claim since 2023. Both filed and approved for similar conditions. Tax qualified policies. Both had $380 per day home health unlimited lifetime. Both claimed they needed assistance with five out of six ADLs. Neither claimant had precipitating event. 12 hours a day 7 days a week for husband. 16 hours for wife. On claim same year. Documentation issues. Desktop investigation. Social media. Husband was sole owner of home care agency. Both reported not driving, using cane. Too consistent. Handwriting gave them away. The same individual did all the documentation. Extremely clever in how projected. Reviewers struck gold in social media, found something interesting. Extensive overseas trips while on claim, including Spain, Portugal, Puerto Rico, California. How could they do that while on claim? Are caregivers actually showing up? Got video taking trash out with no trouble, walking with no cane. Wife shopping loading, stuff in vehicle. All while claiming many hours of care. All activities while caregiver supposedly providing care. Did 15 days of surveillance. Never saw a single caregiver come. Interview. Time to talk to claimant. What did you do today, yesterday? Called and talked to husband. Insisted both need claims, can’t leave home without caregiver. Are caregivers present? Yes, but just stepped out to get lifesaving medications.

Showed him all documents, pressed further, eventually admitted he created all the documentation including the claims. Said took caregivers along on international trips. Should be records of this. Showed clips of him and wife moving independently. We’re always in pain, they said. Where are your caregivers? Biggest turn of investigation. Caregivers returned from errands. Did not see anyone from our surveillance. No photo IDs. Husband answered all their questions. Week later, called husband back. He admitted in Philippines. Who were those individuals claimed to be caregivers? Just locals from Philippines. Case outcomes. Both claims reviewed by medical staff. Claims closed. Fraud, waste and abuse reported to Dept. of Insurance. Settlement reached. Surrendered both policies and made some repayment.  

Second Breakout, Monday, March 9, 2026, 2pm
Track: Legal, Compliance, & Regulatory
Title: Inside the Jury Box: An LTCI Mock Voir Dire, How Everyday Consumers View LTC Insurance
Description: What do everyday consumers really think about long-term care insurance—and how might those views shape the outcome of a trial? In this interactive session, we’ll stage a mock voir dire (jury selection) to explore how potential jurors respond to key concepts like policy language, benefit triggers, and product design. Participants will observe and engage with the process as attorneys question mock jurors, uncover biases, and strategize selections. Beyond the courtroom drama, this session offers a rare opportunity to hear unfiltered consumer attitudes toward LTC insurers, coverage expectations, and claims disputes. Whether you're in legal, compliance, product, or risk, you'll walk away with a deeper understanding of how your decisions may be interpreted by a jury—and how to prepare for it.
Moderator:
Gina Fortin, Unum
Presenters:
Matt Kops, Blueprint Trial Consulting
Chris Petillo, Faegre Drinker
Michael Rafalko, Cozen O'Connor
Comments: Clever idea. Attorneys for the plaintiff and the defendant interviewed “jurors” playing various roles to represent different kinds of consumers. Jurors bring experiences, attitudes/values and personalities to court. A “jury consultant” commented on the process of selecting or rejecting jurors in the voir dire process of a trial. All 9 jurors interviewed by both attorneys based on a hypothetical complaint fact pattern. Each attorney eliminated three jurors based on brief 4-minute interviews leaving three of the nine empaneled. The session used audience polling. The idea was to tease out consumer attitudes about LTC insurance, but the jurors were all people in the business. So I’m not sure that objective was achieved. But the session definitely invited consideration of complex ideas and attitudes about the product.

Third Breakout, Monday, March 9, 2026, 3:45pm
Track: Wellness & Aging in Place Solutions
Title: Imagineering Aging with a Gen Z Advocate: Promising Models and Interrogational Collaboration
Description: In this fireside chat led by Gen Z advocate Arielle Galinsky, we'll explore bold ideas for aging-in-place, LTC policy reform, and the importance of multigenerational collaboration. Arielle brings her deep passion on all things aging & LTC as well as her commitment to advancing aging policy reform at the state and national levels. From her research and experience, she will lead insightful conversation on 1) why aging needs to be an intergenerational conversation, 2) what we can learn from international aging models and policies, 3) and what policymakers need to know to make this vision a reality. Get ready for an energizing conversation that brings a fresh, forward-thinking perspective on aging.
Speakers:
Cailyn Canty, Davies
Arielle Galinsky, The Legacy Project, Inc.
Comments:
This session was intended to bring to light the innovative perspectives of a Gen Z influencer. The principle speaker, Ms. Galinsky, was articulate and knowledgeable. Her views were grounded in personal experience. She became a Certified Nursing Assistant (CNA) to understand better the challenges of caregiving. Very thoughtful, but I discerned little unique perspective from the younger generation. She seemed to be saying what older generations are also saying with little new analysis. A promising wrap up to the conversation was promised. But it amounted to referencing states that have proposed new policy models like WA Cares. What is one thing we can all do? Support the WISH Act; advocate for it. This is not fresh thinking, only restating the current public policy thinking, such as it is in the LTC insurance business.

2^nd day March 10, 2026, 9am
Track: Claims and Underwriting
Title: The Current Anti-Fraud Landscape: Industry Insights
Description: Join leading experts as they share how carriers are currently viewing and addressing fraud. This session will dive into the latest industry survey findings, examine innovative approaches to fraud mitigation, and explore effective models for managing fraud, waste, and abuse (FWA). Attendees will gain valuable perspectives on current challenges and best practices to safeguard the integrity of LTC claims.
Moderator:
Roy Christenson, ERAC
Speakers:
Jeff Ferrand, illumifin
Jessica Loesing Gallagher, Faegre Drinker
Tom McManama, PwC
Comments: Fascinating session. Fraud recognized as a problem 20 years ago, but over the past 10 years it has really taken off. No longer lost in a claims “black box.” Fraud identification and control is getting more sophisticated. Rapid acceleration of technology. Trying to leverage it. Fraud thought to affect other business lines, but now seen to hit LTC insurance too. PwC Anti-Fraud Survey showed 6 to 8% of claims have fraud. $1.3 billion. By 2030 Milliman found $25 billion claims in four years. So $2.5 to $3 billion in fraud. “We are all fraud ambassadors now.” Much higher for home health care than these estimates that are across all products. What is most common type? Claimant and provider fraud and combination, collusion. Not eligible at start or became not eligible but stayed on claim. Provider bills where not providing care. Skimming. Charge for more and pocket some. Easier to investigate home health care (HHC) so tend to start there. Facility fraud has lot of checks and balances. Vulnerability in billing practices. Little prosecution of fraud. Prosecutors focus on bigger fish, like Medicare and Medicaid. The Centers for Medicare and Medicaid Services (CMS) are only now beginning to search for and control fraud that runs rampant in public programs but receives little attention from states that reap a bonanza of federal funding.

2^nd day March 10, 2026, 10:45pm
Track: Management & Operations
Title: AI Fakes and Real Risks: Securing Long-Term Care Systems from Manipulation
Description: As deep fake technology becomes more sophisticated, the long-term care industry faces new threats to operational integrity and patient safety. This session explores how AI-generated falsifications can impact critical areas such as HR, policy administration, and claims —posing risks to claims processing and regulatory compliance. We’ll examine real-world scenarios, discuss detection strategies, and explore how organizations can safeguard against manipulation while maintaining trust and accuracy in their data systems.
Producer (non-participant):
Paul Marquez, Diligence International Group, LLC
Speakers:
Karen Babio, Davies
Kevin Glasgow, Diligence International Group
Comments:
Overview: Fakes not new, old theme, me toos, art of deception. AI to create fakes, creating synthetic identities, tech and tools; is your insurer ready? Most people are honest but some aren’t. Out there to defraud in any way they can. Have to be careful because there are bad actors. What is a deep fake? Universal studios pioneered computer generated voice or image to look real. Systems learn from each other improving deep fakes. Trojan horse. New tools lowered cost and skill needed. Art of deception: cognitive biases, shortcuts, emotional influence, social trust, cooperation, cognitive overload tendencies for over confidence, expertise gaps. They only have to be right a small percent of time. Criminals targeting. Awareness gap. Tech gap. What’s changed? Presenters created the introductory fake very easy, low level. No tech training. Very low cost to create avatar. Could have done anyone in the room.
“Catch me if you can”: movie. Impersonations. Major insight: Change in attitude toward nonviolent crime. Younger generation much more accepting of profiting from nonviolent crime. Consider in context of home health fraud. Effect on jury pools.
Fakes are nothing new. Just new tech doing more things. Voting on which images real. About random chance. Better at finding video fakes.
Using AI fakes to make better, smarter, faster. Phishing, spear phishing (targeted), vishing (video phishing), smishing (using fraudulent texts). Counterfeit compliance certs insurance certificates.
Financial records, invoices paystubs, utility bills tax form, fake ID documents.
Possible imposter originated scams initiators and facilitators: family members, people in position of trust, insurance community members, human traffickers, organized crime groups, paramedical examiners, attorneys, brokers, investors. Getting more organized.
Has your organization any training for deep fakes? What kind?
Apply for credit over and over again. Loyalty information. Gradually create identify. Get higher and higher credit rating. Fictitious person. Continue to “ripen” ID until accepted.
AI fraud surges 195%. AI arms race. Synthetic identities. $30 billion in life insurance industry annually.
Companies need to think more like banks.
Threat actors always out there. Attitude shapes moral compass against insurers. Insurance has a high ROI. Organized crime funding has entered the fray.
SIFT: Stop, investigate, find, trace to original source. 

2^nd day March 10, 2026, 2pm
Track: Management & Operations
Title: Inside the Mind of a Hacker: Cyber security Threats and Defenses in Insurance
Description: Join an ethical hacker for a behind-the-scenes look at how cybercriminals are evolving - and how AI is reshaping the cyber security landscape. Through real-world examples and expert insights, this session reveals common vulnerabilities, emerging AI-driven attack methods, and practical defenses. Learn how cyber security impacts your business - and walk away with actionable strategies to protect your organization from the risks of an AI-enabled threat environment.
Moderator: Christie Conway, Wellcove
Speakers:
Kalin Kelly, Continental General
Tom Liston, Bad Wolf Security
Comments: AI is not experimental, it’s in the wild. Changing rules for defenders and offenders. What is AI? Systems that find patterns, massive data sets, on internet. Lots of knowledge. But dark side. Models mimic understanding brilliantly. But they don’t reason. Excel at static prediction not logical deduction. Content generation, code assistance, customer service, and everything else. Private investment in generative AI soaring. $34 billion, up 19%. Limits of today’s AI, not necessarily going to get same output every time. May confidently present but it is wrong. Not responsible for anything. Falls on humans to control. 4.4% 2023 performance 71.7% 2024 performance. AI coding capability has gone explosive in growth. Hackers faster, defenders smarter. Fraud pattern detection. Synthetic employees, when agents talk to agents. Undercurrent. Sub layer underneath humans. Unmonitored. Could proliferate bad information. Driven social engineering. Excellent impersonalization. Video calls. Texts. Email. Phone. Fake documents. Executive impersonalization. Uncomfortable truth. What companies doing. Not a lot. 78% use, 40% mitigate risk, 37% have governance. Adoption has exploded, but governance last.
97% no access controls, 63% no governance. Average global breach cost: $4.4 million.

Tom Liston: I’m a thief. Broke into banks and much else. 60% of firms suffered data breach; 277 days to discover a data breach; Overall 93% resulted in an external attacker gaining internal network access. He set out to find one compromised business per day. Found 500. Very easy. Who? Small to medium business, large well-known companies, government organizations; universities. Solutions: Treat network as if it is compromised; Limit damage attacker can do, network security basics not magic black box. Use multi-factor identification. Monitor closely.

2^nd day March 10, 2026, 3:45pm
Track: Claims & Underwriting
Title: Game On: Integrating FWA Programs into the Claims Process - A Chutes and Ladders Experience
Description: Join us for an engaging and interactive session that brings the classic board game Chutes and Ladders to life. This dynamic experience combines audience participation with practical insights, guiding you through the highs and lows of integrating FWA programs into the LTC claim process. Each “move” on the board represents real-world examples, challenges, and opportunities - including emerging technologies, digital controls, smart workflows, and human insights. Led by seasoned claims executives and an experienced trial attorney, this session goes beyond theory—offering actionable strategies, risk mitigation tips, and legal perspectives that matter. Whether you climb the ladder of success or slide down a chute of unexpected complications, you’ll leave with a deeper understanding of how to stay ahead in today’s evolving long-term care claims landscape.
Moderator:
Jane Bagley, Fuzion
Speakers:      
Andrew Azarmi, Dentons
Laurene Polignone, John Hancock Financial Services
Kristen Sewell, Continental General
Comments:
Series of scenarios offered. Then vote on whether fraud or not. Go down a chute if wrong; up a ladder if correct. In the middle, I noted “So far all examples obvious.” Andrew, the attorney, comes at it from a different perspective. Lawyer, not insurance company. Lessons learned. Facts in claims can become questionable. Policyholder appeals claim denial. Submits signed letter from primary care physician Dr. Feelgood. Under his care. Suffers cognitive impairment. Needs assistance with several ADLs .You verify Dr. Feelgood is a board certified MD. Video surveillance over 5 days reveals policyholder is walking, driving, entering/exiting sedan, rolling 2 large trash cans from curb up sloped driveway into garage. Picking up dry cleaning while talking on cell. Entering and exiting Pilates studio. Answer: Time review. 

3^rd Day, March 11, 2026, 8:30am
Title: Alzheimer's Association: Explore Cutting-edge Developments in Brain Health, Diagnosis, and Treatments
Description: Learn how lifestyle interventions can reduce the risk of cognitive impairment, how blood-based biomarkers are enabling earlier, more accessible Alzheimer’s diagnosis and advancements in treatments. The second half of this session will provide a comprehensive overview of rapidly moving innovations within dementia care specialty models including both Medicare and Medicare Advantage funded approaches. The impressive early clinical and cost savings outcomes and how LTCI specifically might take advantage in the short-to-mid-term. Discussions will include an overview of the Dementia Care Navigation Service, powered by Rippl and the Alzheimer’s Association, which has shown promising results including a 30% drop in emergency department visits and a 15% reduction in hospital admissions through personalized, proactive support aligned with Center for Medicare and Medicaid’s GUIDE Model.