Written by Peter CarterAugust 3, 2016
Insurers who spy on unwell police officers have been warned that their raft of claims denial tactics will worsen claimant’s health and leave the snoops subject to their own legal prosecution.
A Four Corners report this week detailed how a former police officer struggling with on-the-job PTSD and depression and was subjected to extensive video surveillance by insurer MetLife, even after the insurer’s psychiatrist classified him a suicide risk.
Brendon Bullock witnessed numerous traumatic events in the line of duty before quitting the force in 2011.
His claim for mental illness under a scheme offered by NSW Police’s superannuation fund and managed by MetLife is disputed by the insurer which has launched a barrage of denial tactics against him.
Despite MetLife’s psychiatrist assessing Bullock as having a total and permanent disability, it refused him any payment, preferring instead to search for something that could discredit his claim so it could hold on to the cash its policy promised.
It engaged investigators to watch his every move and monitor his online activity for a 7 month period during which Mr Bullock’s condition rapidly spiraled downwards.
Are these practices illegal? If not, should they be?
Read more about the legal arguments in this ABC news article.
Common claim-denial tactics used by insurers
- Hiring quasi-medicos to review medical records and diagnostic tests to build cases against claimants
- Using video surveillance to monitor claimants’ activities waiting for something that can be misinterpreted as something inconsistent with the injury claimed
- Recording interviews to elicit information that could later be misconstrued or taken out of context. For example:
Interviewer: Good morning, how are you today?
Claimant, giving the regular polite answer: I’m fine, thanks
- Requests for information to which insurers have no entitlement, or may not even be relevant to the claim
- ‘Desktop investigation’ – trawling through the internet/social media/email activity of claimants and their ‘friends’ while masking their visits and downloading items for future reference
- Advising claimants that seeking legal advice is unnecessary, despite the contrary being true
- Asking claimants to authorise the handover of records regarding medical treatment however irrelevant it may be to the claim
- Offering a quick, small settlement in return for the signing of a full liability release before the full extent of the injury isn’t immediately apparent
- Holding out on payments so those facing financial difficulties accept a meagre settlement