What the Insurance Investigator Doesn’t Want You to Know

During a long term disability case, it is common for the insurance investigator to request a “field interview”.

First, they will call you and ask you casual questions about your health and your daily life. Do not be fooled! They are not calling to check on you because they care. They are looking for inconsistencies in your story to prove to a judge that you are lying about your disability.

Second, they will say that they need to have a face to face meeting to discuss how to are doing. This is called a field interview. Field Interviews are used to discredit claimants filing for disability.

Tips to Prepare You for a Field Interview:

Background Checks

Thanks to modern-day technology, insurance companies will have your complete background at their fingertips. They have access to your medical history, your credit report, and liens or bankruptcies, child support payments, delinquent payments, and more. They will use this information during the field interview to try to trick you into saying something that makes you appear to be dishonest. Go over this information with your attorney before the field interview. Plan to be asked some tough questions and stay calm. Your attorney will help guide you through these tough questions.

Pre-Interview Surveillance

Sometimes insurance investigators will put you under surveillance before your interview. They will question your neighbors about your daily activities. They will watch you and follow you to see if you are doing anything that you said you couldn’t. They will record you.

Be vigilant! Do not overdo it. Sometimes your doctor may encourage you to carry on with your daily life to speed up your recovery, but an insurance investigator sees this as you telling a lie about the severity of your condition. Although the actual surveillance cannot be used against you, the insurance company will ask your doctor to look at the tape and make comments on your physical activities that can affect your case.

Interview Location

When the insurance company calls to “check on you,” they will try to persuade you to have the field interview in your home. They are trained to speak in a certain way to make you feel like you have no choice.

That is not true.

You have the right to have your field interview at another location and you should. Why? The insurance investigator is trained to go into your home and take notes on how to live. If you have a large TV, if your home has stairs, if you have pets, or if other people are living in your home. They will use all of this to build a case against you. You do not have to let them in your home. Arrange for the meeting to be somewhere else.

You Have the Right to Have Your Attorney Present

You have the right to have your attorney present. An insurance investigator might try to discourage you from bringing your attorney by implying that it is just a simple face to face conversation. Don’t let them fool you. Your attorney is trained to assist you and support you. Having an experienced attorney present will make your case much stronger and keep you from getting intimidated by the insurance company.

Preparation is Important

If you spend time preparing yourself for the interview, it will go smoothly. Let your neighbors know that there is a possibility that an investigator will come to see them to snoop around. Make sure to take it easy and don’t push yourself in the days before your interview. Go over anything that you think may come up during the interview with your attorney. Although field interviews can be scary, you can get through it with the right preparation.

Field Interviews: What To Do During A Field Interview

In this article, we are going to discuss the field interview requests that commonly come from long term disability insurance companies. The field interview request is when the insurance company says, “We want to send someone to your home to meet with you to discuss your claim.”

Does A Claimant Have to Permit the Field Interview?

First of all, does an individual have to do the field interview? You are probably here because you are wondering, “Hey, the company just called me. Do I even have to meet with them to engage in this field interview?”

As you will see said time and time again on this website, your obligation to participate in the field interview comes down to (i) the policy and (ii) the obligations and requirements that you have under the terms of that policy. Most policies do not require that you must participate in the field interview process under their proof of loss requirements. However, some policies do. Therefore it is really important to review your policy’s proof of loss requirements carefully to determine if you first have to participate in that field interview with an insurance company representative.

Should A Claimant Voluntarily Participate in the Field Interview?

Assuming you are not required by the long term disability insurance policy to participate in a field interview, then you should still weigh the pros and cons of meeting with the representative versus not meeting with them. You do not need to worry just because the insurance company called for one. For some insurance companies, field interviews are simply routine. They may have a protocol where they just say, “Every two years, we’re going to send someone out to meet with you.” And that is just the way that particular company handles their claims.

There are certain companies that if they’re calling you for a field interview, it is not a good sign. For example, the insurance company may have just completed a week of video surveillance on you. Now they are going to try to enter your home, sit you down, and go through a specific line of questioning with you. The representative may make you feel comfortable with them. They’ll tell you that they’re not there to harm you or your benefits. Then they pop open their laptop computer and say, “Oh, can you explain what you’re doing here and why were you able to move in this way? And why didn’t you report it to the insurance company?” You may feel like you have your back to the wall and you’re just saying a bunch of random things in self-defense. The next thing you know – the insurance company uses your own statement to deny your claim or terminate your benefits.

Representation By An Attorney?

Given the foregoing, it is our recommendation that you never undergo a field interview without representation from an attorney. If you do intend to move forward on your own, you should be prepared.

You definitely want to be prepped by someone familiar with the process who could explain to you what to expect at the field interview. Again, you should not believe that the insurance company is going to your house because they care about you and because they are looking out for you. You must understand that they want to make sure there is sufficient evidence to deny your claim.

The Importance of a Field Interview in the Claim

In many cases, the field interview process is a benign process. The field interviewer may be there to obtain an update; to go through some additional questions with you; to review some recent medical treatment that you’ve had; to update your medical folder, including your current list of doctors and why you are seeing them; etc, etc.

In short, it is like preparing for a hurricane. You do not know if that hurricane is going to hit and destroy your home, but you go through the preparations of ensuring that you’re going to limit the damage. The same preparation needs to occur with these field interviews. You need to prepare yourself so you do not cause much damage to your disability insurance claim.

Who Is Actually Conducting the Field Interview?

There are a couple of different scenarios that you might see during a field interview. For example, MetLife is employing some full-time field interviewers. These representatives work for MetLife and conduct the interviews. Hartford has some full-time employees that perform interviews as well. Unum, on the other hand, may hire a third-party company to conduct the field interview. These third parties may not know much about your disability claim except for perhaps what’s on the one pages summary they were sent by the disability insurance company.

There can be a lot of frustration with an interview conducted by a third party. That’s because this person may come to your home, ask you questions for several hours, ask you tons of questions that are already answered in the claim file, and ask you a bunch of questions that may be wildly inappropriate. We try to cut out the duplicative and inappropriate questions to make these meetings go as quickly as possible. You should not have to sit there and start talking more than you have to.

Ways Insurance Investigators Try to Trick You and How to Avoid The Traps

Do Not Have Interview In Your Home

Most insurance examiners will try to insist that you have the field interview in your home. They want to come inside your home and take notes on how you live, whether you have stairs, whether your home is tidy, who you have living in the home, etc.  Your attorney will advise you to meet at a neutral location to protect you against this.

Be Aware of Surveillance Before and After

Surveillance is a tactic used by the insurance company to find holes in your story. In the days before and the days after your field interview, they will question your neighbors about your daily activities; watch you and follow you to see if you are doing anything that you said you couldn’t. They will record you. Be vigilant.

Don’t Overdo It

Sometimes your doctor may encourage you to get on with your daily life to speed up your recovery; This may be a well-meaning intention by your doctor, but an insurance investigator sees that you are ready to go back to work and not disabled. Although the actual surveillance cannot be used against you, the insurance company will ask your doctor to look at the tape and make comments on your physical activities that can affect your case.

Have Your Attorney Present

You have the right to have your attorney present. An insurance investigator might try to discourage you from bringing your attorney by implying that it is just a simple face to face conversation. Don’t let them fool you. Your attorney is trained to assist you and support you. Having an experienced attorney present will make your case much stronger and keep you from getting intimidated by the insurance company.

Be Prepared For Tricky Questions

The insurance investigators are trained to ask you questions several different ways to trick you or confuse you. They may bring up things from your past like your credit history, child support payments, liens or bankruptcies; This is to make you uneasy and get you to say something accidentally that they can use against you later.

Common Questions

There are some common questions asked by the investigator. They are meant to trick you. Here are a few of the common questions:

• What do you do during the day?
• How is your recovery coming along?
• What are your current symptoms?
• How often do you see your doctor?
• What are your current limitations?
• How are you feeling?
• When do you think you can return to work?
• What medications are you taking?

Work with your attorney to prepare for these questions. The more prepared you are the more comfortable the field interview will be.

Provide Explanations When Needed

The investigator prefers you to answer “yes” or “no” to their questions. But if your response begs a further explanation, then don’t be afraid to speak up and give one. The investigator may try to cut you off or move on to the next question but continue with your answer until you are finished. Also, do not give more information than necessary. Giving them too much information will provide the insurance company the opportunity to twist your words. Answer the questions directly but don’t be afraid to explain when needed. A field interview can feel a lot like an interrogation. Do your best to remain calm.

If you spend time preparing yourself for the interview, it will go smoothly. Let your neighbors know that there is a possibility that an investigator will come to see them to snoop around. Make sure to take it easy and don’t push yourself in the days before your interview. Go over anything that you think may come up during the interview with your attorney. Although field interviews can be scary, you can get through it with the right preparation.

Recording the Field Video

Some claimants also ask, “Do I want to record these field interviews?”

There are primary ways to record the field interview: (1) video recording it; (2) audio recording it; and (3) having an actual court reporter present.

These do add costs to the claim but are advantages to recording the interview. For example, the field interviewer’s report may have inaccuracies. They write down things you purportedly said, but those things are not what you actually said. It would be good to have evidence to combat inaccuracies.

But if you are not going to record, then you should ask for a written transcript of the interview and a copy of the field interviewer’s report. You may even ask to review a copy of the interviewer’s notes. Wouldn’t you want to see everything that’s being written down so that you can sign off and say, “Yes, I said A, B, C, D, and E.” Then there are no issues. But keep in mind that the companies won’t often give you their notes.

Legal Representation by Experienced Long Term Disability Attorneys

If you’d like to speak to an experienced Long Term Disability Insurance Attorney about your denied claim, contact us at (866) 853-4512 to schedule a consultation. Although based in Florida, the Ortiz Law Firm represents claimants across the United States. We can help you evaluate your claim to determine whether you qualify for Long Term Disability Benefits and how to navigate through the appeals process if your claim has been denied.