Insurance

You did everything the right way.  You worked hard at your job every day.  Then a disability impaired you, yet you kept going to work, even when you started feeling bad every day.  You could not afford just to stop working, so you used your vacation and sick time to go to doctors’ appointments, hoping that whatever diagnosis your doctors offered was accompanied by a miracle solution that would make your symptoms magically disappear.  But that was not the case, because that is rarely ever the case.  

So you worked as long as you could stand it, thankful that you had disability insurance to help you pay your bills and provide for your loved ones during your time in need.  Or maybe your pain and other symptoms were so bad that you needed in-home help, and so you were thankful you purchased long-term care insurance for just this situation.  Whichever kind of insurance you have, you filed a claim with your insurance company, confident that it would be quickly approved because who could question that you were unable to work or take care of yourself with your impairments.  

But of course, it was not “quickly approved” because that is not how insurance companies typically operate.  Instead, the company took months “investigating” your claim.  Only after the company wrongfully denied your claim did you realize what was really going on.  The company hired someone to follow you around and used that video, often taken out of context, as a pretense to deny your claim.  Those times you thought someone was following you, but convinced yourself you were just being paranoid? Turns out you were right.

Since the late 1980s, when video cameras began getting smaller and cheaper, insurance companies have used surveillance as a tactic to deny claims.  The practice has only increased now that everyone has a camera in their pocket, and technology has advanced so that cameras are so small and undetectable that Sean Connery-era James Bond would be green with envy.  

Logically, it makes sense; at least some small percentage of insurance claims are made by dishonest people who just do not want to go to work.  And those people can be observed out in the world, acting in a manner inconsistent with their claimed restrictions and limitations.  Further, there is no surveillance inside your home and in private places, so it rarely paints the full picture of your daily activities and impairments. Insurance companies should be able to “catch” those people red-handed.  But in reality, the insurance companies use surveillance as a basis to deny valid claims.

What companies do is point to small clips where a person is walking or bending over or reaching overhead and saying, “You told us you could not do that, but there you are.  You are a liar, and we are not going to pay your claim.”  In doing so, the insurers are ignoring the reality of disabled people’s lives.

The insurance companies are purposefully ignoring the fact that, yes, you did those things, but maybe you were in a lot of pain when you did them.  Also, doing something for a few minutes is completely different from being able to do that same task 8 hours a day, 5 days a week.  Or maybe you were having a rare, good day and wanted to take advantage of that fact by getting out of the house.  Or maybe you had just taken your medication and had a brief window in which to get your errands done.  And, of course, there is no surveillance of the hours you spent stuck in your house because the pain limited what you could do.

The question is then, “What can you do about it”?  

If you haven’t filed your insurance claim yet, you need to be aware that at some point, the insurance company can hire someone to sit outside your house until you leave, and then follow you around town, videotaping your activities.  That does not mean you should hide inside your house at all times.  But it does mean that when you are out, be aware of your surroundings and, to the extent possible, make sure your activities are 100% consistent with your reports to the insurance company.  You might also consider keeping a daily log of how you are feeling, so, if necessary, you can present it to the insurance company as evidence that the day they videotaped you was one of your rare “good days.”

If your claim was denied, and the insurance company’s decision was based on the surveillance video, you should request a copy of the video and any accompanying reports.  Then you should contact a lawyer with experience in disability claims or long-term insurance claims, because they will best know the way to respond to the insurance company to try and get your benefits reinstated, or, if that’s not possible, file a lawsuit against the company.

If your claim for disability benefits or long-term care benefits was improperly denied, call Donahue & Horrow LLP at (877) 664-5407 for a free consultation.  Our dedicated team is ready to fight for the benefits you deserve.