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The Truth About Insurer Surveillance
26January 18

The Truth About Insurer Surveillance

insurer surveillance New JerseyInsurance companies frequently hire private investigators to monitor disabled workers. Sometimes, surveillance footage is used to deny or terminate disability benefits. Frequently, the footage is taken out of context and its weight is disputable. If you think you are under insurer surveillance, it is important that you understand the impact of surveillance footage and your legal rights.

Why Do Insurance Companies Spy on Claimants?

Insurance companies are highly skeptical of disability claimants. If your claims examiner questions your credibility or thinks you may be malingering, he or she may hire a private investigator.  

Insurer surveillance footage on a “good day” can damage your credibility and result in a denial of benefits. Many chronic conditions wax and wane. Other times, a disabled worker may fight through symptoms to meet family obligations (like attending a child’s school or a sporting event).

Surveillance is particularly common in claims that involve self-reported or subjective complaints (like fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome claims). These conditions cannot be diagnosed through fact-based, diagnostic testing — and claims examiners frequently see these diagnoses as a “red flag.”

You also may be monitored by a private investigator if you have a high-value disability claim. Insurance companies do not like paying out benefits — and as your costs increase, your claims examiner may try to discredit you.

What Surveillance Methods Do Insurance Companies Use?

An insurance company’s private investigator may use several insurer surveillance methods in a disability claim. These may include stakeouts, tracking, interviewing, and online monitoring.

Stakeouts and Tracking

Most people associate surveillance with stakeouts and tracking. During a stakeout, a private investigator will monitor a single location — typically a claimant’s home or a doctors’ office.  If you notice an unfamiliar car parked outside your home for long periods of time, it may be a stakeout. (Consider closing your blinds and limiting outdoor activity if you suspect a stakeout.)

If an investigator is tracking you, he or she will follow you for a period of time. The investigator may use information from your disability claim (such as daily activity information) to understand and follow your activities.

Interviewing Friends and Family

A private investigator may also contact your friends or family. Sometimes, the investigator will pretend to be a mutual friend or acquaintance — and ask questions about your function and health conditions.

It is important to remind your loved ones that they should never discuss your medical conditions or problems without your permission. They may accidentally give inaccurate information — which may subsequently lead to a denial of your benefits.

Social Media and Online Monitoring

Surveillance companies love social media and the Internet. Since most people tend to minimize their medical conditions online, social media profiles can be damaging to your credibility. For this reason, private investigators may frequently visit you and your friends’ profiles in search of information.

Here are some tips for managing your social media and online profiles:

  • Consider deactivating your accounts during your disability claim.
  • At the very least, make them private (and do not accept “friend” requests from people you do not know).
  • Avoid posting images that imply you are more active than you really are.
  • Ask your friends and family to avoid posting pictures that the insurance company may view as a “red flag.”
  • Be honest in your posts. Don’t write that you had a “great day playing baseball with the kids” if you really sat on the bleachers and watched.
  • Do not joke about being off work or on pain medications. These statements may be interpreted as malingering.

If you need help locking down your online information, consider asking a more computer savvy friend or family member.

Can I Tell a Private Investigator to Leave Me Alone?

Most insurer surveillance methods are legal. However, a private investigator cannot trespass on your property, harass or threaten you. In most states, surveillance is allowed in public places where you do not have a reasonable expectation of privacy. (Surveillance in a restroom or changing area would be illegal.)

It is also permissible to monitor someone’s activities in and around their home — as long as the investigator does not trespass or violate your privacy. If you discover an investigator on your property, you may ask him or her to leave. If the investigator returns, you should call the police. However, the law does not consider your sidewalk and the road in front of your home to be private property — and the investigator may legally be there.

Additionally, an investigator may not harass or threaten you. If an investigator’s behavior makes you feel unsafe, contact the police immediately.

Can Insurer Surveillance Footage Hurt My ERISA Claim?

Sometimes, insurer surveillance footage catches a fraudulent claimant. However, most footage requires a more nuanced analysis. A brief video rarely gives the viewer the complete picture — since it may not fully document your activity tolerance or the severity of your symptoms afterward. And an unscrupulous surveillance company may skew its footage to subsequently support a denial of benefits.

How Can I Minimize Surveillance Footage?

Frequently, insurer surveillance footage is benign. The footage may be brief — and often does not document your increase in symptoms after the period of activity. However, there are things you can do to avoid damaging surveillance footage.

Follow Your Restrictions

If your doctor says you should not lift more than 10 pounds, listen to him or her. If you do things outside your restrictions, you risk re-injuring yourself. Furthermore, a video of you performing heavy lifting or other physical activity may damage your credibility.

Be Honest With the Insurance Company

During your disability claim, you will complete a lot of insurance company forms. It is important that you are honest on these forms and avoid exaggeration. For example, if you drive to the pharmacy and doctor’s appointments, do not say that you “never” drive. Surveillance video that discredits your statements can lead to a denial of benefits.

Contact an Experienced ERISA Lawyer

If you believe that a private investigator is monitoring you, consider speaking with a disability lawyer. Experienced ERISA lawyers understand that surveillance footage may be skewed and inaccurate. They can also help you develop a more accurate picture of your daily functioning. Moreover, if your claim is denied, an ERISA lawyer can properly appeal your claim and protect your right to benefits.

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