Reasons For Disability Denials

What Is Surveillance In Disability Insurance?

Surveillance is a standard practice for insurance companies, as their ultimate goal is to deny your claim or terminate your existing benefits. To build a case against you, the insurance company will often check in on you to ensure that you’re not lying or exaggerating your insurance claim.

Perhaps you like spending time outdoors with family and friends, and you may even participate in activities and recreation. Seemingly innocent activities like riding a bike, mowing your lawn or carrying groceries, can lead to a termination of your insurance claim. Knowing what you are up against is half the battle to winning and keeping your disability benefits.

Surveillance evidence is often presented out of context and can be manipulated to prove that you are not disabled. It generally documents a quick action or moment and does not show the true nature of the activity or the detrimental result of the activity (like the ease of the activity, or pain and stiffness caused by the activity). It is also a poor indicator of your ability to return to work because it only focuses on an isolated incident, rather than your full day. For example, you may be equipped to take out the trash once a day, but that doesn’t prove that you can safely return to your heavy lifting job with your back injury.

Do insurance companies really use private investigators and other forms of surveillance to disprove claims?

Surveillance is a technique frequently used in long term disability cases, or where claimants allege disability based upon either subjective type conditions or where the objective support is not indicative of the restrictions or limitations. In long term disability claims, the insurer is willing to invest significant money to terminate or deny a potentially expensive claim. Claimants must be wary not only of their activity levels while on claim, but of any statements made to the insurer about their daily activities. Inconsistencies can be fatal to a claim: the expression "a picture is worth a thousand words" holds very true with regard to surveillance.

Is the insurance company allowed to hire an investigator to follow someone?

Surveillance requested by an insurance company and carried out by a licensed private investigator is permitted. However, there are certain ethical rules that they must follow. If you feel that you are being followed in a threatening manner, then you can report it to the police who may confront the investigator and advise them to move on. While it is legal for a private investigator to watch and document a claimant’s actions in public, they are not permitted to trespass on private property.

Is it legal for the insurance company to visit my home?

Home visits are common techniques employed by insurers when assessing disability claims. An insurance company representative, often identified as a rehabilitation consultant, will stop by either unannounced or at a prearranged time to speak to the claimant. This individual will seek to ascertain the claimant's activity level, determine whether the claimant is working, or to develop information to be used by the insurer. Caution should always be used when speaking to the insurer or its representative. Such interviews should be done on the claimant's terms, whether recorded with witnesses, or by having a confirmation of interview prepared -- all to avoid anyone distorting the information provided.

How do insurance companies conduct surveillance?

There are many different ways insurance companies conduct surveillance. If you have a public presence on social media, you are potentially being watched by your insurance company.

These companies are looking for something that indicates that you are not affected by a disability. If they see you taking part in activities like playing fetch with your dog in the backyard or picking up your children or grandchildren, they can argue that you are participating in “healthy behaviour”. They can record footage of your activities to use as evidence against you in order to deny your claim or terminate your existing benefits.

Insurance companies regularly conduct surveillance on individuals who have filed a claim for long-term disability benefits or who are currently receiving benefits. They conduct surveillance to combat fraud and avoid paying benefits by finding evidence to dispute claims.

Surveillance is used more frequently in high-benefit claims and in claims where the alleged disability is “invisible”, such as with mental illness or chronic pain claims.

Claimants should be aware that as soon as they file an insurance claim, they may be under surveillance. The question they often ask is, “Does the insurance company have the right to invade my privacy?

Insurance Company Surveillance Tactics Include:

  • Compiling video surveillance of claimant outside of their home or in public
  • Interviewing claimant’s neighbours
  • Performing unannounced “field visits” or “home visits”
  • Monitoring claimant’s online activity (social media) through social networks such as Facebook, Twitter, Instagram, etc.
  • Tailing the claimant’s car

While claimants should be cognizant of how their daily public activities may be construed by the insurance company, they should also continue to live their life as they normally would, as long as they are following their doctor’s recommendations and staying within their prescribed limitations. If a claimant has been honest about their limitations to the insurance company, they will have nothing to hide.

Tips Regarding Surveillance:

  • You Can Fight It - Always tell the truth about your disabilities from the start. Be upfront about which activities you can engage in and which you can’t; if you have a bad back but can still carry light groceries – be transparent about it. It’s important to let your lawyer or doctor know that it’s an activity you still engage in.
  • Don’t Overshare - Be wary of what you share online and on social media – you never know how that content might be misconstrued or manipulated. Re-consider standing in a photo with family and friends at your summer barbecue if you use a wheelchair.
  • Get a Good Lawyer - If you suspect that surveillance footage is used against you, stay calm and hire an experienced lawyer. Here at Share Lawyers, we can help fight if your benefits get denied or cut off. Our experienced disability lawyers will also be able to help demonstrate that the incident in question was most likely isolated and that you are deserving of continuing benefits.

Have you recently filed a disability insurance claim? Perhaps you already receive long-term disability benefits? You should know that the insurance company may be watching you!

Has your insurance company denied your claim? Contact Share Lawyers and put our experience to work for you.

We offer free consultations and there are no fees unless we win your case. Find out if you have a disability case.

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