In the case of Solnin v. Sun Life and Health Insurance Company, et al., the plaintiff, an assistant bank manager, injured her back at work and was initially granted short term disability benefits under her employee benefit plan. The case has an extensive procedural history of Sun Life terminating benefits, adminstrative appeals and at least one previous court case.
In this action, in its attempt to discredit the plaintiff and prove she was not disabled and could work under the “any occupation” clause that now applied to her disability claim, Sun Life presented 17 days of video surveillance it conducted between April 15, 2002 and August 17, 2012. Sun Life claimed the videos showed the plaintiff engaging in activities inconsistent with her claims of disability. The court disagreed with Sun Life and, relying on Second Circuit precedent stated, “Although video surveillance tape may be instructive in comparing claimant’s behavior with her reported limitations (citations omitted), the information gleaned is not necessarily dispositive on its face and must be considered within the context of the particular case.”
Plaintiff’s Evidence Supporting Her Disability and Sun Life’s Response
Plaintiff’s treating physician examined her 36 times and concluded she was totally disabled from her spinal injury. She refused to undertake the risks associated with surgery and chose instead to live with chronic pain. In the fall of 2007, her physician noted that she could sit or stand continuously for only one hour at a time. He stated she could not sit for more than a total of two hours a day and placed the same limitation on her ability to stand. She could only carry up to 10 pounds occasionally and, if she was able to work at all, it would need to be at a job that would allow her to take 15 to 20 minute breaks whenever she needed them. Any employer could expect her to be absent four or more days a month.
Subsequently, Sun Life read a newspaper report about an intercontinental trip the plaintiff participated in. The report inspired Sun Life to begin video surveillance of her activities. Over the years, 17 different videos were taken and provided to the court with Sun Life’s claim that the videos proved she was not disabled as she claimed to be.
The Court’s Analysis of the Video Surveillance Tapes
The surveillance tapes showed the plaintiff watering her lawn for 12 minutes, dragging a trash can in front of her house, driving her car to various appointments, picking up dry cleaning and eating lunch in a restaurant. On 10 of the surveillance days, she never left her home. Even so, Sun Life seemed to be saying, “Gotcha” to the plaintiff, thinking the videos supported its denial of total disability benefits. It even had independent medical experts view the videos and agree with Sun Life that she was not disabled.
The court disagreed with Sun Life and its experts. It noted that there are cases where surveillance tapes reveal activity totally inconsistent with a claimant’s reported limitations, but “that is not the case here.” It determined that nothing shown on the tapes was inconsistent with the limitations put on her activities by her treating physician or in a statement she herself had submitted to Sun Life concerning her inability to work. The court concluded, “When viewing the totality of the evidence… plaintiff has proven, albeit it not overwhelmingly, but by a preponderance of the evidence, that she meets the definition of ‘totally disabled’ pursuant to the plan.”
This case was not handled by our office, but it may provide claimants guidance and hope as they continue a long term pursuit of total disability benefits under their insurance policy. If you need assistance with a similar matter please contact any of our lawyers for a free consultation.