Surveillance is widely used in the insurance claims and risk management business. Large and small claims have been mitigated or denied using this age-old but highly effective tool. The decision to use surveillance can be based on a wide variety of factors, right down to an experienced claims professional’s ‘hunch.’ However, typically the reasons to use surveillance include one or more of the following: the level of exposure of the claim, suspicious accident details, contradicting medical evidence, and leads regarding the subject’s activity level or work status.
When used properly, surveillance can be a powerful risk management tool for employers and claims administrators. It is employed to document a subject’s activities and capture anything found inconsistent with alleged injuries for use in claims evaluation, settlement, or in a trial setting. Certainly, surveillance video contradicting a claimant’s allegations can carry significant weight in the midst of any negotiation, hearing or trial.
Making the case and making it stick
When it comes to employing surveillance on any particular claim, obtaining a favorable settlement or verdict is really a ‘team’ effort. Choosing the right surveillance vendor is vital, but the whole process begins with the claims professional and the file selection process. Surveillance cannot and should not be used on every claim, so identifying those claims with the most potential is crucial. Once the vendor has been selected, authorizing the appropriate budget for the case should be carefully considered, as each scenario is different. You only get out of surveillance what you put into it!
Next is communicating all known information before and during the investigation and assigning the right defense attorney to present any video evidence. No matter how much damaging video is obtained, if the defense attorney does not have experience with video evidence then it could all be for nothing. This doesn’t only mean having knowledge of the discovery rules, but also the ability to be able to bargain with and/or use video evidence at trial with confidence.
If your surveillance vendor is consistently not returning useful information or video, first examine the whole process from claim selection to communication amongst each party involved to identify any breakdown. If no clear breakdown exists, it is time to more closely evaluate your vendor. Discuss the vendor choices of colleagues and their experiences with results. Obtain the opinion of your defense counsel. Lastly, express your concerns with your vendor, listen to their perspective and discuss what can be done to improve results.
If things don’t improve, it’s time to move on. Be sure to rate your perspective surveillance vendors and know what percentage of video your vendor obtains on a whole and on your referrals.
We all know how one bad loss can affect the bottom line; a solid, consistently performing team can be your greatest asset in claims defense and mitigation.