Ask anyone over the age of 40, and they can complete this old TV theme song: “When you least expect it, you’re elected, you’re the star today! Smile, you’re on…”
“Candid Camera!” The program secretly filmed ordinary people put in intentionally silly or embarrassing situations, all for laughs. It remained one of the most popular TV shows of the ‘60s and ‘70s, thanks largely to the hook of catching people in the act of being their real selves.
In the world of workers compensation insurance, catching people in the act of being their real selves happens too. But it’s rarely, if ever, for laughs. The use of surveillance has been and remains a central tool in identifying and minimizing insurance fraud.
Workers comp providers press for surveillance when a claim warrants additional proof of injury or disability pertaining to a claimant. Obtaining proof of what an individual does in his or her off-hours can have direct implications on whether their claim is valid, and if so, to what degree.
The employer paying for workers comp coverage has or wants this additional, objective information on a claimant, and approaches the insurance carrier, who typically makes the decision on whether to pursue surveillance. Third-party private investigators may be used. Social media, thanks to its ubiquitous presence and its ability to share information and images immediately, also comes into play.
A workers comp claimant looking for a large settlement because of an inability to work due to a back injury should not be photographed or videotaped participating in a bowling league, or lifting large heavy packages into a friend’s pickup truck, for instance. Capturing evidence like this, which contradicts a claim’s baseline argument, can frame mediation or a settlement in short order.
Surveillance can shorten the life of a claim, leading to settlements of lower, many times fairer, value. Of course, if no evidence of fraud is discovered via surveillance, the settlement will be every bit as fair, based on the proven and justified accuracy of the claim.
It’s worth always keeping in mind, though, that the workers comp provider’s “candid camera” is ever at the ready, and that it is up to the claimant to file claims accordingly.
Contact the team of professionals at the Reschini Group for more information on surveillance and other tools to safeguard your organization’s workers comp coverage.
Copyright 2020 The Reschini Group
The Reschini Group provides these updates for information only, and does not provide legal advice. To make decisions regarding insurance matters, please consult directly with a licensed insurance professional or firm.