The letter arrives every month like clockwork: the premium notice for a life insurance policy taken out decades ago. For years, it represented a promise—a safety net for loved ones. But now, with the rising costs of healthcare and the potential need for long-term care, that monthly payment feels less like a security blanket and more like a financial burden. This is a situation many West Virginia seniors face, caught between a valuable asset they can no longer afford and the pressing need for liquidity to fund their golden years with dignity.

What Exactly Is a Life Settlement?

A life settlement is the sale of an existing life insurance policy to a third-party investor for a lump-sum cash payment. This payment is more than the policy’s cash surrender value but less than its full death benefit. Think of it this way: selling your policy is like selling a classic car. The insurance company might offer you a low trade-in value (the cash surrender value), but a collector (the life settlement provider) sees its potential and is willing to pay more for it. The new owner then takes over the premium payments and receives the death benefit when the insured passes away.

It is important to distinguish a life settlement from other policy options:

• Cash Surrender Value: This is the amount the insurance company will pay you to terminate the policy. It is often a fraction of the policy’s face value.
• Life Settlement: This is a market-driven value paid by a third-party buyer. The amount is almost always higher than the cash surrender value.
• Death Benefit: This is the full face value of the policy paid to your beneficiaries upon your death. A life settlement provides a portion of this benefit to you while you are still living.

Who Is Typically Eligible for a Life Settlement?

While every case is unique, life settlement providers generally look for a combination of factors to determine if a policy qualifies for a sale. The ideal candidate is someone whose circumstances have changed since they first purchased the policy.

The primary eligibility criteria usually include:

• Age of the Insured: Most providers seek clients who are 65 years of age or older.
• Health Status: The insured person has typically experienced a change in health, leading to a shorter life expectancy than was projected when the policy was issued. This is a key factor in determining the settlement amount.
• Policy Type: Whole life, universal life, and convertible term life policies are the most common types sold. Some standard term life policies may also qualify if they can be converted.
• Policy Face Value: Providers usually have a minimum face value, often starting at $100,000, though this can vary.

How Does a Life Settlement Differ from a Viatical Settlement?

The terms “life settlement” and “viatical settlement” are sometimes used interchangeably, but they serve different populations. The distinction is a matter of life expectancy.

• A viatical settlement is specifically for individuals with a terminal illness, generally defined as having a life expectancy of 24 months or less.
• A life settlement is for seniors who are not terminally ill but whose life expectancy has been reduced due to age or chronic health conditions.

Essentially, all viatical settlements are a type of life settlement, but not all life settlements are viaticals. This distinction is meaningful for tax purposes and regulatory oversight.

Why Would a West Virginia Senior Consider a Life Settlement?

The decision to sell a life insurance policy is deeply personal, but it is often driven by immediate financial needs that outweigh the policy’s future benefit. For many seniors in West Virginia, a life settlement can be a powerful solution to several common challenges.

• Funding Long-Term Care: The primary reason most people explore life settlements. The cost of skilled nursing or assisted living in West Virginia can quickly deplete a lifetime of savings. A settlement can provide the funds needed to pay for quality care without liquidating other assets.
• Supplementing Retirement Income: When pensions, Social Security, and savings are not enough to cover living expenses, a life settlement can provide a needed financial cushion.
• Eliminating Unaffordable Premiums: As seniors age, fixed incomes can make rising insurance premiums untenable. Selling the policy eliminates this monthly expense and provides a cash infusion.
• Accessing a Higher Payout: If a policy is no longer needed—perhaps the children are financially independent or a spouse has passed away—a life settlement offers a payout that is significantly higher than the cash surrender value offered by the insurer.
• Avoiding a Policy Lapse: Instead of simply stopping payments and letting a policy lapse (which provides zero value), a life settlement allows the policyholder to recover a portion of the premiums they have paid over the years.

The Life Settlement Process: What to Expect

The process of selling a life insurance policy is regulated in West Virginia by the Offices of the Insurance Commissioner to protect consumers. While a legal and financial advisor can guide you, the general steps are fairly consistent.

• Initial Assessment: You and your advisor will review your policy to determine if it meets the basic eligibility criteria for a life settlement.
• Information Gathering: You will need to provide authorization for a life settlement broker or provider to access your life insurance policy details and medical records. This information is used to assess your life expectancy.
• Appraisal and Offers: The broker submits your case to multiple licensed buyers (providers). These providers conduct their own underwriting and, if interested, will make cash offers to purchase your policy.
• Offer Evaluation: Your advisor helps you review the offers. The decision is based not only on the dollar amount but also on the terms and conditions of the sale.
• Closing the Transaction: Once you accept an offer, you will complete closing documents to formally transfer ownership of the policy to the provider.
• Receiving Funds: The funds are typically placed in an escrow account for security. Once the insurance carrier confirms the change of ownership, the funds are released to you, and the transaction is complete.

The Critical Intersection: Life Settlements and Medicaid Planning

This is where thoughtful planning becomes paramount. In West Virginia, eligibility for long-term care Medicaid is subject to strict income and asset limits. An individual can typically have no more than a few thousand dollars in “countable assets.” While some assets are exempt (like a primary residence, under certain conditions), a life insurance policy with a cash value is often considered a countable asset.

Receiving a large lump-sum payment from a life settlement can immediately push a senior far over the Medicaid asset limit. Without a proper legal strategy in place, this influx of cash could lead to:

• Disqualification from Medicaid: The individual would be deemed ineligible for benefits they desperately need.
• A Required “Spend-Down”: The state would require the individual to use the settlement funds to pay for their care out-of-pocket until their assets are back below the Medicaid limit. This effectively negates the financial advantage of the settlement.

Protecting Both the Settlement and Medicaid Eligibility

The goal is to use the life settlement proceeds to enhance a person’s quality of life without jeopardizing their access to essential long-term care benefits. This requires proactive legal strategies designed to convert the countable cash asset into a non-countable form or to structure it in a way that complies with West Virginia’s Medicaid rules.

Several tools and strategies can be employed:

• Medicaid Asset Protection Trust (MAPT): This is an irrevocable trust designed to hold assets so they are not counted for Medicaid eligibility purposes. However, assets must be transferred into the trust well in advance of needing care to avoid penalties from the five-year Medicaid look-back period.
• Strategic Spend-Down: The funds can be used to pay for goods and services that are not counted by Medicaid. This might include prepaying for funeral expenses, making accessibility modifications to a home, purchasing a new vehicle, or paying off a mortgage and other debts.
• Pooled Trusts: For individuals with disabilities, funds can be placed into a pooled special needs trust managed by a non-profit organization. These funds can be used for supplemental needs without affecting benefit eligibility.
• Gifting Strategies: While direct gifting can trigger penalties, a carefully structured gifting plan, implemented well ahead of the need for care, can be part of a larger asset protection strategy.

The correct strategy depends entirely on the individual’s health, family situation, and the timing of the life settlement. This is not a do-it-yourself endeavor; the rules are complex and unforgiving.

Tax Implications of a Life Settlement

A common question is whether the proceeds from a life settlement are taxable. The answer is that they can be, and the tax treatment is complex. The American Taxpayer Relief Act of 2012 clarified the tax rules, which generally break the proceeds into three parts:

• Tax-Free Portion: The amount you receive up to your “cost basis”—the total amount of premiums you have paid into the policy over its life—is generally returned tax-free.
• Ordinary Income Portion: Any amount you receive that is above your cost basis but less than the policy’s cash surrender value is typically taxed as ordinary income.
• Capital Gains Portion: Any amount you receive above the cash surrender value is taxed as a capital gain.

Because of this complexity, it is important to consult with both a qualified legal advisor and a tax professional before finalizing a life settlement.

Navigating Your Options with Confidence

The decision to part with a life insurance policy is never easy. It involves weighing a future promise against a present, often urgent, need. Financial tools like life settlements introduce new possibilities for funding long-term care and achieving financial stability in later life, but they exist within a complicated legal and financial framework. For West Virginia families, making an informed choice requires a clear view of the opportunities and a solid plan to navigate the risks.

The principles of elder law planning are designed to protect your assets, preserve your legacy, and ensure you receive the care you need. If you are a West Virginia resident exploring ways to fund long-term care or manage an unaffordable life insurance policy, taking the time to seek knowledgeable guidance is a critical first step. Contact Hewitt Law PLLC today to schedule a consultation. Our team is dedicated to helping West Virginians develop comprehensive strategies that provide for their future well-being and protect their hard-earned assets.