When her sister suffered a massive stroke 14 years ago, then lost her house and assets in trying to pay for nursing home care, Anne Donner vowed that the same would never happen to her.

"You get that fear in you," she said, a fear of destitution, of becoming a burden. So the Bridgeville woman began paying on a long-term care insurance policy, which promised to cover a certain percentage of the nursing home tab if she became unable to care for herself.

The policy, purchased through Transport Life Insurance in 1993, was later acquired (along with the rest of the company) by Conseco Senior Health Insurance, whose parent, Conseco Inc., is now the subject of a vague Congressional inquiry into allegedly "unfair and deceptive" business practices.

Ms. Donner's policy seemed, at the time, a good bet -- she'd pay a few dollars a month, and if she ended up needing long-term care, the policy would pay out up to $70 a day. But Conseco, before its 2002 bankruptcy, lobbied the state Insurance Department here and elsewhere to approve higher and higher premiums, having underestimated the long-term costs of nursing home care. And Ms. Donner, 87 and living on Social Security, now pays $134 a month in premiums, $1,600 a year.

"Now," said Ms. Donner, "I can hardly afford it."

There are plenty of reasons that financial advisers and attorneys tell seniors to do their homework before investing in long-term care insurance: high expense, uncertain payout and, in some cases, a burdensome claims process that can be hard to navigate.

It's harder, reported the New York Times, with some companies than with others. Conseco, its affiliate Bankers Life, and Penn Treaty all have abnormally high complaint rates nationwide with regards to their long-term care insurance policies. Both customers and insurance company employees describe a worst-case scenario in which the carriers purposely stall paying claims, or deny the claims, to save money.

The same holds true in Pennsylvania, which generates dozens of complaints for Conseco and Penn Treaty each year. In 2006, for example, Conseco's Senior Health Insurance division received 63 complaints from Florida, 50 from California and 47 from Pennsylvania, according to the National Association of Insurance Commissioners. In 2005, Pennsylvania led all states with 61 formal complaints; it was the same story in 2004, with 42 complaints.

Each year, the vast majority of complaints involve the long-term care coverage, says the NAIC, which tracks the number of complaints as well the nature of them. In 2005, for example, Penn Treaty earned a total of 32 Pennsylvania complaints -- 22 of them about long-term care. Unaffordable premiums, cancelled policies, payment delays and denials of claims are the most common gripes, NAIC reports.

Insurers, meanwhile, have sprung to their own defense -- many of the problems come from a handful of companies and stem from years-old, badly written policies. Newer policies are better-written, and the biggest underwriters of long-term care policies -- John Hancock, Genworth Financial and MetLife -- are well-capitalized, with a broader risk base, they say.

"Obviously, there have been problems with those few carriers," said Mark Wardell, who sells coverage in Tennessee for Long Term Care Financial Partners. But that was "more of a pricing problem. The pricing models that have been worked out by the major carriers in the last three to five years" should help cut down on consumer complaints and the companies' financial difficulties.

The Congressional probe and the Times article both come as the government is trying to reduce entitlement costs by encouraging states to change long-term care insurance and Medicaid eligibility rules.

For example, if someone bought $150,000 in long-term care insurance, which would pay for nursing care or in-home care in certain circumstances, he or she theoretically could shelter up to $150,000 of assets in the event that Medicaid was asked to take over for long-term care. Usually, to be eligible for long-term care under Medicaid, you'd have to spend down your assets, emptying savings and selling property -- a process known as "estate recovery."

Pennsylvania took its first steps toward authorizing these partnership policies this month, when the Legislature directed the Department of Welfare to rewrite its regulations.

The point of the incentive is to prod middle-class consumers to enter the long-term care market, transferring a portion of the expense of care from the government to the private sectors -- a move that could be essential since the care of America's Baby Boomers figures to be one of the biggest drains on federal and state budgets in coming years. Advocates say the long-term care provision of the Deficit Reduction Act will save billions over the next decade -- skeptics say the savings figure is dubious.

Only 8 million Americans -- 9 percent of the roughly 90 million over the age of 50 -- have long-term care policies, which is one reason regulators haven't paid much attention to this sector of the insurance market to date. Many carriers offer the coverage, but most don't push it -- six companies control 70 percent of the long-term care premium money. (In Pennsylvania, 36 carriers are allowed to offer long-term care insurance.)

But as insurance carriers begin to market the policies more aggressively, taking advantage of the tacit federal approval and the asset-protection partnerships being authorized from state to state, long-term care policies will be featured on the menu of options being considered by seniors as they prepare for their retirements and Golden Years.

The question is, though, is the payoff worth the investment?

Kimberly Dayton says no.

She's an attorney specializing in elder-care issues and a professor at the William Mitchell College of Law in St. Paul, Minn. Statistics gleaned from a 14-year, four-state pilot project show that only 2 percent of people who bought "partnership" policies -- the kind with the asset-sheltering benefit attached to it -- needed to access their long-term benefit at all.

There are other options, said Pittsburgh-based investment adviser Christian Halas. One is a hybrid policy that mixes life insurance and long-term care benefits -- if you end up needing long-term care, the benefit will pay for that. If you don't, it's a standard death benefit that can be passed on to heirs.

You can also see if your employer offers group-rate long term care insurance.

As for people like Ms. Donner, who questions whether she should continue paying on a policy she can't afford, there's always the option of dropping the coverage. Many policies have non-forfeiture clauses, meaning you can't cash out as you might with a life insurance policy, but you'd receive at least a portion of your originally stated benefit, should you someday need care.