Disability Insurance Q&A: What Does Your Firm Do To Help Doctors File a Successful Claim for Disability Insurance Benefits?
Question: What does your law firm do to help doctors file a successful claim for disability insurance benefits?
Answer: From the beginning of the process, we help doctors, dentists and other professionals by analyzing complex claims applications and disability insurance policies and identifying potential coverage issues. We have particular skill in documenting claims, completing claim forms, and communicating with treating physicians. Once the claims process begins, we fiercely protect our clients against unreasonable delays and abuse by the disability insurer. We also provide knowledgeable advice and practical guidelines on how to handle an independent medical examination or other testing that may be required by the disability insurance carrier.
Further information about what we do and what to expect is available on our website at this link.
Disability Insurance Q&A: When Should I Contact An Attorney About My Claim?
Question: When should I contact an attorney about my claim?
Answer: Doctors and dentists who are considering filing a claim for disability insurance benefits should meet with an attorney experienced in the area well before submitting a claim. Each disability policy has different, complex language that insurance companies may manipulate to circumscribe and restrict coverage. A physician or dentist should make a coordinated effort with an attorney’s assistance to determine whether a particular claim is covered, and if so, how that claim is best presented to ensure payment.
Coming soon, we will be distributing a monthly e-mail newsletter. The newsletter will contain information not included on this blog, such as:
- Detailed tips for filing disability insurance claims with various carriers;
- Examples of best practices vs. worst practices when interacting with your insurer;
- Updates on recent disability cases relevant to your claim or potential claim;
- Specific answers to common questions, which newsletter recipients can submit anonymously; and
- Information on lectures and classes you can attend to hear the firm’s attorneys speak about choosing disability insurance policies and filing claims.
If you are interested in subscribing (at no cost, of course), please sign up here:
Disability Insurance Newsletter
Your name is not required. Please rest assured that we will not use or distribute your e-mail address for any other reason.
Disability Insurance Q&A: What is the Difference between “Own Occupation” and “Any Occupation” in Disability Insurance?
Question: What is the difference between “own occupation” and “any occupation” in disability insurance?
Answer: Most doctors purchase an “own-occupation” policy, which provides compensation following a disability that prevents the insured from performing his or her particular duties. If an insured doctor or dentist does not have an “own-occupation” policy, he or she must be disabled from performing the duties of any occupation for which he or she is reasonably qualified in order to receive disability benefits.
Some disability insurance policies are a hybrid, providing own-occupation benefits for a limited period of time, and then converting coverage to the “any occupation” standard.
Some of our previous blog posts analyzing some of the potential loopholes that disability insurers will try to apply to an own-occupation policy can be read here and here.
Insurers’ Law Firms Using New Technology
to Track Your Social Media Activity
As many disability insurance policyholders already know, insurance companies regularly look to claimants’ social media accounts (Facebook, LinkedIn, Twitter, Instagram, etc.) for information to help justify a claim denial.
What you may not know is just how important those social media searches are to the insurance company’s lawyers whenever a claim goes to litigation.
At a recent disability insurance law conference attended by attorneys for both claimants and insurers, one insurance company defense attorney spoke about just how crucial it can be to find supposedly damaging information about claimants on social media. “I don’t know how we defended these cases before Facebook,” she said. “It’s a great resource. We’ve found pictures of claimants dancing . . . all kinds of things!”
Your insurance company’s lawyers are so eager to use social media to find information that can make you look bad that they are now shelling out extra money on software specifically designed to monitor and archive everything you say and do on social media. This trend is explained in further detail in the ABA Journal’s recent article: 6 tools to help firms track social media. While the article states that some firms are using the tools to monitor their own clients, there is no doubt that they are being used to monitor their clients’ legal adversaries.
The information that can be gleaned using this type of software is unsettling. One example from the article:
“For instance, if a post says something like ‘I’m having breakfast at this great restaurant’ and there is a picture of what they are eating . . . the software should also be able to show the GPS coordinates, other people they are with, information about the restaurant, etc., so that the whole story is presented, not just the text.”
What this means for claimants is that they must be extra vigilant about what kind of image they are projecting on social media. Everyone, no matter how disabled, has moments of joy in life. But if those joyful moments are posted on social media, they can easily be misconstrued, especially without context.
New: Disability Insurance Newsletter
We receive many, many requests for more information on disability insurance companies, disability insurance claims, and other relevant news and updates.
This blog is a great way for us to keep you informed about general disability news and claim topics, but we wanted a way to keep those most interested in what our firm does up to date in a more comprehensive way.
Coming soon, we will be distributing a monthly e-mail newsletter. The newsletter will contain information not included on this blog, such as:
- Detailed tips for filing disability insurance claims with various carriers;
- Examples of best practices vs. worst practices when interacting with your insurer;
- Updates on recent disability cases relevant to your claim or potential claim;
- Specific answers to common questions, which newsletter recipients can submit anonymously; and
- Information on lectures and classes you can attend to hear the firm’s attorneys speak about choosing disability insurance policies and filing claims.
If you are interested in subscribing (at no cost, of course), please sign up here:
Disability Insurance Newsletter.
Your name is not required. Please rest assured that we will not use or distribute your e-mail address for any other reason.
Changes in DSM-5 Could Affect Some Disability Insurance Claims
More than a decade after work began on updating and revising the Diagnostic and Statistical Manual of Mental Disorders, DSM-5 replaced DSM-IV-TR in May 2013. While some of the changes in diagnostic criteria for disabilities such as intellectual developmental and specific learning disorders or the addition of new diagnoses in DSM-5 for disorders such as hoarding and gender dysphoria are unlikely to affect the private disability insurance claim of a doctor or dentist, the changes in the criteria for diagnosing post-traumatic stress disorder or substance-related and addictive disorders and the addition of the diagnoses of social (pragmatic) communication disorder and mild neurocognitive disorder have potential implications in the context of private disability insurance claims. Additionally, the elimination of the Global Assessment of Functioning (GAF) scale, widely used by insurance companies in determining the medical necessity of treatment, is likely to have an effect on some disability insurance claim determinations.
Some of the changes in DSM-5 are outlined below.
Social (Pragmatic) Communication Disorder: This new diagnosis, which cannot be diagnosed unless autism spectrum disorder has been ruled out, is described by the American Psychiatric Association as pertaining to individuals “who have significant problems using verbal and nonverbal communications for social purposes, leading to impairments in their ability to effectively communicate, participate socially, maintain social relationships, or otherwise perform academically or occupationally. . . Symptoms must be present in early childhood even if they are not recognized until later. . .”
Substance-Related and Addictive Disorders: The categories of substance abuse and substance dependence have been combined, and the criteria for a diagnosis have been strengthened. Where DSM-IV required only one symptom for a diagnosis of substance abuse, DSM-5 requires 2-3 symptoms from a list of 11 potential symptoms. Drug craving has been added to the list of symptoms and “problems with law enforcement” has been eliminated due to cultural differences in law enforcement internationally.
Post-Traumatic Stress Disorder: There are a couple of significant changes in the diagnostic criteria for post-traumatic stress disorder (PTSD). The requirement of DSM-IV that the person personally experience or witness the traumatic event has been eliminated and DSM-5 allows for a PTSD diagnosis when the person has learned that the traumatic event occurred to a close family member or friend, or experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (from sources other than media, photos, television or movies, unless work-related). Additionally, the requirement that the person experience “fear, helplessness or horror at the time of the traumatic event” has been deleted.
The criteria has also been changed to require “actual or threatened death, serious injury, or sexual violence.” The previous manual also allowed for “a threat to the physical integrity of self or others” but did not specify sexual violence.
Mild Neurocognitive Disorder: The American Psychiatric Association describes this new disorder in DSM-5 as “an opportunity for early detection and treatment of cognitive decline before patients’ deficits become more pronounced and progress to major neurocognitive disorder (dementia) or other debilitating conditions.” The APA goes on to characterize the disorder as:
Mild neurocognitive disorder goes beyond normal issues of aging. It describes a level of cognitive decline that requires compensatory strategies and accommodations to help maintain independence and perform activities of daily living. To be diagnosed with this disorder, there must be changes that impact cognitive functioning. These symptoms are usually observed by the individual, a close relative or other knowledgeable informant, such as a friend, colleague, or clinician, or they are detected through objective testing.
Global Assessment of Functioning (GAF) Scale: The GAF scale of 1-100, which was a single global assessment combining separate assessments of symptom severity, danger to self or others, and ability to care for oneself and function socially, has been eliminated from DSM-5. In the place of assigning a GAF number, separate assessments of severity and disability are recommended. The World Health Organization Disability Assessment Schedule (WHODAS 2.0) was determined to be the best current measure of disability for routine clinical use by the DSM-5 Disability Study Group.
The changes in DSM-5 are, of course, far more complex and detailed than what we have outlined above, but if you are suffering from a mental disorder and thinking of filing a private disability insurance claim, we recommend that you coordinate with not only your psychiatrist but an attorney before filing your claim with your insurer.
More information related to DSM-5 is available at this link.
CIGNA fined in Multi-State Regulatory Settlement Agreement Re Group Long-Term Disability Claims Handling; Some CIGNA Claims to be Re-Evaluated
Following a Targeted Market Conduct Examination of CIGNA’s disability insurance claims handling practices, CIGNA companies — Life Insurance Company of North America, Connecticut General Life Insurance Company, and Cigna Health and Life Insurance Company (fka Alta Health and Life Insurance Company) — entered into a Regulatory Settlement Agreement in May 2013 with the California Department of Insurance, the Connecticut Department of Insurance, the Maine Bureau of Insurance, the Massachusetts Division of Insurance, and the Pennsylvania Insurance Department. Insurance regulators of other states may adopt the terms by becoming a Participating State. As of this time, Arizona is not amongst the Participating States.
The targeted market conduct examinations were initiated by the Maine Superintendent of Insurance and the Massachusetts Commissioner of Insurance in 2009 to investigate whether CIGNA’s claim handling practices conformed with the standards upheld by the National Association of Insurance Commissioners. The regulatory concerns raised by the initial examinations prompted Connecticut and Pennsylvania’s insurance commissioners to open similar examinations and for the California Department of Insurance to reopen its 2006 examination.
As a result of the examination, the CIGNA companies were ordered to pay fines in the amounts of $500,000.00 to the California Commissioner of Insurance, $175,000.00 to the Maine Superintendent of Insurance, and $250,000.00 to the Massachusetts Commissioner of Insurance, and to take certain corrective actions in the handling of group disability insurance claims, to include:
- Giving significant weight in a claimant’s favor if the SSA has awarded SSDI disability income;
- Improving procedures for gathering medical information, attempting to resolve discrepancies in medical statements or conclusions, documenting and outlining the medical conclusions upon which a determination of disability is made, and evaluating functional capacity with the presence of co-existing or co-morbid conditions;
- Following written guidelines for using external medical resources if medical opinion/information is unclear or contradictory or if the claims adjuster disagrees with the opinions of the treating physician(s); Continue reading “CIGNA fined in Multi-State Regulatory Settlement Agreement Re Group Long-Term Disability Claims Handling; Some CIGNA Claims to be Re-Evaluated”
Does Your Unum Claims Handler Have a Personal Financial Incentive to Deny or Terminate Your Disability Claim?
The transcript of Unum Group’s May 23, 2013 Annual Shareholder Meeting provides some disturbing insight into what may motivate claims personnel at Unum to deny or terminate a legitimate disability claim.
Unum’s Chief Executive Officer, President and Director, Thomas R. Watjen reported to the shareholders that they had “overwhelmingly approved” an employee cash incentive system based on performance:
The fourth item of business is the approval of our annual incentive plan, which provides employees the opportunity to earn cash incentive awards based primarily on the company’s performance each year. Our company performs well, employees get treated well from a financial standpoint. Our company doesn’t perform well, employees don’t get treated as well. . . . So our shareholders see, as we as directors and managers see, how to run the company successfully by creating an incentive system based on performance. So that has been overwhelmingly approved.
Later in the meeting, Unum’s Chief Financial Officer, Richard P. McKenney, spoke about the performance of Unum’s “closed block of business,” which includes its individual disability policies issued prior to the mid-1990s–the type of policies that Unum no longer sells.
We do have our Closed Block business. These are policies which are written some time ago. We serve those customers equally as well. But the returns in these businesses are lower.
Taken together, the two statements paint a picture of claims personnel handling the closed block of business under pressure to improve the returns, or else they “won’t get treated as well” or receive as sweet an incentive bonus.
We often hear from claimants who are incredulous that their claims have been denied or terminated despite a mountain of evidence of their disability. This may be one explanation, and having an attorney to advocate for you as a claimant can be essential when you have a financially-motivated adjuster reviewing your claim.
The full transcript of the Unum Annual Shareholder Meeting is available at Seeking Alpha.
Financial Stability of Disability Insurance Companies
Over the past few months, A.M. Best, Fitch Ratings, Standard & Poor’s (S&P’s) and Moody’s Investors Services have updated their ratings of the stability of several insurers that sell disability insurance.
In March 2013, A.M. Best affirmed the financial strength rating (A) (Excellent) of Union Central Life Insurance Co. Concurrently, they affirmed the debt rating (a-) of Union Central. Also in March 2013, Fitch affirmed the rating outlook of Stable for Hartford Financial Services Group and its insurance subsidiaries.
In June 2013, A.M. Best affirmed the A++ (Superior) rating of Berkshire Hathaway Homestate Insurance, in part because of Berkshire’s reputation for “aggressive claims management, effective loss control services and history of conservative loss reserving standards.” Berkshire may be better known to some disability insureds as Guardian Life, and insureds should consider seeking the advice of an experienced disability insurance attorney before filing a claim with a company with a reputation for aggressive claims handling.
The financial outlook in June 2013 also improved for some other disability insurers, including New York Life Insurance Co., Massachusetts Mutual (MassMutual), and Northwestern Mutual. Standard & Poor’s upgraded all of those companies from Negative to Stable, and the Stable rating for New York Life was affirmed by Moody’s in July.
Penn Mutual saw its rating from Moody’s drop from Stable to Negative in June 2013 due to its weaker business profile as a result of increasing product risk and modest earnings and profitability.
Should Your Disability Insurer Still Require Medical Treatment?
Almost every disability insurance policy issued today requires that you are under the regular care of a doctor in order to be eligible for total disability benefits. However, for permanent medical conditions, sometimes additional treatment just isn’t necessary. For instance, if you undergo a spinal fusion, no amount of treatment is ever going to restore you to exactly how you were before. In addition, people with disabilities are often in a financially vulnerable position, and paying for unnecessary medical treatment can cause further strain.
The people that write and sell disability insurance policies understand this, so they often include an additional benefit in the policies: a waiver of the medical care requirement when treatment is no longer needed. This reasonable provision helps sell policies.
Unfortunately, once a claim is made, the companies are often unwilling to actually provide the benefit. What many insureds may not realize is that the language of these waiver provisions is designed to give the company wide latitude in determining whether or not to provide the benefit.
Continue reading “Should Your Disability Insurer Still Require Medical Treatment?”
Protecting Yourself in the IME Process: Get a Copy
This post is the last in our series on tips for undergoing disability insurance Independent Medical Examinations (“IME”). Today’s topic is a step to take after the examination is over:
Get a copy. After the exam, contact your insurer to ask for a copy of the IME report. Most IME doctors have a copy of their report to the disability insurer within two weeks. Your insurer may send a copy of the IME report to your own treating physician and ask for his or her comments on the exam. In that case, the company will require you to request the IME report directly from your own physician.
When you get the report, review it and compare it against your notes and/or recollection. If anything needs to be clarified, discuss it with your disability insurer or attorney. If you received the copy of the IME report from your own physician, talk about it with him or her. An inaccurate or misleading IME report can be dangerous to your claim for disability benefits, so it’s important to address any inconsistencies as best you can.
For more information on dealing with an IME, see our prior posts:
Protecting Yourself in the IME Process
Completing Intake Forms in Advance
Protecting Yourself in the IME Process: Bring a Friend
We have talked about involving a disability insurance attorney in the IME process, understanding what the insurance policy requires, completing intake forms, making lists, and taking notes. Today in our series about tips for Independent Medical Examinations:
Bring a friend. Taking notes is great, but having a witness present is best. That way, you can focus on participating in the examination, and your witness can focus on observing and taking notes. Moral support is an added benefit.
A friend, spouse or partner can be a good witness, especially if he or she is a medical professional. If you have a disability insurance attorney, he or she may also attend with you or send a representative from the law office.
Take note, however, that some insurance companies specifically state that witness are not allowed at IMEs. Normally, this alleged requirement is stated in the letter the insurer sends you to confirm the examination. If you have a disability insurance attorney involved, the attorney can review the letter, the policy and the law and determine whether or not a witness is allowed to attend.
Protecting Yourself in the IME Process: Make Lists and Take Notes
In our series of suggestions for handling an Independent Medical Examination (“IME”), we have already discussed getting a disability insurance attorney involved, knowing the disability policy requirements, and completing the intake forms. Here are today’s tips:
Make lists and bring them to the IME doctor. Don’t be afraid to bring information with you to help answer questions from the IME doctor. Some examples are a timeline of your symptoms—i.e., when they started, when they got worse, etc.—or a list of all your medications so you don’t accidentally forget one. If you have photos or videos showing certain injuries or symptom flare-ups, consider bringing those along as well.
Take notes. This will make sure that your recollection of the IME is recorded along with the doctor’s recollection. Your notetaking should start when you arrive at the IME provider’s office, as your time in the waiting room is often part of the final IME report.
For instance, IME doctors will often report something like, “The patient sat for half an hour before my exam completing the paperwork without any apparent discomfort.” If you take notes before the IME to memorialize how long you sat in the waiting room, if anyone was watching you fill out the paperwork, if you had to stand to stretch, etc., you will be able to show the insurance company whether the doctor’s statement is accurate.
If possible, take notes during the IME as well, so that you can remember exactly what testing was performed and what types of questions were asked.
When you leave the IME, take a few minutes to immediately jot down your impressions and any issues you think you need to follow up on with your disability insurer or attorney.
Protecting Yourself in the IME Process: Intake Forms
Up next in our series of tips for disability insurance policyholders being asked to undergo an Independent Medical Examination (“IME”):
Complete intake forms in advance. When you go to the IME, the doctor will most likely ask you to complete intake forms, including questionnaires outlining all of your symptoms and medical history. If you are stressed or hurried, you may forget to include something that could support your claim for disability insurance benefits. But if you have the forms in advance, you can answer each question carefully and accurately without leaving anything out. Consider asking (or having your lawyer ask) if you can have the forms beforehand to save time once you arrive.
Also review our prior tips on getting a disability insurance attorney involved and reviewing the disability policy requirements.
Protecting Yourself in the IME Process: Reviewing the Policy
In this series, we are outlining some tips for claimants facing an Independent Medical Examination (“IME”). Yesterday, we wrote about getting a disability insurance attorney involved. Today, we’ll explain another important step:
Make sure the exam is required by the disability insurance policy. This is another step where it is beneficial to have an attorney involved to review your disability policy. Most disability insurance policies do have a provision that allows the company to have you submit to an Independent Medical Examination or Physical Examination. However, sometimes those provisions aren’t totally clear on exactly what types of examinations are allowed.
For instance, here is a typical disability insurance policy provision that your insurer might cite to tell you that you have to undergo an IME:
At our expense, we can have a physician of our choice examine you as often as reasonably required while your claim is continuous.
This provision states that the examination should be conducted by a “physician.” Do you have to submit to a Functional Capacity Evaluation with a physical therapist? The provision also states the examination should be “reasonably required.” Has that qualification been met?
Here is another typical provision:
We shall have the right to have you medically examined at our expense when and as often as we may reasonably require while you claim to be disabled under this policy.
This provision says that you have the right to be “medically examined.” Does that mean you can only be examined by a medical doctor? Do you have to undergo a neuropsychological evaluation with a Ph.D.? Again, has the qualification that the examination be “reasonably required” been met?
These are the kinds of questions you may want to get answered before you agree to the exam.
In the next post, we’ll talk about the IME intake forms.
Protecting Yourself in the IME Process
As we have discussed before, disability insurance claimants are often asked to submit to “independent” medical examinations (“IME”) with a doctor chosen by the insurance company.
IMEs are a source of anxiety for many insureds, especially because they are often a first step towards termination of a disability claim. Fortunately, there are some steps you can take to help ensure that you are treated fairly.
Over the next few days, we will outline some general tips on dealing with IMEs. Keep in mind that these tips are no substitute for the advice of a disability insurance lawyer who knows the specifics of your situation. Hence, today’s tip:
Get your attorney involved. If you don’t have a disability insurance lawyer to help you with your claim, now is a good time to seek some advice. Oftentimes, insurance companies use IMEs to try to show that you aren’t entitled to disability benefits anymore. A lawyer can help protect your rights during the IME process by, among other things, finding out what the disability policy requires (and doesn’t require) and discussing those requirements with your insurer. If you aren’t sure how to find the right lawyer, consider our Questions to Ask When Choosing a Disability Insurance Attorney.
Disability Insurance for College Athletes
In a recent article, written in the wake of NCAA basketball player Kevin Ware’s traumatic leg fracture, The Atlantic explores whether college athletes should purchase disability insurance.
Like doctors and dentists, whose physical health can be crucial to performing their job duties, many professional athletes purchase disability insurance. By doing so, they attempt to protect their income from sickness or injury that interferes with their work.
For college athletes, disability insurance is intended to protect potential, future income that they expect to earn once drafted to professional sports teams. Because the term of the policies is so short – ordinarily just one to two years – and the potential benefits so high – often millions – these disability policies can be extremely expensive. The article discusses athletes and their families that paid upwards of $40,000 in premiums over one or two years.
As the article explains, though, this type of disability insurance is rarely collected. Though these athletes’ disability insurance policies are unique, the difficulty of collecting may sound familiar to many other types of professionals facing disability insurance claims:
[T]hese policies, meant to hedge against risk, are risky in themselves: None of these student-athletes is likely to ever collect a dime, even if they are hurt. These guarantees cover “permanent total disability,” meaning only policyholders who are never able set foot on a field or court again—not simply those who suffer injuries that may reduce their earning potential—can file a claim.
Read the full article here: The $5 Million Question: Should College Athletes Buy Disability Insurance?
For Doctors, Risk of Relapse Can Cause Total Disability
Because of the high-stress nature of their occupations and their ready access to pharmaceuticals, both physicians and dentists are at high risk of developing substance abuse issues. In a recent disability insurance case, Colby v. Union Security Insurance Company & Management Company for Merrimack Anesthesia Associates Long Term Disability Plan, the United States Court of Appeals for the First Circuit recognized the challenges that doctors can face when they are disabled due to substance dependence.
The insured in this case, Dr. Colby, was a partner in an anesthesiology practice. Like many anesthesiologists, she kept a demanding schedule, working 60 to 90 hours per week. In 2004, her colleagues discovered that she had been struggling with chemical dependence after she was found sleeping or unconscious on a table in the hospital. She tested positive for Fentanyl, an opioid used in her practice.
This led to the revelation that Dr. Colby had been self-administering opioids, and had become addicted. Shortly thereafter, Dr. Colby entered inpatient substance abuse treatment. As of January of this year, Dr. Colby had not resumed using Fentanyl.
When her drug dependence first came to light, Dr. Colby filed a claim with her disability insurer. Even after completing her treatment, Dr. Colby feared that returning to the anesthesiology environment, where Fentanyl (along with many other drugs) was easily accessible, would lead to her relapsing. However, the insurance company denied her claim for disability benefits. The insurer argued that she had been discharged from substance abuse treatment, and that although she was still under a doctor’s care and feared a relapse, “a risk for relapse is not the same as a current disability.”
Ultimately, the Court of Appeals disagreed. Judge Selya explained:
In our view, a risk of relapse into substance dependence—like a risk of relapse into cardiac distress or a risk of relapse into orthopedic complications—can swell to so significant a level as to constitute a current disability.
As this case demonstrates, doctors struggling with substance dependence should be cognizant of the fact that their occupation puts them at higher danger for relapse, and may contribute to their total disability from practicing. If you are facing this situation, it’s important to talk to your treating providers, disability insurance attorney, and disability insurer about how your work environment affects your risk of relapse.
Review the entire Colby opinion here.
Ranking Arizona Names Firm #1 for the Second Year in a Row
We are pleased to announce that we have been named the #1 Arizona Law Firm with 24 or fewer attorneys by Ranking Arizona: The Best of Arizona Business for the second year in a row.
Ranking Arizona is an annual publication of Arizona Business Magazine. Every year, Arizona Business Magazine compiles a list of the top companies in the state in various categories, including professional services such as accounting, real estate, and law. The final rankings in each category are selected by Arizona residents, who vote for the firms they most recommend.
In addition, attorneys Edward Comitz and Patrick Stanley, were both named Top Healthcare Attorneys in Ranking Arizona‘s individual rankings.
Pima County Medical Society Publishes Ed Comitz and Karla Thompson’s Article Re Surveillance in Disability Insurance Claims
The January 2013 edition of Sombrero, the publication of the Pima County Medical Society, features an article by disability insurance attorneys Edward O. Comitz and Karla Baker Thompson. The article, “Surveillance Misuse in Claims Investigations,” reviews some of the ways in which evolving technology has led to overly intrusive surveillance of claimants by insurance companies.
Among the surveillance techniques being utilized are stakeout operations, tailing (sometimes using a “decoy” investigator), pretexting (obtaining your personal information under false pretenses), and GPS and cell phone tracking. For example, some private investigators use a stingray, which is a cell phone tracking device that operates as a miniature cellular tower from inside of the PI’s vehicle. The device enables an investigator to connect to a claimant’s cell phone, even when it’s not in use, and, after taking measurements of the phone’s signal strength, triangulate its location. Since most people tend to carry their cell phones at all times, the device then allows the investigator to track the insured’s movements remotely.
The law surrounding some of these intrusive surveillance techniques, which have been made possible by modern technology, is not yet settled, and it is important that anyone on claim with their disability insurance carrier remain vigilant to the possibility of surveillance at all times, regardless of whether a human being is conducting the surveillance. Long gone are the days when surveillance was only conducted by someone with a camera sitting in a car outside an insured’s home.
