ARE YOU BEING WATCHED? WHAT HAPPENS WHEN YOU MAKE CLAIM FOR LONG TERM DISABILITY BENEFITS?
When a person makes a claim for Long Term Disability benefits, under the ERISA statute, they fill out a claim form stating what the condition or conditions are that causes them to be disabled and unable to work. The claims are governed by the ERISA statute 29 U.S.C. Chapter 18 which sets forth the rules of how the insurance company is supposed to manage your claim.
When you complete the application for long term disability benefits you state what your disability is and what you cannot do anymore that prevents your form working. These are called restrictions and limitations. These restriction and limitations are what prevent you from being able to do your job thereby being disabled per the definition of the policy. Then the insurance company decides whether what the person says they can or can’t do is consistent with their alleged disability preventing them from working.
For example, if you state that your hurt your back and can’t bend over, can’t lift things over your head or carry anything over five pounds, the insurance company routinely conducts what is called sub rosa investigations. This means they do things without you knowing and they are legally allowed to do it without tell you about it. They do this in hopes of catching you doing something you say you can’t so they can deny your ERISA claim.
What can the insurance company legally do? The insurance company will hire a private investigator to follow you and film you anytime you leave your house. They can ONLY follow you and film you when you are out in public. They can never film you inside your home or in a private location that the public does not have access too. Once you are outside your home in and you are in plain sight, they are free to film you and follow you wherever you go.
They will sit outside your home and wait for you to come outside and/or leave the house to go about your life. They will follow you and film you in hopes of catching you doing things that you say you can’t do to help them deny your claim. For example, gardening and bending over to do things, lifting a ladder, or reaching above your head, basically anything that they can use against you to deny your claim. They will follow you into the market, doctor’s appointments, anywhere you go.
This is all legal and done all the time. The insurance company will say things like; you walked with ease, showed no signs of pain, you lifted heavy items, anything and everything they can to deny your ERISA claim. So when making claims for long term disability benefits just realize that the insurance company will be watching you. Generally, they will hire the investigator that will pick three (3) random days in a row to watch your house. So if you see a random car parked not to far away, or you see the same car when you are out and about at different locations be aware you may be being followed and filmed.
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