Insureds are phoning me like crazy reporting strange cars on their streets, familiar faces popping up in the store, spooky, burly men following them, and well, you got it, strange phone calls, and door knocks.
Insurance surveillance is a normal thing, expected, and understood to be a part of the “receiving benefits from a third party” process. What is more important, though, is insureds’ reactions to insurance surveillance that absolutely ensure THEY are managing the activity and not some insurance investigator hiding behind blacked out windows.
It’s the end of summer. What do you think insurance companies are doing now? Last opportunities to say, “gotcha” are moving full throttle, trying to observe violations of medical restrictions and limitations reported to them. Insurance companies are smarter than you might think, but they are definitely watching.
Insureds who tell me, “I don’t care about surveillance since I don’t do anything wrong”, just don’t get it. Surveillance is one of those things where “seeing is believing” can be misrepresented to deny benefits. If insurance companies just presented what they saw factually, surveillance would be a waste of money.
Therefore, this is just a reminder that DCS continues to recommend that all insureds comply with the medical restrictions and limitations reported to the insurance company. Functional Capacity is an interpretative concept, and I’m betting no one wants to have a denied claim by Labor Day.
