Insurance Company Investigating


#1

I’ve scoured this site and found many useful tips and plenty of pertinent information. I’m just wondering is it possible that insurance companies could use information shared on this site against a person with an ongoing claim?


#2

Hopefully they ( Insurer employees) learn their job from reading this site!!!
You should always be careful what you post to any social media when on claim.
I don’t see how asking a question or providing information would cause anyone an issue.


#3

Yes this is public information and insurance companies do online surveillance so it is possible they could read this information. If you are concerned about privacy don’t use identifying information or contact us for a confidential consultation.


David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliabile manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.


#4

Can an insurance company subpoena your internet browsing history or phone call activity?

My case manager always asks me about my smart phone, reading and tv watching activities? What should I tell her?


#5

The short answer is yes, but only in the context of a lawsuit or criminal investigation. The courts have established rules that balance privacy interests v legitimate interests in defending a lawsuit. They don’t have a an unrestricted right to this info, it’s decided on case by case basis.

They are gathering information to challenge your credibility and understand your activity level. If you spend all day on a computer they will say you can work. They are always concerned a person may have a home business they don’t know about. Selling things on Facebook, etc.

Often when they ask these questions they know the answer to some extent and are setting you up to give inaccurate descriptions of your activities. They also get these statements from you so a lawyer can challenge later, if contrary information is produced from online or video surveillance.

My best advice is tell the truth and not understate your activities in any way. If the questions are too personal you can refuse to answer.


David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliabile manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.


#6

Yes, the ins companies will use any useful info they come across on these sites.

I had a facebook page I used to blog about WCB issues. I had posted an issue on my page that had to do with an employer who wanted to kill me, run me over in a crosswalk (long story I will share online again someday and I do have evidence that employer (emp) had a personal issue with me), that emp caused me intentional stress and I did fear she would try to cause me physical harm if I was on her property alone with her, I went on stress leave due to her and was on EI benefits for 4-months.

After becoming disabled from an injury that had been planned by that employer (I said it was a long story) and never been able to go back to work yet (since 2008), and because of WCB I started to blog about them because at the time there weren’t any helpful sites or any lawyers that I could find (all I could find were complaint sites that shared their own WCB stories) I blogged about how I should have filed for WCB due to the stress from the last employer because stress is an injury. Well didn’t WCB go and make a policy that they only accept “tramatic stress injury”, all because of my page and I think WCB even put a rush on getting this policy made in February 2010 because I haven’t seen any evidence to show that this topic was up hearing from stakeholders or the public like they do with other policies.

Another thing I had posted on my page was about having a WCB denied claim reconsidered, well didn’t WCB go and “change their policy on that too” adding more stipulations to it.

Was it because of my page? Yes it was, I emailed my WCB advisor about my page saying that I’m going to share everything about WCB and I wrote to WCB the same thing. After I seen the WCB policies as mentioned above I then downloaded my facebook file in a single file so I had a record of all my posts and then I deleted my page because my page was meant to help injured workers and not WCB.

I’ve also seen written in WCAT tribunal decisions where WCB used a workers facebook posts of showing and doing activities as evidence against the worker.


#7

Elaine, your case manager has joint planning meetings with the claim team to review ways to reduce costs. The questions they are asking sounds like they are seeing if you are capable for a particular line of work. Watch TV, read and use a smartphone for a set amount of hours and you could be a security monitor viewer or other type of sedentary work.

Every question usually has a purpose behind it. If you request your claim file in its entirety you may be able to figure out the direction they are headed.

Always be careful when they ask you if you can do something…most will answer no I can’t do…or.I can only walk so far. These questions are dangerous as often you could do what they are asking if you absolutely had to. Any questions about your restrictions or limitations should be cautiously answered.

Good answers are not usually, it depends, I will suffer if I do but sometimes there is no choice… Never answer in absolutes. If they ask how much can you lift, how far can you walk, can you bend…these are traps.


#8

I agree. The most common problem I see is people not being precise with their language and descriptions of their abilities. Many people save “never” or “can’t” or “bedridden”, when in 99% of cases is not accurate. Many people describe only their worst days because of fear of having payments wrongfully cut off. More important to be accurate and focus on accurate ranges of good and bad days.


David Brannen

Disability Lawyer with Resolute Legal

The response posted above is based on the limited factual information made available and is not intended as a full and complete response to the question. The only reliabile manner to obtain complete and adequate legal advice is to consult with a lawyer, fully explain your situation, and allow the lawyer enough time to research the applicable law and facts required to give an adequate opinion. The basic information provided above is intended as a public service only, a full one-on-one discussion with a lawyer should be done before taking any any action. The information posted on this forum is available to the viewing public and is not intended to create a lawyer client relationship with any person. If you want one-on-one advice, please click here to request a free consultation or call toll free 1-877-282-5188 to speak with a member with our disability claim support team.


#9

People share too much unnecessary stuff on social media these days, like enjoying themselves on a beach while on disability.

Yes, I noticed that. She calls and asks a lot of questions for an hour. Usually she doesn’t ask follow up questions or comments much. Just listens to my answers. Sometimes I have a feeling she is not listening to my answers at all. Busy with something else. I think she records the answers for their doctors to review.

Thank you. Sometimes I describe only negative days and forget that I have good ones too.
It is quite normal to have good and bad days even if you are on disability.

How and when is my insurer going to use all the recordings of the answers I gave them? Should I continue talking to my case manager on the phone?


#10

I doubt they are recording you unless they advised you in advance or asked permission.

You need to cooperate with them in good faith and reasonable phone calls are often the best way to do that. If you have concerns keep your own notes of the calls. You should advise them if you plan to record calls.


#11

Elaine there is some merit to using your worst days to describe what you are dealing with as long as you are accurate in that description and you qualify it as my worst part of the day is… or my hardest hours, time of the day is…

My husband keeps a pain/fatigue diary where he lists by the hour his pain and fatigue levels from 1-10. He also notes what he was doing at the time. It gives a snapshot of each day. Once in the last 3 months we went to a movie and he tried to use the snowblower. Other days he is down for the count almost the whole day.

Not just for claim purposes, but the diary is helpful for Doctor visits and for us to figure out a pattern so we can try to manage our lives around his issues.

The sad part of not being accurate is when a injured/ill insured says I could never do that, or I can not walk more than 1/2 a block etc… Then the Insurer catches you doing something you said you absolutely could not do. Credibility is then deeply hurt and the Insurer now can use misspoken words to terminate a claim. Then you need a lawyer to try and help.

My opinion is you should never talk for that long to a case manager. They are trying to determine your capacity to work, or have you speak in absolutes. Why not request your claim file for your records-just say a friend told you that it would be a good idea. You maybe surprised at what is in there. You could also say you want the claim file incase you need to appeal CPP-D-again say a friend told you to ask for it :smile:


#12

We deal in emails, letters only because the Insurer is aware we will record calls and they prefer now only written correspondence. We prefer it as well.
When we did get our claim file the Insurer’s rehabilitation consultants notes from her phone interview were verbatim from my spouses interview with her-except for a few verbatim sections that were missing to the Insurers advantage.

I advised after the fact that we had recorded and requested their recordings-since how could she take 100% notes word for word (except for some deleted sentences)

So they may not record but it sure seems like they have voice dictation technology. All they replied with is they do dictate

The Insurer also had uploaded and saved voice mail messages left from my husband


#13

I thought it’s legal in Canada to record conversations without other party’s consent. I know it is not legal in some states in the US.

When I call my insurance company there is always a voice notifying me that the call will be recorded but there is nothing like that when my case manager calls me.


#14

I already refused to sign the forms and they seem quite puzzled :thinking: If in addition I refuse to talk to them on the phone and request a copy of my file then they will think there is a rebellion or may even conclude that my condition progressed into paranoia :grinning: Taking into consideration that they didn’t give me much reason for being suspicious.


#15

It is legal to record phone conversations and any conversation that you are a party to. The issue David has is the optics of doing that. It can harm credibility and can be seen as sneaky etc… even unfair to a degree.
So it can damage credibility.
I tape, or have my husband record calls, so I can make accurate notes. Then if my notes are challenged I can say it is from the tapes.
I was in a 6 year lawsuit with an Insurer so my experience is if I had tape recorded one encounter there would have been no lawsuit. I stood my ground, they ended up paying us multiple times over the original amount of the lawsuit but the stress involved was not worth it.


#16

Elaine you have every right to only communicate in writing as well as request your claim file. My concern is why you are doing it that way. If your gut feeling is there is going to be issues then going that route makes sense. You never want to be difficult or combative. If it is for mental health reasons, cognitive issues, paranoia etc… then let them know that it makes you better able to cope with your illness when everything is documented.
If that is the truth then let them know you are asking purely to cope, so that your Insurer understands you are not trying to be difficult.

Always go with the truth and you can not go wrong. Always stay humble.


#17

You can lawfully record calls between you and another person in Canada as long it is for personal or journalistic reasons. The exception is that can’t secretly record calls in connection with commercial activity. This is why the insurance company has to advise you. Since you are dealing with them in a commercial context the notice requirement may apply to you to. I am not a privacy law expert, but I always err on the side of being 100% above board so not to harm credibility.


#18

Thank you for all your input.


#19

BC case that allowed in surreptitious recording http://www.courts.gov.bc.ca/jdb-txt/SC/12/04/2012BCSC0440.htm

It is a difficult choice, but I am glad my husband recorded his experience with the referred treatment providers.


#20

I’ve been recording every conversation I’ve had with my case manager simply for my own use as my recollection of events, particularly conversations, are lacking at best. I then used these to transcribe verbatim what was discussed. I am thankful I did because just yesterday I received a call from my case manager informing me that my claim had been denied (this has been going on since Nov. 2016) despite having a team of professionals providing reports and input. The delays asking for more information appear to me to be a delay tactic and nothing more. I’ve since had a fall (in January on some ice) injuring my shoulder. Saw a doctor who send me for an MRI which showed a full thickness tear of my rotator cuff on my left shoulder. I will be having surgery on it this Tuesday, May 16 and will be unable to do much for the first 6 to 8 weeks. In the conversation with the case manager she is now saying they can’t pay benefits unless they receive this medical information. This has nothing to do with my reason for claim. I re-read the transcript from that conversation and it make no sense at all as she was moving from one excuse to another for the denial. I plan on going over all other conversations and having them transcribed as well as I seem to recall one from a few weeks ago stating that they had all the documentation needed and it would be 5 to 10 business days for a decision.