Can Surveillance Be Used to Disprove LTD Claims?

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Can Surveillance Be Used to Disprove LTD Claims?

Can Surveillance Be Used to Disprove LTD Claims? By David Lackman

Dealing with an insurance company after filing a long-term disability (LTD) claim can be frustrating, especially if your benefits are denied or terminated. The process can become even more overwhelming if you are placed under surveillance.

When you have health insurance, you expect to receive benefits if you are injured or become ill. However, insurance providers do not simply approve every claim. They closely scrutinize your eligibility based on the policy’s criteria.

To support your claim, you must provide necessary evidence such as medical reports, clinical records, and other paperwork like proof of income. Once your claim is submitted, your insurer may conduct an investigation, including an interview or verification of medical documentation, to ensure eligibility.

If your insurer questions the validity of your claim or whether your condition satisfies the criteria, they may hire investigators or use in-house resources to observe your activities. Surveillance is more common than many realize and can occur in cases of physical or mental health disability claims. This experience can feel invasive, leaving claimants stressed or unfairly judged.

If you feel your rights are being infringed or your claim has been denied, you should seek legal advice. The knowledgeable team of long-term disability lawyers at Gluckstein Lawyers can advocate for you and ensure fairness when dealing with your insurer.

Surveillance of LTD claimants is legally permitted but has clear limits. Investigators often monitor a person’s daily routine to assess physical activities and report their findings to insurance providers. This might involve taking videos or photos, gathering statements from neighbors, and detailing observations about your behavior and physical condition.

Investigators can take photos or videos in public spaces, but they cannot trespass on private property, record conversations without consent, tamper with mail, or harass the claimant.

Social media is another tool insurers use to challenge claims. Posts or photos depicting activities that appear inconsistent with your medical condition could be used as evidence. While such postings don't provide a full picture of a person's functionality, they can still create complications. To protect your claim, ensure your social media accounts are private and avoid posting during the claims process, as even harmless updates can be misinterpreted.

Investigators also conduct data surveillance, such as checking public records or conducting online searches. However, they can only access information available to the public and no more.

Insurance companies may initiate surveillance when they doubt the validity of an LTD claim or when deciding to terminate benefits. However, video recordings or photographs rarely provide a complete perspective on a person’s health or ability to work.

A moment of activity might reflect a claimant's "good day," followed by several days of pain and reduced ability to function. For example, someone with a back injury may be able to complete limited physical tasks, like gardening for an hour, but that does not mean they are capable of performing sustained, physically demanding work over a full workday.

This was demonstrated in the Ontario Superior Court of Justice case Fernandes v. Penncorp. The insurer denied an injured bricklayer's claim after over 140 hours of surveillance during 19 days. Although the claimant was filmed completing light manual tasks, the court found these activities were not comparable to the heavy demands of bricklaying. The court acknowledged the claimant suffered pain during and after these activities and awarded him substantial damages for the insurer’s conduct.

It’s natural for insurers to scrutinize disability claims. However, as a claimant, you have the right to challenge surveillance findings if they mischaracterize your condition or unfairly question your eligibility. Experienced legal professionals can help you push back against unfair practices and advocate for the benefits you deserve.

If you’re facing a denied LTD claim or feel overwhelmed by the surveillance process, reach out to Gluckstein Lawyers. Their team is committed to providing trusted advice and ensuring transparency in your interactions with insurance providers.