A home care agreement is usually read for its rate terms and visit schedule, but the paper that decides who pays when something goes wrong sits in a different folder. An agency's insurance certificate is a short summary issued by the agency's insurance agent. It is not the policy itself. The certificate tells a family which coverage the agency says it holds, the company that issued it, the policy period, and the limits. The policy wording governs what is actually covered, so a family reviewer should check the summary against the signed agreement and ask for the policy language whenever the summary leaves a question open.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Match the names first

The named insured on the certificate has to be the same legal entity that signs the agreement. Agencies often operate under a trade name that differs from the registered company name, and a parent company may hold the insurance while a subsidiary employs the aides. Compare the name on the certificate, the name in the agreement signature block, and the name on the agency's invoices and visit notes. If the three names differ, ask the office to explain in writing which entity employs the aides who enter your home and which entity carries the coverage for them.

Read the dates and the lapse plan

Check the policy period on the certificate against the start date of the agreement. A certificate that expires during the early months of service is a scheduling problem, not a formality. Ask how the agency notifies clients when a policy renews, whether it sends a fresh certificate at each renewal, and what happens to the service schedule if a policy lapses before the new one is issued. Keep the answer in the folder with the signed pages.

Coverage lines that matter in a home

Coverage types are not interchangeable. Ask the office which of the following it carries and whether each one appears on the certificate:

  • General liability, which responds to injury or property damage caused in the home.
  • Workers' compensation, which responds to an injury to an aide while working in the home. Ask whether the agency's policy is the first place a claim goes, and whether the family's own homeowner or renter policy has a notice requirement the family should know about.
  • Auto coverage, if any aide drives the client to appointments or errands in a personal or agency vehicle.
  • Bonding or fidelity coverage, which speaks to theft or misuse of property by staff, including keys, cards, cash for errands, and household items.

Ask for the coverage limits, not only confirmation that coverage exists, and ask whether any limit is shared across all of the agency's clients.

Questions for the office

  • What is the legal name of the company that employs the aides, and which company is the named insured?
  • Who issued the certificate, and can the insurance agent send it directly to the family?
  • Does the policy period cover the whole agreement, and when is the next renewal?
  • Which coverage types are in force, and what is the limit for each?
  • Is bonding or fidelity coverage in place for staff who hold keys or handle household items?
  • Who files a claim after an injury inside the home, and how soon must the family report an incident?
  • Will the agency provide the policy wording for any coverage the family wants to read in full?

Verify the certificate yourself

Ask for the certificate to come from the insurance agent by email, not only as a file forwarded by the agency's own office. Then call the agent using the number on the agent's own business listing rather than a number printed on the certificate alone. Ask the agent to confirm that the policy is in force and that the agency is named on it. A certificate handed over during a sales meeting is a starting point. A confirmation sent by the issuing agent is the check.

What to file with the agreement

Keep a dated copy of the certificate, the agency's legal name and address, the policy period, and the name and phone number of the issuing agent in the same folder as the signed agreement. Note the date the certificate was received. When a renewal certificate arrives, replace the old copy and compare its named insured and limits against the first one. A change in either is a reason to request a written explanation from the office before the next visit.

When the paper and the household do not match

Check whether the certificate names the agency for the services listed in the agreement. If the agreement covers errands, personal care, or overnight coverage, the certificate should not describe a narrower business. Check the service address as well, since some certificates list a branch office rather than the household. A mismatch between the paper and the service the family is buying is the first thing to resolve, because the paper determines which claims can be made.

This guide is a checklist for reading the paper. It is not legal or insurance advice. For a reading of the wording in a specific policy, the family can ask the insurer that wrote the policy or a lawyer of its own choosing. The local area agency on aging or the county senior services office can also point to general questions families raise when they review home care paperwork.

For the supply side of the same decision, see Finding help where the supply is thinnest.