What surveillance techniques do insurers use to reject claims?

Published 08 Jan 2018

Author: Gerard Malouf

Purchasing insurance can provide peace of mind for people who want a financial safety net in case of unforeseen circumstances.

Employees typically have access to several life insurance products through their superannuation fund. These policies may include cover for total and permanent disabilities (TPD), critical illnesses and income protection.

Insurers must approve a claim before individuals are granted payouts, and this process can involve a private investigator (PI) placing people under surveillance to gather evidence.

The insurer may then use this information to reject a claim or try to discredit a plaintiff if a superannuation dispute reaches the court. Here are two of the most common forms of surveillance:

Video and camera

Insurers regularly use video and camera surveillance to record claimants while they are performing day-to-day tasks.

If the individual is seeking TPD compensation, for example,  a PI may try to catch the person participating in activities they are allegedly unable to do, such as playing sports, lifting heavy objects or dancing.

People who are suffering from mental health problems, such as post-traumatic stress disorder (PTSD) or depression, often have claims rejected because they are filmed appearing happy or celebrating an occasion.

Some individuals even give up on their claim due to the stress of constantly being followed and recorded. For those with psychological disabilities, the additional pressure can exacerbate their existing symptoms and delay recovery.

Social media

The rise of social media has given PIs another avenue to track claimant’s activities. Investigators can examine and collect your photos, as well as use status updates as evidence against a claim.

Recently, a TPD claim went before NSW Supreme Court in which the plaintiff’s Facebook activity was monitored. The woman – a former police officer diagnosed with PTSD – had attended horse shows and posted about how happy she was, despite making a claim for social phobias.

Justice Stephen Robb ultimately ruled in favour of the plaintiff, awarding her $788,000 from her TPD policy. Nevertheless, the case highlights how insurers may use social media surveillance to reject legitimate payouts.

The woman later alleged that Metlife had invented a fake Facebook account in order to befriend one of her contacts so the insurer could gain access to her profile, which was set to private. Metlife denied the claims.

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