Can you get long-term care insurance if you have a history of falls?

Falls get more direct attention in long-term care underwriting than almost anything else on this site, because a serious fall is one of the single most common events that leads directly to needing long-term care. Applicants — especially older ones — are routinely asked specifically about falls in the past year or two as a standard part of the application.

How underwriters weigh a fall history

• A single fall with a clear, one-time cause (you tripped on a step, slipped on ice) and a full recovery with no lasting injury is usually manageable and often does not change the outcome.
• Recurrent or unexplained falls are a serious red flag, since they suggest an underlying balance, strength, or neurological problem rather than a one-off accident — and that underlying cause is what really concerns an underwriter.
• A fall causing a fracture — especially a hip fracture — is treated as a much more serious event than a fall alone, because hip fractures in particular are strongly linked to a subsequent loss of independence.
• Reliance on a walker or wheelchair following a fall often leads to a decline for traditional coverage, since it signals that help with daily activities may already be needed.
• Underlying causes. Falls are considered together with conditions that contribute to them — osteoporosis, arthritis, inner-ear or balance disorders, and medications that cause dizziness are all part of the same picture.

A realistic picture

• A 70-year-old who tripped once on an icy sidewalk two years ago, with a full recovery and no other falls since, is usually not meaningfully affected.
• A 70-year-old with two unexplained falls in the past year, one resulting in a wrist fracture, faces a much harder path and is more likely to be declined for a traditional policy.

Falls frequently connect to osteoporosis and arthritis, which underwriters consider together rather than in isolation.

If you are declined

A significant fall history is one of the harder situations to place with a traditional carrier. Asset-based or hybrid policies are worth exploring, and addressing fall risk directly — home safety, physical therapy, a medication review with your doctor — can improve both your safety and, over time, your insurability.

General information only. Underwriting varies by carrier and changes often, and we do not publish carrier-specific approval thresholds. Nothing here is a guarantee of coverage or a quote — only a licensed carrier reviewing your medical history can tell you what you qualify for. This is educational and not insurance, legal, tax, or financial advice.