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Circling Back: How checking up on disability claimants can uncover truth

art14-16The general counsel for a regional insurer contacted the offices of ResultQuest and requested surveillance over the course of two days. The surveillance would be targeted at a man who had been injured on the job years earlier and was receiving payments for full and permanent disability benefits for a back injury. The subject was scheduled to visit his attending physician and coverage of the day before and the day of the visit were indicated.

It was revealed that the subject was fully ambulatory, as extensive film footage (obtained from a camouflaged position), showed the subject washing a large motor home using a tall folding ladder and long-handled brush. He also repeatedly climbed into and out of a raised driver hatch that required pulling himself up with his arms to utilize a small stepladder below the hatch.

The next day the man’s wife drove him to his doctor’s appointment in Tyler, TX, where he listlessly emerged from the passenger side of the car and was “helped” to his feet by his wife, who removed a set of crutches from the back seat to further aid the subject. The subject walked at a snail’s pace as he entered the office building.

Following the appointment, the couple drove to a catfish restaurant in Tyler, and, miraculously, the subject was no longer in need of crutches as he walked normally in and out of the establishment. He then proceeded to drive as they returned home to Athens.

Although the Henderson County District Attorney had agreed to present the matter to a grand jury, the insurer opted to accept a rescission of all claims from the claimant, along with repayment of a portion of the fraudulent gains.

Paying an able-bodied person who deceitfully claims to be hurt is costly and unfair to your stakeholders. If you are supporting a disability claimant and want to know their true condition, the experts at ResultQuest stand ready to act as your truth detector. Call us at 713-781-904 for a free evaluation and cost estimate.