Surveillance is the Tool to Dispute
The insurance industry handles thousands of claims each day, most of which are legitimate claims. However, all too often fraudulent or exaggerated claims are paid out unknowingly. There is a tool available to claims professionals to dispute fraudulent and over inflated claims: that tool is surveillance.
Surveillance may be just the tool to dispute fraudulent and exaggerated claims. However, the surveillance must be done properly in order to stand up in a mediation or court proceeding. Quality surveillance video footage can provide indisputable evidence when introduced at a mediation or trial. Consider the following points:
- Whether utilizing an internal Special Investigative Unit or an outside vendor of investigative services, be sure to clarify the restrictions on the claimant to the investigator. For example, if the claimant suffers from an alleged neck injury, repetitive side-to-side head movements without noticeable discomfort may prove the claim to be fraudulent or exaggerated.
- Consider scheduling surveillance around the claimant's IME or therapy sessions. This is an excellent time to record the claimant's activity. Claimants tend to be active after or before an appointment and are often recorded participating in activities contrary to their claim.
- Also, consider performing night or undercover surveillance. History has shown that claimants tend to be active at night or at an indoor facility. Consider the following scenarios: a claimant with a back injury is active playing pool at a local bar; a claimant with a wrist injury is recorded participating in a bowling league, a claimant with a lower back injury is recorded working another job rotating tires. Consider also that claimants remain active in the winter months, but many of their activities may take place outdoors. Surveillance may be obtained anywhere as long as it's performed in a public arena.
- Communicate regularly with an investigator handling your case. Often times the investigator can provide cost effective advice and advise on the best scenario to expedite the investigative process.
- When utilizing a vendor of investigative services, be certain to inquire about the company's experience, surveillance equipment, insurance coverage and professional references.