A person who can pick up a prescription or drive to school may still struggle to sustain a full workday. In Montour v. Hartford Life & Accident Insurance Co., the Ninth Circuit examined how an insurer used brief surveillance observations when it terminated long-term disability benefits.
Robert Montour had back problems and other conditions, and Hartford had paid his claim before ending benefits. Hartford was both the administrator deciding the claim and the insurer responsible for paying it. That dual role was one factor the court considered when reviewing the termination.
Four days of observations
Surveillance over four nonconsecutive days captured Montour driving on occasional errands, including trips involving his grandchildren and a pharmacy. He acknowledged that the footage accurately reflected what he could do. The dispute was what those activities showed about his capacity to work.
The court relied on findings that Hartford overstated the observations by presenting separate activities as though they showed an ability to sustain them throughout a working day. A separate home interview recorded signs of pain, including moaning when Montour stood or twisted and complaints of back pain. Those interview observations were distinct from the surveillance footage. Brief activity, spread over several days, was not the same as demonstrated capacity for a full-time occupation.
The full record mattered
Surveillance was only one part of the decision. Hartford obtained medical file reviews, contacted physicians, and considered an occupational analysis. The appellate court considered how the surveillance descriptions affected the wider review and how Hartford evaluated Montour’s pain and functional restrictions. It also considered the insurer’s treatment of a Social Security disability award. A Social Security award does not automatically decide an ERISA claim, but it can be relevant evidence that deserves consideration.
Applying abuse-of-discretion review and considering the insurer’s conflict alongside the record, the Ninth Circuit concluded that Hartford abused its discretion. It directed the district court to order reinstatement of benefits.
What claimants can take from the case
Surveillance is not automatically improper, and the result in Montour does not mean that every observed activity is consistent with disability. The important questions include what was actually observed, how often and for how long, whether symptoms or recovery time were recorded, and how those observations relate to the plan’s occupational standard.
A detailed account of daily activities can help put evidence in context. It may explain not only whether a task was possible, but also how long it took, what assistance was needed, and what happened afterward. Medical records and the specific plan language remain important to the analysis.
Feden Law Group can help assess an ERISA disability denial or appeal. Learn about our disability practice or schedule an initial consultation.
You can also explore the FLG Claim Analyst (Beta).
This article provides general information, not legal advice. Reading it or requesting a consultation does not create an attorney-client relationship.