There are many times when I get the feeling that my articles about insurance surveillance are not taken seriously. I guess people are going to do what they are going to do, but “surveillance isn’t a game.”
Most insureds just don’t get it. Whenever I write, or speak about surveillance people respond with, “I’m not worried about surveillance, I don’t do anything wrong.” My first thought is, “here we go again.”It really is too bad that insureds are not well learned when it comes to insurance investigation.
Insurance surveillance isn’t about the actual observation, it’s about “observation potential” (my term), meaning any insurance company can misrepresent visual observation any way they want to. It’s not hard. Unum observes an insured walking their dog, and BOOM, they can work. Or, insureds who can grocery shop, ride bicycles etc., are documented as being able to work full time jobs. Therefore, coming out the gate, know upfront that although you really aren’t DOING ANYTHING WRONG, in the actual surveillance report, you are written up as having full-time work capacity.
It is the “work capacity potential” concocted and documented by an insurance reviewer, regardless of what you did or didn’t do, that will result in a denied claim. Any surveillance reviewer can look at a video CD and see work capacity obvious enough to document.
Please think about this next sentence carefully. Everything a disability insurer does is an illusion presented in a misrepresentation wrapper. For example, most internal medical review documentation is written for the purpose of creating an illusion of work capacity that is sufficiently credible to convince any judge that it’s opinion is the only correct one. This is why most insurance medical reviews read like the conclusions don’t even match the same claim. Creating the illusion that insurance is accurate and correct is a strategy insurers have been using for over 50 years.
And, insurance companies pay dearly for it, too! Insurance companies pay a great deal for the use of internal medical reviewer credentials, mentioning “Board Certified” I every letter.
Do you not think the same techniques and strategies aren’t being used for surveillance as well? Of course they are. All an insurance company has to do is see you active and they can create “a story” any appeal reviewer, or ERISA judge would agree with. And yet, some people still think surveillance is a game because they don’t do anything wrong. It’s a grave mistake to think that way.
Insurance surveillance is very hard to dispute because the insured has to prove a negative by identifying the lie, and then proving it doesn’t exist. Although seeing is believing, have you ever tried to prove that an intersecting parallel line won’t produce 90 degree angles? It doesn’t work.
Insurance surveillance is profitable to any insurance company. Just because you don’t think you’re doing anything wrong doesn’t mean the insurance company can’t make it seem as though you are. We are headed toward the holiday season, and I’d like to ask you to think about surveillance and the damage it can cause to a claim.
