Long-term disability insurance companies are focused on their bottom line. Therefore, when you submit a claim for long-term disability insurance, your insurer will look for inconsistencies and other red flags that could indicate an exaggeration or falsification of your disability. In some cases, your insurer may request that you meet and speak with a “field representative,” which is a euphemism for a private investigator. If your insurer makes this request, it is important that you understand your rights and properly manage the investigation to protect your interests.
Private Investigators
Some insurance companies employ their own private investigators, while others hire private investigators from third-party vendors. Whether the private investigator is in-house or from an outside company, a large majority of them have law enforcement backgrounds. They will approach your case like a detective investigating a crime, trying to catch you telling lies or performing tasks that are inconsistent with your stated level of disability. The insurance company will then use these findings as evidence to deny your claim.
How a Field Interview Is Initiated
Insurers initiate a field interview in one of two ways. The first, and most civilized, way is for the insurance company claim representative to call you and set up a mutually convenient time. In many cases, however, a private eye will just drop by your home or office, unannounced, under the auspices of being a goodwill ambassador for the insurance company, who “just happened to be in the neighborhood,” or something to that effect.
How to Respond to an Interview Request
Some insurance policies require that you meet with their investigator as part of your policy’s proof of loss requirement, while others do not. When given the option, the decision to meet with the private eye should be made on a case-by-case basis.
Before proceeding with any meeting or field interview with an insurance company representative, you are strongly advised to consult with a long-term disability insurance attorney who is familiar with these types of interviews. Do not meet with an insurance company private eye without preparing in advance. Your attorney can help you prepare and accompany you to the meeting. If your insurer has devoted resources to pay for a private eye to meet with you, you can bet that the company has some serious questions regarding the viability of your long-term disability claim. Additionally, you can rest assured that the insurance company has done its due diligence prior to the field interview. For example, the insurer has likely run a full background check on you, looking into everything from the debts you may owe to the cars that are registered to you. The insurer will have also scrutinized your photos and comments on social media and performed in-person surveillance to observe your activities and functional capabilities.
Preparing for Your Interview
Before your field interview with the private eye, gather relevant documents and plan how you will respond to a broad range of questions. Be prepared for questions pertaining to your pre-disability occupational duties and the physical or mental restrictions and limitations that prevent you from returning to your previous occupation. The investigator will likely ask you about certain line-items in your tax returns, your current sources of income, your activities of daily living, your current treating physicians, your most recent medical appointments, your prescription drugs, your last vacation, gym memberships, golf club memberships and more.
Most private investigators are not really interested in your responses to many of the above questions. They ask these questions to camouflage the one or two “true” questions they came to ask, which are designed to catch you in a lie. For example, in response to a question from the private eye, you may state that the maximum amount of weight you can lift is 10 pounds. Unfortunately for you, insurance company surveillance may have already revealed you lifting a 30-pound case of water into the trunk of your car in the Costco parking lot. The insurer will then use your contradictory statement as evidence to dispute the validity of your claim.
While some policies require that you meet with an insurance company representative for a field interview, I have never seen a long-term disability insurance policy that requires you to meet with an investigator in the privacy of your own home. Private eyes love to take a look around your home. They will note golf trophies on your fireplace mantel, the skis in your garage, and the elliptical exercise machine in your den. Do not meet with a private investigator in your home. Try to meet in a neutral space like in a quiet Starbucks, a hotel lobby, or, better yet, your attorney’s office.
Finally, at the conclusion of the interview, do not sign any statements drafted by the private investigator. If the private investigator wants you to sign a piece of paper that is full of statements attributable to you, contact a qualified attorney as soon as possible.
If you have questions about your long-term disability insurance claim, or if your claim is being challenged or has been denied, contact Schwartz, Conroy & Hack PC. We have the expertise, experience and tenacity to make insurance companies keep their promises to policyholders like you.