Doctor Says Insurer's Video of Disabled Man Eating Taco Chip 'Means Nothing'
The Hartford Reinstated Disabled Man's Benefits After Being Contacted by 'GMA'
By CHRIS CUOMO and GERRY WAGSCHAL
Nov. 13, 2009—
We've all heard stories of people who fake injuries in order to collect lucrative insurance benefits, and how insurance companies catch them in the act by using videotape surveillance. But critics say sometimes insurance companies go too far, by videotaping people who are truly disabled and then using that video against them, no matter how harmless the video seems.
Jack "Rocky" Whitten -- who suffers pain and memory loss as a result of a broken neck -- says his disability insurance payments from The Hartford were terminated in part because the company caught him on video eating a taco chip.
Videotape of Whitten -- captured by a private investigator hired by Whitten's insurance company -- that shows him reading a magazine, getting into a car or dipping a chip into salsa might seem innocuous, but that video helped cost Whitten and his family dearly.
Insurance Company Questions Disability
The married father and grandfather broke his neck, which he had previously injured, in a fall seven years ago. Doctors declared him permanently disabled, and said he would not be able to return to work.
Dr. Roger Cicala treats Whitten, and said his patient is disabled.
"I'm absolutely sure," Cicala said. "This man has tried everything he could to get back to work."
Whitten said his vision is affected by all the medicine he takes.
"I have severe headaches," he added. "I have problems with short-term memory now."
Whitten, who'd had a well-paying job as manager of a Walmart, had planned for unforeseen hardships.
Ten years ago, he bought a disability insurance policy from The Hartford. The policy would pay him 60 percent of his salary if he ever became disabled.
After the accident, Whitten filed a claim and began receiving benefits in 2003.
But last year, a man from The Hartford came to visit Whitten and his wife Leigh at their home.
"He started asking Rocky questions concerning his limitations," Leigh Whitten recalled.
Whitten Had 'No Difficulty Dipping Chips at a Restaurant,' Company Says
The couple was stunned when the representative showed them video that the private investigator had recorded.
The video showed "Rocky getting out of a van. Followed us into a bookstore. Rocky looking at a magazine. … He was eating chip and dip, like salsa and chips, at a local restaurant here in town," Leigh Whitten said.
Soon after that visit, the Whittens received a letter from the insurance company. It said the videotape showed Jack Whitten had "no difficulty dipping chips at a restaurant," and that he "could shop, reach, bend, enter and exit a vehicle."
A doctor hired by the insurance company -- who had never met Whitten -- said medical records and surveillance video showed he was "physically capable of performing full-time sedentary occupations," the letter added.
Even though three of Whitten's doctors and the Social Security Administration all had stated that Whitten was permanently disabled, the insurance company cut off his benefits.
"To me, that is just their way of getting out of paying us," Leigh Whitten said. "I mean, they found the least little thing that makes no sense. He has to eat. I mean, a chip means nothing."
Without Payments, Family Faced Crisis
Cut off from the payments, the family faced a financial crisis.
"I was worried if I was going to be able to take care of my kids and get them to college, and keep food on the table," said Whitten, who has two sons and a grandson.
Cicala said the type of activity shown on The Hartford's videotape isn't relevant in making a determination about his patient's fitness for work.
"Eating a taco means nothing," Cicala said. "We know he can eat. His hands work. … If there's a job eating tacos, he might be able to do that. I don't know of such employment."
Company Says Claim Handled 'Fairly'
Whitten's attorney, Alicia Paulino Grisham, said The Hartford uses the videotape surveillance to intimidate claimants into giving up and not pursuing their claims.
"They suggest fraud and it scares claimants," she said.
The Hartford denies that claim. The company sent ABC News a statement saying the company's "overarching mission has always been to ensure people with disabilities receive the benefits to which they are entitled," and that it handled Whitten's claim fairly.
The company said it uses surveillance to prevent fraud, and that it's used in less than 5 percent of claims. It added that out of those 5 percent, the surveillance, along with other factors, ends in the cutting off of clients' disability insurance 30 percent of the time.
But ABC News has learned there have been over a dozen cases where federal courts ruled The Hartford improperly overemphasized their surveillance video. The Hartford said these cases don't "fairly or accurately represent The Hartford's strong record of paying disability claims or our limited use of surveillance to review and validate claims."
To see some examples of such cases, click here, here or here.
Payments Are Reinstated
In January 2009, Whitten and his attorney lost their appeal to The Hartford, and were preparing to go to court.
But on Oct. 8, 2009, eight days after "Good Morning America" called the company to inquire about Whitten's case, The Hartford reinstated his $2,100-per-month payments and sent him a check for $45,675.57 to cover past benefits.
The company said it reinstated Whitten's benefits after his lawyer provided new information.
Click here to read the entire statement from The Hartford.
Jack Whitten's lawyer says she's now looking into a class action lawsuit against The Hartford for unfairly targeting disabled people for surveillance in an effort to cut off their benefits.
Whitten and his family are relieved. Getting back his disability insurance is a huge weight off the family's shoulders.
The family has been able to start paying off bills that had become seriously past due.
The Whittens say now they can put their two sons through college and enjoy their baby grandson.