The connection between employing a carer or a foreign care worker and a long-term care insurance claim: why the employment itself strengthens the file, which documents to keep from day one, what changes between a fixed-sum and an indemnity policy, and the mistakes that cost money.
If there is already a carer at home, there is probably something to check
A family that has reached the point of employing a live-in carer or a foreign care worker has already passed the stage where there is any doubt that help is needed. That decision arises from a real and continuing need.
And yet a large proportion of those families have never checked whether a long-term care policy exists. They pay out of their own pocket, sometimes for years, without knowing there may have been an entitlement to a monthly benefit that offsets the cost.
It should be said plainly: employing a carer does not by itself create entitlement. Entitlement is determined by the definition in the policy — dependence in daily activities or a need for supervision. But it is a strong sign that checking is worthwhile, and it is supporting evidence when documented properly.
Why the employment strengthens the file
In a long-term care claim the insurer examines one central question: how far the person depends on the help of others. A family employing a paid carer supplies a factual, corroborated answer to that question.
It is stronger than a verbal description. "She needs help showering" is a sentence; an employment contract for a carer who is in the house eight hours a day, with payslips over two years, is a documented fact.
So in precisely these cases it is a shame to settle for a general description. It is worth detailing exactly what the carer does — not "helps", but washes, dresses, feeds, transfers from bed to chair, accompanies to the toilet, stays overnight.
- A breakdown of the activities the carer performs, one by one
- The scope of hours and whether there is a night-time presence
- When the employment began and what preceded it
- Whether the scope has grown over time and why
- What happens during the hours or days when the carer is not there
The documents you must keep from day one
This is the point it is most costly to miss. If the policy is an indemnity policy — meaning payment is tied to proven expenditure — the supporting documents are not a nice-to-have, they are a condition.
Many families discover this late, after a year or two of employment during which they paid in cash, kept no payslips or never drew up a proper contract. Reconstructing expenditure retroactively is usually impossible.
Even where the policy is a fixed-sum one and no supporting documents are required, the record is still worth having — it evidences the extent of the need.
- A signed employment contract, including the scope of hours and duties
- Payslips and payment confirmations across the whole period
- Employment permits and confirmations from the Population and Immigration Authority, where a foreign worker is involved
- Receipts for payments to an agency or care company, if one is used
- Documentation of changes in the scope of employment over time
A foreign worker, the care benefit and the permit
It is important to separate three matters that are constantly conflated. The first is the permit to employ a foreign care worker — a process with the Population and Immigration Authority, with its own conditions.
The second is the long-term care benefit from National Insurance, which can include a component of care hours. In certain cases the benefit may be used towards employing a carer, in accordance with the current rules.
The third is a long-term care insurance claim against an insurer or a health fund — an entirely contractual route. These are three separate processes, and approval in one does not bind another. Conversely, the documents gathered for one usually serve the others as well.
Fixed sum or indemnity: what it changes when there is a carer
Under a fixed-sum policy, if the claim is approved the stated amount is paid — regardless of what you paid the carer. If your outlay is higher than the benefit, the gap stays with you; if it is lower, the difference stays with you too.
Under an indemnity policy the picture is different. Payment may be limited to the expenditure proved, and sometimes to a ceiling that has been set. Here keeping supporting documents is not a recommendation but a necessity.
So this is the first question worth asking the insuring body: which type of cover is it. The answer completely changes what needs to be collected and when.
Mistakes that recur and cost money
From experience with families who employ carers, there is a clear pattern of avoidable mistakes.
- Paying in cash with no record over a period of years
- Employing someone without a written contract setting out the duties
- Never checking whether a long-term care policy exists before the employment began
- Describing it generally as "help at home" instead of detailing the activities
- Not updating the insuring body when the scope of employment grows substantially
- Waiting years before checking entitlement, which makes the start date hard to establish
Frequently asked questions
We employ a carer — does that mean we are owed a benefit?
Not automatically. Entitlement is determined by the definition in the policy — dependence in daily activities or a need for supervision. But the employment itself is a strong sign that checking is worthwhile, and it is supporting evidence when documented.
Which documents should we keep when employing a carer?
A signed employment contract, payslips and payment confirmations, permits and employment confirmations where a foreign worker is involved, and receipts from an agency or care company. Under an indemnity policy these are a condition of payment.
What is the difference between a fixed sum and an indemnity when there is a carer at home?
A fixed sum pays a set amount regardless of expenditure. An indemnity may be limited to the expenditure proved, which makes keeping supporting documents essential.
Does the care benefit cover employing the foreign worker?
The care benefit may include a component of care hours, and in certain cases it can be used towards employing a carer under the current rules. That is a separate route from an insurance claim.
We paid a carer in cash for two years — can we still claim?
You can check, but the absence of supporting documents is a particular difficulty under an indemnity policy. Start documenting immediately and establish which records do exist — bank transfers, messages or a contract.
Do we need to update the insurer when the scope of employment increases?
Where there is a material change in the condition or in the extent of help, it is worth documenting it and sending a current record through the official channel, attached to the existing claim number.
Official sources for further checking
This is general information and does not replace personal medical, legal or insurance advice. Eligibility is determined by the documents and rules that apply to each case.
