Your initial claim for long term disability benefits has been approved.  However, insurance companies will continue to monitor and investigate your claim, even after initial approval, for a basis to discontinue benefits.  

Some Tactics Used by Insurers to Terminate Disability Insurance Benefits

Surveillance of an Insured

The insurance company often hires a private investigator to conduct video surveillance of disability insurance claimants.  Prior to the investigator initiating surveillance, an insured is required to complete a questionnaire that asks about all of an insured’s daily activities.  The activity observed during the video surveillance will be compared with the answers on the questionnaire.  If the activities do not match, the insurer will attempt to use the discrepancy against the insured.

The tactics used by the insurance investigator can be even more devious.  If you must attend a doctor’s appointment, you can presume that you are being watched during the entire trip to and from the appointment.  The insurer might even set up an appointment for an “independent” medical evaluation.  The appointment will be scheduled shortly before the lunch hour with the hope you will elect to shop or visit a restaurant on the way home.  Evidence of you with an armful of packages or loading the car after grocery shopping can be used against you.  Insurers will exploit such footage in an attempt to discontinue disability payments.

Burying Claimants in an Unending Waves of Paperwork

The insurer’s claims representative will bury you in requests for documentation regarding your disability insurance claim for the purported purpose of “updating” your file.  The document requests can have a far more nefarious purpose.  The insurer has determined that your benefits might be terminated, so the insurer is going to meticulously review the documents you provide to find a basis for denying further benefits.  Frequently, a nurse reviewer will prepare a summary of all of the medical records, so an “independent” medical consultant can analyze the records to develop a medical justification for your return to work.

Field Interviews (aka In-Home Interviews)

An investigator who is hired under contract by the insurance company will contact you and request to meet with you.  The individual who contacts you will be an experienced disability insurance claims investigator.  While she might make it sound like she was in the area, this representation is likely not true.  The goal of attempting to arrange a meeting on short notice in your home is to catch you off-guard and unprepared to answer questions.  Policyholders are under no obligation to agree to this type of impromptu meeting, and they have nothing to gain by doing so.  The insured should insist that such a meeting be coordinated well in advance.

You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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