The PI Chronicles: Five Things Not to Do When on an Insurance Claim
Based on my years of experience as a Surveillance Specialist in Ontario.
5) Long Term Disability insurance (LTD) is not like winning the lottery.
When you are approved for an LTD claim, it does not mean you can forget the insurance company and go on with your life as though there’s nothing wrong. Consider that the insurance industry is spending more money on LTD claims than on any other type of claim. They take on the responsibility to support you to the agreed upon degree for the agreed upon term, whether that be for the rest of your life or for a specific number of months.
For the vast majority of cases, the claimant well deserves the money they receive, whether that be the result of someone else’s negligence or not, they have suffered the loss of functionality in their lives and cannot, for whatever reason, go about their lives at the same level of purpose. However, those who abuse this level of the system, should be prepared to be scrutinized, examined and ultimately left behind by their insurance carrier at the first sign of fraud; and make no mistake, carrying on with an insurance claim, especially an LTD claim, when you are knowingly fine or otherwise not eligible for that claim is fraud.
A legitimate LTD claimant is recognised as having a reduced capability to function in their life, as it was previous to the claim. Being awarded the claim is an attempt at recompense and is intended to assist the person in gaining back, some of all of the personal freedom they enjoyed previously. However, the simple facts of life dictate that a person who has been awarded a long term disability claim will never be able to enjoy the physical freedom they once enjoyed, and this is the fine line we walk when we investigate these types of fraud cases.
We understand that life can and will be frustrating for the LTD claimant, and at times they will rebel against their new physical restrictions by behaving outside of what might be considered a safe frame of activity. Though, over the long term, their behaviour will be fairly easily measured, and be certain when I tell you, that we can and will identify consistent behaviour that is contrary to your claim.
Overall, the insurance industry has its flaws; it is populated by people, people with egos and sympathies. There is a very good reason for the largely faceless interaction we have with our insurance companies, and while that may not always be admirable or even moral, it does serve to clinically separate them from their clients, which in most cases in beneficial for all parties involved.
The bottom line here is, that if you decide to overextend your welcome on any claim, you might find yourself in my company, though you’ll never know I’m there.
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