Are you being watched by your insurance company?
Author: Attorney Lonnie Roach
Long-Term disability insurance companies will often surveil their customers to avoid paying disability benefits.
It has become the practice of many long term disability insurance carriers in Texas hire private investigators to conduct surveillance on their insureds.
It is often done around the time of a scheduled medical examination with one of the disability insurance carrier’s physicians. The scheduled doctor’s visit gives the insurance company some guaranty of the insured’s physical location at this point in time. It also gives the company a way to compare what the insured tells the doctor about his physical limitations to his actual activity level just before and after the doctor’s visit.
For example, if the insured tells the examining doctor that he always uses a cane and walks with a decided limp, when in fact, he only uses a cane when walking more than a few blocks and only limps after being on his feet for an hour or more.
The insurance company will want to use surveillance data to document any time the insured walks without the assist of a cane and/or without displaying a limp. While many object to the privacy concerns over being observed, the most directly related problem with the practice of surveillance in the disability insurance verification process is that it is normally conducted over a very short, very specific period of time. As a result, it only captures a very small window of the disabled person’s life and their experience of the disability. It can, however, have a big impact on the success of his disability claim.
If you or anyone you know has been denied disability benefits don’t give up! Believe in your claim. Call 512-454-400 for help today.
If a disabled insured spends most of his day experiencing very little physical exertion and then walks outside to pick up a paper without limping or using his cane, surveillance of this event leads to the mistaken impression that the individual does not limp or need a cane.
However, reality could be that if the same person has to go to the grocery store and be on his feet for more than 30 minutes, he may begin to limp and need his cane. He may have gone out albeit experiencing great discomfort knowing it was just for a short moment. A video taken after the grocery store visit may more accurately document the disabled person’s limitations than the one where he just walks outside to pick up his newspaper.
Where most people find themselves in trouble with video surveillance is when they make too broad a statement to their doctors or to the insurance company about their disabilities.
In the first example, the person with long term disability tells his doctor that he always uses a cane and cannot walk without a limp. What he likely means to say is that he uses his cane when he has to walk longer distances or when he is in unfamiliar territory and that he begins to display a limp when he is on his feet for a while. A person does not have to use a cane in every situation to be considered disabled.
An insured individual needs to be careful when giving any statement to the insurance company or doctors.
He must avoid using absolute declarations such as “always”, “never” and “constantly.” Private investigators and insurance carriers live for disproving such absolute declarations which are easily avoided and not necessary for proving a condition to be disabling.
The team of disability lawyers at Bemis, Roach & Reed knows how crucial disability benefits can be for maintaining financial stability. Our attorneys are assisting clients with their disability cases in cities all across Texas. If you are seeking disability benefits contact our attorneys today at no cost to you. Call 512-454-4000 and get help NOW.
Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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