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Archive for the ‘Surveillance Info’ Category

Broken RecordWhile insureds and claimants are planning that annual 4th of July family renunion at the lake, insurers have already scheduled surveillance that will likely take place on Thursday, Friday and Saturday. I know I must sound like a broken record to my readers, but better that than denied claims on July 5th.

In fact, I’m beginning to wonder whether insureds take me seriously, or I’ve become just another Internet alarmist, writing the same old story every holiday. Unfortunately, after the holidays I receive calls asking what to do when insureds receive the inevitable denial letters, and I rest my case. I hate it when I’m right.

Already DCS, Inc. is receiving calls with reports of surveillance, somewhat early, but I imagine investigators have given priority to insureds with high value claims on July 4th.  While I’m sure there will be many disabled golfers on the putting away this holiday, their disability benefits won’t be found in the tall grass rough they find themselves in afterwards.

Although insureds today seem to think they can claim disability and do anything they want in terms of activity, many claims/benefits they don’t  know about are denied as the result of surveillance. Trends indicate there’s no coming back from visual surveillance when juries realize an insured is receiving $9,000/month and scoring 18 under par at the same time.

Still, as an expert claims consultant I can only  repeat what I’ve said many times before. Insureds should NEVER exceed their reported medical restrictions and limitations. If you are caught performing in excess of your doctor’s R&L recommendations, your claims will most likely be denied.

However, my recommendations consider not only insurance surveillance, but insureds’ health as well. I sincerely hope you think twice before risking your disability benefits. As I said, I hate it when I’m right.

 

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DSC04171I wonder sometimes whether readers of the blog really take my articles seriously. This is a real life picture of a Unum surveillance vehicle parked outside the home of one of my clients.

I always ask my clients to face-off with surveillance investigators and take pictures. It’s not that the pictures are so valuable, but we do want to send the message that we are aware of the surveillance.

In this case, the claimant’s spouse went out to the car and chit-chatted for awhile with the investigator noticing the technology, files and computer in the back seats. (Check out the blacked-out windows and tires!) After a while, the car just drove away and wasn’t seen again.

If you think insurance surveillance won’t catch up with you, please think again, and then think one more time. The probability of surveillance is not in your favor. Think about what you are risking and then ask yourself whether pushing the R&L envelope is worth it!

 

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Stop spyingThis is just a friendly reminder that all major insurers conduct frequent surveillance during the summer months, particularly on the 4th of July and Labor Day holidays.

I’ve been getting the impression lately that more insureds are pushing the envelope of functional capacity and activity falsely thinking they can have a disability claim and do what they want in terms of activities anyway. Unfortunately, Murphy’s Law seems to creep up on those who exceed their reported restrictions and limitations and claims are denied.

Surprise, surprise! Claimants never thought that their insurer’s investigators would catch them hiking, camping, playing golf, mowing the lawn, planting the garden etc., but still a denied claim is a denied claim. Also, I’ve seen more than one court case decided in favor of the insurance company because of surveillance. The old adage of “seeing is believing” isn’t helpful in court to insureds who claim disability, but exceed restrictions on a regular basis.

My opinion has always been that insureds and claimants should never exceed medical or mental restrictions and limitations reported by their physicians. A denied claim is an excessive cost to pay for a day in the sun and a hike.

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No trespassingThis is probably one of the most important articles I will write in 2019, and it of grave interest to all disability insureds. I sincerely hope my visitors read this post carefully.

Although in recent years it appeared clear to me that insurers were NOT engaging in “Activities Checks”, reports are coming in to the office that HUB investigators are knocking on neighbor’s doors to solicit information about you.

Years ago Unum’s own private investigators showed up unannounced at insureds’ doors ready to do field interviews. The purpose of the impromptu meeting was to deny insureds time to prepare with witnesses/videorecording, and most likely catch them when the house is in disarray etc. The result was really scary for many insureds who found themselves face to face with HUB investigators without notice.

At the time, I coined the phrase “private trespass” because it is unrealistic, and frankly insurer-sneaky, to expect insureds to allow investigators into their homes unannounced. There are horror stories of female insureds feeling threatened and calling the police.

Recent information to DCS reports that when Plans and policies DO NOT include language requiring field interviews, HUB investigators just show up anyway and demand entry into the home for a field interview, which they boldly announce may take several hours.

As if this were not enough, it is also reported to me that “Activities Checks” are once again taking place. This is when investigators actually knock on your neighbor’s doors to ask questions about you such as, “So what does this guy do every day?” “Does she go to work?” “Have you seen this woman doing lawn work?” “What do you see your neighbor doing?”

If your neighbors like you that’s one thing, but if they are still upset about your son’s loud guitar playing last night, reports may exceed all negative expectations. You get my point.

Another example is Guardian who sent investigators to interview former peers as they came out of work and asked for signed statements about insureds. Investigators have also been known to show up at the location of former employers and ask to use the actual work location to interview staff because a former worker went out on disability. Guardian also checks the FBI’s most wanted list, so what does that tell you about how far the company will go to discredit insureds.

Many other insurers also hire HUB Enterprises, so it seems to me the door is open once again to a whole list of “private trespasses” right on your front doorstep.

Here is what DCS recommends (with a few comments):

  • No claimant or insured is required to give a field interview without having the opportunity to check Plans and policies, or arrange for a witness and digital recording.
  • Place a small “No trespassing sign on your lawn. You can then file a police report when investigators continue knocking on your door. If they show up unannounced, follow through and file a police report.
  • If you get along with your neighbors and feel comfortable to, speak with them about the possibility of a private investigator asking them questions. They do not have to answer, please inform them of that. This goes for former workers as well.
  • By law investigators are required to ask permission of ajacent property owners when conducting surveillance from their property. Ask your neighbors to give you a call if they are approached for permission.
  • If you notice unfamiliar cars parked near your home, or following you, call the local police to see if investigators have checked in. Private investigators are required to “check in” with local police if they are watching a particular area.
  • Never allow a private investigator into your home, and never agree to an interview unprepared or without a witness. Demand at least a 30 days notice for the interview to take place in a busy place.
  • Never give a field interview anywhere voluntarily — check your Plans and policies.
  • Former employers are NOT required to allow use of their business for private interviews with staff concerning workers out on disability. Or, if former employers agree to it, charge the insurance company for the loss of time for your employees and rent of office space.
  • Anytime you are made fearful because of constant knocking, or calling you to arrange for hurry-up meetings, or trespassing on your property, please call the police and file a report.

Remember, an “Activities Check” is defined as “investigations involving those around you, including your support group about your activities while receiving benefits.” It’s a very underhanded way of finding out information that can be used to discredit your claim. Irritated neighbors are not the best advocates, so it’s best to have a conversation ahead of time about the possibility of a HUB investigator showing up at THEIR doors.

Insurance investigation is outlandish and often invades your property in addition to the snooping on the Internet social media. If you have any questions regarding this subject please give me a call.

I personally find “Activities Checks” and “private trespass” a particulary sneaky way of doing business. (Please let me know your reactions in the Comments section and let’s talk about this.)

And, get those small “No Trespass Signs” posted on your lawns.

 

 

 

 

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Stop Watching meInsurance surveillance is routinely conducted by private disability insurers to “catch” insureds exceeding medical restrictions and limitations thereby demonstrating work capacity.

After all, what qualifies insureds for disability benefits is the definition of disability that states “unable [or limited] from performing material and substantial duties.” And, insurers are very carefully watching!

While insureds are well aware of the possibility of surveillance they do not often realize that the simple act of conducting surveillance is often enough to support claim denials. Or, so goes the story from the insurer’s point of view. Surveillance is always misrepresented regardless of whether insureds were “doing something wrong” or not.

The old “walking the dog” scenario is used by many insurers to allege that “walking a dog” indicates work capacity when in fact a 15 minute walk up the street is only a 15 minute walk up the street. While insurers typically conduct three-day surveillances, normal activity of daily living self-care, although permitted, is used against insureds when they drive to the pharmacy to pick up medications, or go to their doctors’ offices.

Incapacity for work, via a medical disability defined in a Plan or contract does not mean that insureds need to be housebound, in bed, with a comforter up to their nose, although insurance companies want that to be the case. When observed, insurers presume all insureds, must at least show some semblance of being disabled all of the time.

Years ago I had a Unum client who was so frustrated with multiple surveillances that he finally asked his children to fish out old granny’s wheelchair from the basement. He then sat in the wheelchair, complete with huge white bandages around his head, and had his kids wheel him down the driveway. Halfway down, he yelled out and fell out of the wheelchair and couldn’t get up. Amidst screams of pain his children had to pick him up off of the driveway so he could stumble back into the wheelchair. He actually put on quite a show!

When he told me what he’d done I didn’t support it, of course, because it wasn’t truthful. But, the incident did make a point. Surveillance is only credible when it is unknown to the insured. Insureds can put on any type of show they want when they are aware surveillance is taking place.

Insureds aren’t the only schemers either. A few years ago, another ER physician client reported to me that sometime in the middle of the night he was awakened by a loud bang in front of his apartment building. Living on the 5th floor with a balcony, he looked below to find a grayish looking van and what appeared to be a human body next to a bicycle on the side of the road. The driver was calling for help and shouting for the physician to come below and help the victim.

The physician considered. As a DCS client, he was well aware of what to look for. To him, the event seemed staged and unreal. He yelled down to the driver that he would call 911 and get some help. After several more minutes of panicked persuasion, it became obvious to the driver that the ER physician was not going to join him at the scene.

To the doctor’s amazement, when the sirens of the summoned ambulance could be heard, the driver quickly threw open the back of the van, tossed the dummy and bicycle into the back and took off. Obviously, the surveillance was staged to bring the ER physician to an emergency situation proving work capacity for his own occupation.

Finally, there are times when insureds themselves do not use good sense. There was a report that a young woman, on a ladder, with alleged back problems was observed putting up Christmas lights on a 25 foot tree in front of her house. Another report observed an insured putting a new roof on his house and nailing tiles with a huge hammer. A very unwise insured actually started to clean up his yard after a hurricane with a chain saw and was seen sawing up trees, carrying wood, and pulling branches off of his house. (How would a surveillance team be able to show up a half hour after a hurricane?)

Playing golf is always a bad idea, and yet insureds will complete 18 holes and not think a thing about it. Golf is a game that requires: standing, walking, pushing overhead, bending, concentration, strategic thinking, exposure to elements, fine finger manipulation, physical stamina, and just over all fitness. And yet, one of the most popular questions I’m asked is if insureds can play golf and still receive disability and SSDI. Ludicrous!

What insureds often forget, too, is that Murphy’s Law is always in play……”Anything that can go wrong, will go wrong, and at the worst possible time.” This idea that “I won’t get caught just this one time”, doesn’t always play out. The first time you get on a plane to see family in the middle of the Grand Canyon for two minutes is when the surveillance team shows up.

Insurance surveillance must always be viewed in its proper perspective. The majority of three-day surveillances are NOT evidences of full-time work capacity, although insurers might try to say that it is. Short surveillances do not capture physical capacity for full-time work, and clearly citing a “walking the dog” scenario is pretty desperate on the part of insureds. “Walking dogs” is very rarely cited by treating physicians as a medical restriction, and insurers know that.

Insureds who exercise good sense when they know they are being observed fare best. Unfortunately, surveillance will remain a common occurrence as long as claims exist, but at least insureds can act accordingly, but without the wheelchair of course!

 

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Surveillance1It’s hard to know exactly what is, and what isn’t legal these days. Or, if things ARE illegal who will be prosecuted and what “over the top” really means. How is it possible to say what surveillance is legally allowed, when no one is held accountable to play by the rules?

Reports have been coming in to DCS that The Hartford is engaging in what is described to me as “underhanded illegal surveillance.” I’ve known for quite some time that The Hartford stepped up its investigative tactics assigning at least three people to each claim, one of which is a private investigator. While at one time The Hartford only employed 16 investigators, I’m told there are now over 60.

I also know that Hartford’s claims handlers, like Unum’s, are programmed with a fraudulent malingering mindset that presumes everyone with a claim is out for secondary gain. One of Hartford’s claims handlers told me, “You just don’t know how many people are trying to cheat us. Most of them are no better than thieves.”

Unum’s perspective is a bit different said one Unum manager on her FB page, “Insureds are like Slinkys, they aren’t worth very much, but everyone likes to see one tumble-down the stairs every now and then.” Attitudes like these are programmed into company employees who know it’s either their employer’s way or the highway.

A few sources are reporting Amazon’s Alexa boxes and other home appliances like TV screens, computers, and phones provide the means for spying, not just by insurance companies, but by government agencies, and social media itself. The problem isn’t just that insurance companies are spying on their insureds, it’s that the American public is spied on by nearly every imaginable source.

Specifically, insureds contacting me are often harassed by The Hartford’s surveillance to the point of being frantic, mistrustful, and extremely worried about their benefits. Apparently, The Hartford’s methods are so frequently imposed, some of their own claimants describe Hartford’s activity as “stalking.” The difference between surveillance and stalking is that insurance stalking is an attempt to terrorize insureds to the point that it is likely they would withdraw their claims – an easy way out for The Hartford.

In most other claims areas, The Hartford’s claims management process is very much like Unum’s. Since most of the company’s executive management hailed from Unum’s old Dickinson & Holt subsidiary, claims practices between the two companies remained basically the same. However, in recent years The Hartford made decisions to engage in surveillance to the point of insured harassment.

Surveillance technology today unleashed a tremendous boon in the frequency and nature of “listening in”, “tailing”, and “spying” on unsuspecting insureds, or even insureds who KNOW they are being tapped, but don’t care. I am not an expert on the technology of surveillance, but it makes sense to me that insurance investigators will use every means “to catch you” even if it could be considered illegal in some states.

Clearly, The Hartford is “way out there” with its investigation of claims. Those with  Hartford Plans might want to take notice and protect themselves from invasions of privacy that are likely to be on the horizon.

And please, everyone should know by now that social media is the largest insurance spy network in the world. Those on claim should NOT be posting family information anywhere on the Net if they plan to keep their claims.

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Christmas Grinch“And he puzzled and puzzled ’till his puzzler was sore. Then the Grinch thought of something he hadn’t before. What if Christmas, he thought, doesn’t come from a store. What if Christmas, perhaps, means a little bit more.”

Here we are within three weeks of end of the year profitability for the big Robber Barons. Lurking behind evergreen bushes, trees and hedges, surveillance investigators are out in full gear hoping to find evidences of “inconsistency of report” as many people push the envelope by exceeding reported medical restrictions and limitations.

It seems like the Grinch is waiting for insureds to do something wrong so the “who stole Christmas” becomes a giant corporation hoping to make profit in 2018 at your expense. This is just a friendly reminder that investigative teams are ready and waiting to gather information that can be interpreted as adverse to you.

This includes, by the way, Facebook, Twitter, My Space, LinkedIn pages that are susceptible to scrutiny by those looking to deny claims. Hacking into social media is now more the norm of surveillance rather than sitting in front of your house, hanging out the window with a video recorder.

Please be aware of the possibility of Grinch surveillance and act accordingly.

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