Question has been answered


#1

Question has been answered


#2

If they already have enough surveillance evidence to prove you are dishonest, do they just deny you future ltd benefits and terminate the claim or do they also make you pay back all the past payments? Also, what other penalties will the insurance levy on a dishonest claimant?

They send the activity form in hopes you will say you can not do something and they have proof that is untrue. Then they will deny your benefits.

If you are committing fraud and working then very likely they will want money back.

They video will be quite clear with a zoom lens. Mistakes happen…but not likely.


#3

Insurance companies will send out activity forms from time to time. Sometimes this is coordinated with video or online surveillance they have done (or plan to do), but not always.

Answer to question 1: Rarely is surveillance evidence on it own enough to “prove you are dishonest”. When what is seen on the video appears to contradict what a person has said they can do, then the insurance company will say there is cause to terminate a claim. This is why they want to have video of a person doing actives and then ask a person what activities they can do. It is the contradiction between video and what a person says they can do that is often the cause of the denial…not simply the video on its own, except in very are circumstances of actual fraud where what is seen on the video contradicts past statements of the persons abilities.

Answer to question 2: They can’t always confirm the person on the video is the intended person. I have been involved in cases where the filed my client’s brother believing it was him. This can happen, but usually they get the right person on video.

While fraud does happen, most people cause problems for themselves with surveillance because of not using precise language when describing their disability. There is a tendency for people to say things “figuratively”, but not mean it “literally”. When a person says: “I never leave the house anymore”, they mean they “hardily ever go out as compared to before”…but the insurance company will treat this as a literal statement and video of you leaving the house will create a credibility problem.


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 reliable 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

Question has been answered


#5

Normally payments are just terminated going forward. If they believe there is real fraud going on they may seek repayment of back payments but that is very rare. They are usually happy just to stop payments.