The Claims Video That Helped the Claimant
Luis is a Nevada PI under contract with an insurer to investigate a workers' compensation claim by Maria, who says a back injury prevents her from lifting more than 10 pounds. Luis's spouse is a paralegal at the law firm representing Maria. Luis does not disclose this. Over three days Luis records Maria carrying groceries, then a 50-pound bag of concrete, then using a cane and grimacing while walking to her car. The insurer's adjuster tells Luis to "send only the concrete clip; the cane stuff will confuse the claim." Maria's attorney calls Luis directly and asks what he has. Luis has billed 26 hours, including 4 hours of "report preparation" that he has not done.
1. What conflict of interest exists, and what should Luis do about it?
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Luis has a conflict because his spouse works at the firm representing the claimant. Even if the spouse has no role in the case, the relationship creates an appearance of impropriety and a risk of inadvertent disclosure. Luis should disclose the relationship to the insurer immediately and to the claimant's attorney if the insurer wants to proceed. The insurer can waive the conflict in writing after considering the risk, but if the spouse has access to the claimant's file or the firm's strategy, the conflict is non-waivable and Luis should withdraw. He should not continue surveillance while the conflict is unresolved because any report he writes may be attacked as biased. The Board expects candor and loyalty; hiding the relationship is worse than the relationship itself.
2. Must Luis follow the adjuster's instruction to send only the concrete clip? Explain the reporting duty.
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Luis cannot follow the adjuster's instruction to send only the concrete clip. The duty to report is not a duty to report only what helps the client. If Luis has video showing Maria using a cane and grimacing, that is material to the claim and may be exculpatory or explanatory; omitting it would mislead the insurer and any tribunal. Luis should preserve the complete video, log the footage, and provide a report that describes both the concrete lift and the cane footage, with times and context. He can explain that the clips show different activities and let the client decide how to use the evidence, but he cannot delete or suppress the unfavorable portion. If the adjuster insists on suppression, Luis should escalate to the insurer's compliance/legal office and consider withdrawing.
3. How should Luis handle the attorney's call and the billing discrepancy?
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Billing 26 hours when 4 hours of report preparation have not been done is inaccurate and potentially fraudulent. Luis should bill only time actually worked, describe tasks in the time entries, and correct any invoice already submitted. The phone call from Maria's attorney is also a warning: Maria is represented, so Luis should not discuss the substance of the investigation with her directly or through the attorney without the insurer's authorization. He should refer the attorney to the insurer's counsel, document the call, and avoid any ex parte communication with Maria. Accurate time records and a complete report are part of professional conduct; padding bills or hiding evidence can lead to Board discipline and civil liability.