I’ve Been on Claim for Years—Am I Safe from Surveillance? A Case Study
Once you have been on claim for a while, it might seem like your insurance company will just keep paying for the life of the claim, especially if you have a long-term, chronic condition and have the continued support of your medical providers. However, technically, the insurance company has the right to request proof of loss of each month and, under the terms of most policies, do a deep investigation into a claim at any point. One way they might do this is through surveillance—as in the case of Eggleston v. Unum.[1]
Eggleston, a clinical research nurse, became disabled due to multiple chronic illnesses in 2011 and Unum granted her benefits. After 24 months, her policy went from own-occupation to any occupation, and at this point she claimed she was unable to work at all because of increasing joint stiffness and pain. Unum agreed she was disabled due to these subjective complaints and elevated inflammatory markers.
Over the years, Unum continued to pay benefits, even though Eggleston’s conditions appeared to objectively stabilize over time, given her complaints of pain and her providers’ assertions that she was unable to sit or stand for more than five to fifteen minutes at a time due to these self-reported pain levels. However, in 2021, Unum discovered posts on Eggleston’s social media that indicated that she was operating a soul food catering business, taking trips to the Virgin Islands, and attending long performances and a wedding.
Unum argued that if Eggleston was this active and could stand or sit for multiple hours for entertainment purposes, she may be able to return to work and decided to a do a deeper dive into her medical file. They discovered, through calls to treating providers and Eggleston herself, that new tests results were “unremarkable”, her conditions were generally well-controlled, inflammatory markers were now within normal limits, and that she had stopped taking her medication at intervals in the past. Even though Eggleston’s providers continued to support her claim that she could not work, Unum terminated her benefits.
Eggleston sued but the Courts ultimately found that Unum’s decision was not unreasonable, given the facts. As this case shows, even with a long-standing diagnosis and provider support, insurance companies will often continue to dig to find reasons to argue a claimant is capable of a return to work and to cease paying benefits. If you feel your insurance company has conducted surveillance and/or is in the process of terminating your benefits, an experienced disability attorney can help you evaluate the situation and identify what options are available to you.
Every claim is unique and the discussion above is only a limited summary of the court’s ruling in this case. If you are concerned that your insurer is not evaluating your claim under the proper standard, an experienced disability insurance attorney can help you assess the situation and determine what options, if any, are available.
[1] Eggleston v. Unum Life Ins. Co. of Am., No. 24-13678 (11th Cir. Dec. 3, 2025).
