Successful Cases We Have Handled – Litigating Fraud
From time to time, carriers decide to follow clients to try to catch them doing things that seem to be illegal or just plain sneaky. Most of the time, the videos are no more than a way for insurance companies to avoid paying what they owe. Over the years, I have had many cases in which I have had to review evidence and in the vast majority, we have been successful in showing the clients are deserving of their benefits. Here a few examples over the years.
We successfully settled a case in which the carrier had videos that they insisted showed our client was working in a carpet cleaning business while at the same time claiming he was too disabled to work and that therefore he was not entitled to workers’ compensation payments. The carrier charged the worker with fraud and his attorneys told him they couldn’t help him and that he should consult with a criminal attorney.
We reviewed the videos carefully and discovered the videos were altered and our client was not working at all. Following a trial and an appeal in which the Workers’ Compensation Board ultimately ruled that the videos did not prove fraud, we were able to settle the case and the client received over $250,000 in benefits.
In another case, the insurance company at first agreed to pay our client lifetime payments and then claimed they had incriminating videos showing the client was not disabled after all. It turned out the videos merely showed our client walking his dog one day. After challenging the carrier to show the judge the videos, we were ultimately able to have the lifetime payments restored.
We have also used videos ourselves to catch the insurance company in the act, turning the tables. We had one case in which our client took videos of the insurance company doctor’s exam. When the doctor testified completely differently from what our videos showed, we were able to obtain a lifetime pension for our client.
We even had a case in which the carrier followed our client out of his apartment to his job and then tried to stop his benefits after the client insisted he was not working. A careful review of the evidence showed the worker was tall and heavy while our client was short and thin. The man who was followed to work was in fact the client’s roommate and cousin, of the same ethnic group, but otherwise bearing no resemblance. Once we established that the person on the video was not our client, we proceeded to settle the case.
Clearly, carriers following clients and setting up surveillance is not the norm. The point here is that sometimes even innocent people are caught in the web of overzealous carrier’s defenses of claims. Yes, it occasionally gets nasty and we have seen it all. We are there to help prove that you deserve the benefits you seek and we can handle matters ranging from quick answers to your questions to going to a full blown trial to show that just because the insurance company says you did something wrong, at the end of the day, it is the judge who decides.