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Facebook Photos Lead To Cancellation of Quebec Woman's Insurance 645

Posted by timothy
from the public-option dept.
No. 24601 writes "A Quebec woman on long-term sick leave, due to a diagnosis of depression, lost her health benefits after her insurance provider found photos of her on Facebook smiling and looking cheerful at parties and out on the beach. Besides all the obvious questions, how did the insurance company access her locked Facebook profile?"
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Facebook Photos Lead To Cancellation of Quebec Woman's Insurance

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  • by Mr. Freeman (933986) on Sunday November 22, 2009 @08:55AM (#30192642)
    First question, is she sure it was actually locked down? Some of those settings sound like nonsense to the non-technical.
    Second, is she the one that posted the photos? If someone else posted photos of her on a public page, anyone can see them.
  • Well yes... (Score:2, Insightful)

    by Gordonjcp (186804) on Sunday November 22, 2009 @08:56AM (#30192652) Homepage

    ... because people with depression must wear black on the outside, as black as they feel on the inside.

    Yet another reason why private healthcare must be stopped. Curing people doesn't come into it - it's about keeping them sick enough to stay profitable.

  • by sopssa (1498795) * <sopssa@email.com> on Sunday November 22, 2009 @08:56AM (#30192656) Journal

    Second, is she the one that posted the photos? If someone else posted photos of her on a public page, anyone can see them.

    Exactly, and because of tag-a-person-in-photo feature it's quite easy to find the photos too.

    She said her insurance agent described several pictures Blanchard posted on the popular social networking site, including ones showing her having a good time at a Chippendales bar show, at her birthday party and on a sun holiday — evidence that she is no longer depressed, Manulife said.

    This is evidence that she is no longer depressed? Depression is a lot deeper thing than that. Obviously you have happy moments and can smile on birthday party or on holiday. But in no way that mean that you really feel good and like that always. And I think you're supposed to try to have fun, so that said depression would actually go away.

    "We can't ignore it, wherever the source of the information is," she said. "We can't ignore it."

    Like a depressed person wants to always show everyone that she is depressed? Facebook isn't a complete picture in to your life. It is what the person posts there, and usually people like to make themself look good and not like a depressed wreck.

  • by danerthomas (1633403) <drt@mac.com> on Sunday November 22, 2009 @08:56AM (#30192662)
    Suppose she has friended coworkers who know that she is collecting disability pay for depression but is posting party pics. Or suppose that the pics were posted by others who have not limited access to them. If she is tagged and the photos aren't actively blocked to outside viewers, they are fair game.
  • Re:Well yes... (Score:3, Insightful)

    by 4D6963 (933028) on Sunday November 22, 2009 @09:05AM (#30192702)

    Curing people doesn't come into it - it's about keeping them sick enough to stay profitable.

    No, it's about taking the money of the healthy people and finding any excuse to get rid of the sick (cause they cost money). What you said doesn't make any sense.

  • by thetoadwarrior (1268702) on Sunday November 22, 2009 @09:05AM (#30192704) Homepage
    Facebook has so many little loopholes and you can be sharing information without realising it. I know a few people who think their accounts are locked down andyou can't view anything from their profile page. However their photo albums show up in other areas even if you can access it from their profile page. I assume they've not set the right settings for that particular album.

    This is why I don't use my real name on Facebook or use my exact location. It may mean friends, relatives, etc find it harder to find me but if I want to speak to them then I'll look for them.
  • Evil (Score:5, Insightful)

    by Aldenissin (976329) on Sunday November 22, 2009 @09:06AM (#30192708)

    Evil insurance company, plain and simple. I am not saying that they all are, but this is beyond grasping at straws. This is healing someone because they are sick, and them kicking them to the curb and throwing them out because they show signs of recovery. She should sue them for making the depression worse. We should get together and figure out how to draw enough attention to put a stop to this, and make an example for other insurance companies.

      This is a prime example why I don't think capitalism alone has all of the answers. If A needs B and C to prosper, and C needs A & B, A will rape B dry until C is so bad off that it is also hurting A. How does this make sense?

  • Not Surprising (Score:5, Insightful)

    by eldavojohn (898314) * <eldavojohn@gm[ ].com ['ail' in gap]> on Sunday November 22, 2009 @09:07AM (#30192712) Journal

    She also doesn’t understand how Manulife accessed her photos because her Facebook profile is locked and only people she approves can look at what she posts.

    Oh, please, you're talking to a generation that grew up watching Dateline and 20/20 where insurance companies hired private investigators to stalk people who would do the following:

    1. Bring a flask of water or oil into Walmart or some supermarket.
    2. Covertly empty it onto the floor.
    3. Come back minutes later to 'slip' on said spill.
    4. Sue the hell out of the store and claim crazy grief and pain charges in court.

    So then you'd see the companies hiring PIs to track the people (who allegedly could barely move) tearing it up at Disney World. Yeah, scam artists and fraudsters.

    You shouldn't be surprised to see insurance companies being very proactive in their searches to follow up on people. I cannot say whether or not she is legitimately getting the short end of the stick or if she's defrauding the company. Sounds like the former. If she had made claims that she never smiled and couldn't go out in public due to depression then she might have problems. Why doesn't she just get her doctor to send a note to her insurance company explaining that people suffering from this magnitude of depression (and those recovering from it) can force themselves to smile for a picture? I mean, it's likely that the insurance company got tired of paying sick leave for depression unless it could be shown to be a chemical imbalance they probably were just looking for any reason to have to stop forking over pay.

    Personally, I was offered $250 by my company's health insurance plan if I signed something that said I had not used tobacco products in the past 6 months. I hadn't but a few years ago I had (what I was told) were Cuban cigars in Mexico. Those friends put pictures of me on Facebook smoking them. So what? Well, if they found contrary evidence to my claim, I faced having my insurance terminated. Not worth the $250. Be aware of what Facebook puts on display for the world--even if you think it's private it's usually not. I mean, it could be as inane as some coworker who doesn't like her sees her other friend at work tagged in a photo with 'depressed' coworker on leave and decided to copy what photos they could see and forward them on to the insurance company?

  • by Xeleema (453073) on Sunday November 22, 2009 @09:07AM (#30192714) Homepage Journal

    after her insurance provider found photos of her on Facebook smiling and looking cheerful at parties and out on the beach....

    Well, she was on benefits because she was diagnosed as depressed, and it's already been said that any psychiatrist worth their salt will tell you to get yourself out there and at least *try* to have a good time.

    But seriously, this is a bit out of hand, hasn't anyone at her insurance carrier ever had a picture taken? What does the photographer usually scream at you?

    SMILE!!!

  • by malkavian (9512) on Sunday November 22, 2009 @09:14AM (#30192750) Homepage

    I think this could rebound terribly (and rightfully) on the insurer.
    The worst thing for a clinical depression is to stay closeted away. In the UK, there is no "social prescribing", where a GP may decide that the root of your troubles are a social disconnection. This disconnect raises stress, and is a sizable aspect in depression.
    Rather than pump people full of antidepressants, they prescribe you a visit to a local social group that is ratified as being suitable for this (can be activity groups, plain social groups, heading to a gym, or whatever would best fit the person that's available).
    This has had marked benefits to many that use the service.
    Depression is always a fight, and when you fight it best, there's always a time that you smile. It may not last for long, but every point you can laugh and be brought out is an absolute gem. And there's no surprise that mates will take a pic of you when you're smiling and paste it on Facebook, rather than ones of you looking glum and disconnected.
    One of those gems, for me, was years ago, just after my brother had had a massive car smash that left him on life support. One of my friends had first been blunt (there's nothing you can do, so get on with life while this goes on and things work themselves out), then actually managed to get me out and make me laugh. For just a minute; epic effort on his part, but it gave me a moment's respite, for which I'm eternally grateful.
    Now, if anyone had dared to say to me in that minute or two of respite that I wasn't upset, torn up and terrified, I'd have torn them several new ones, and stomped on the pieces until the men in white coats dragged me off.
    Smiling pictures of a depressive are not evidence they're not depressed. They're evidence that they have a good support network of people who are prepared to do the heavy emotional lifting to keep them going..
    Cutting the insurance is going to make anyone depressive (or recovering depressive) fall far back down the treatment path..
    Wouldn't be surprised to find this one in litigation sometime soon.

  • by Pedrito (94783) on Sunday November 22, 2009 @09:15AM (#30192752) Homepage
    This is a HUGE part of the current problem in the States with health insurance. Health insurance companies are not doctors. You can't make a diagnosis by looking at pictures on someone's facebook account. They teach you that in medical school, I think. I'm all for the public option myself, and I hope it puts the health insurance companies out of business. Frankly, I think anyone who works for an organization as corrupt as an American health insurance company, has it coming, because nobody who works for one can possibly claim ignorance to the crap that goes on with them.
  • Re:Well yes... (Score:2, Insightful)

    by CrackedButter (646746) on Sunday November 22, 2009 @09:17AM (#30192762) Homepage Journal
    Lol, 'greatest healthcare system in the free world', you're stretching the limits of sarcasm here I hope.
  • by JohnFluxx (413620) on Sunday November 22, 2009 @09:18AM (#30192764)

    And you are hardly going to be post pictures of when you're unhappy, and people tend to smile just for photos, so you get a selective image of someone.

  • by Anonymous Coward on Sunday November 22, 2009 @09:18AM (#30192766)

    I have suffered from depression at some times in my life.

    I found that you 'put on a face' sometimes to live a normal life. People around you don't want to see people with a miserable expression, talking in a depressive way and acting depressed all the time.

    The way we appear look socially is virtually never a direct reflection of the way we really feel, for anyone, depressed or not. We choose how much of what we really feel we communicate to others. If this were not the case then it would be impossible even to go shopping while clinically depressed.

    If the social situation calls for smiling and looking cheerful, well, that's what you do.

  • by Anonymous Coward on Sunday November 22, 2009 @09:28AM (#30192800)

    That just makes you a cunt.

    As someone who has been hospitalized multiple times for psych problems, and never taken a dollar of disability (aside from county hospital time) I declare: fuck you.

  • Re:Well yes... (Score:3, Insightful)

    by Pyrion (525584) * on Sunday November 22, 2009 @09:30AM (#30192810) Homepage

    He's confusing insurance companies with pharmaceutical companies. Insurance companies want you to stay as healthy as possible requiring as few doctor's visits, treatments and prescriptions as possible for them to stay profitable. Pharmaceutical companies want you to stay as sick as possible while only providing marginal, long-term treatment (almost never a flat-out "cure") for them to stay profitable.

  • by epiphani (254981) <epiphani AT dal DOT net> on Sunday November 22, 2009 @09:32AM (#30192824)

    Like a depressed person wants to always show everyone that she is depressed? Facebook isn't a complete picture in to your life. It is what the person posts there, and usually people like to make themself look good and not like a depressed wreck.

    My best friend and my brother have both had severe depression problems. It is quite possible to be out and functioning at moderate levels of depression - talking, smiling, looking like you're enjoying yourself. I think one described it something like this:

    I was standing there having a conversation, smiling and laughing, while thinking about different ways I could kill myself to get out of that situation.

    So you know what, fuck you Manulife. You are in no situation to reverse a doctors' diagnosis based on some pictures you found on the internet.

  • by TheLink (130905) on Sunday November 22, 2009 @09:35AM (#30192846) Journal
    Yeah.

    A cancer patient might be rather sick, but make an extra effort for special events.

    What next? They're going to cancel insurance for cancer patients if they look like they're better?

    An insurance agent is unlikely to be an authoritative expert on medical matters (or in the rarefied field of "psychiatric diagnosis via facebook photos") - they may know some stuff (just like I do), but when it comes to a court case or other legal stuff it should not be their call to make. If the insurance company has doubts they should insist that the policy holder be examined by a certified expert in the relevant field. After all, it's not unusual that you have to go for a medical examination when you sign up for certain sorts of insurance. They don't just leave it to an insurance agent to say "hmm she looks ok to me".

    Too bad if her case is genuine she'll likely be too depressed to sue them (unless she can afford her meds and is still taking them).
  • by commodore64_love (1445365) on Sunday November 22, 2009 @09:36AM (#30192850) Journal

    So will this new "no denial for existing conditions" Congressional law stop this stuff from happening? I hope so. I understand insurance companies need to watch out for fraudsters, but they should have more evidence than "we saw her smiling" to deny coverage.

  • Re:Well yes... (Score:3, Insightful)

    by commodore64_love (1445365) on Sunday November 22, 2009 @09:40AM (#30192876) Journal

    >>>"Yet another reason why private healthcare must be stopped."

    Why? So we can switch to a government system where they ration care, like sayng, "Raise the mmamogram age from 40 to 50," and "We don't need annual PAP smears. Every three years is good enough." That last one really bother me because it reminds me of the story from the UK, where a college aged woman was told "no" every time she asked for a PAP smear *even though he grandmother and mother* had cervical cancer, and therefore she was high risk.

    She then developed cervical cancer at age 25 and died shortly thereafter. Government rations. That's the whole reason why "NICE" exists in the UK - to deny care.

  • Re:Well yes... (Score:3, Insightful)

    by Nuskrad (740518) on Sunday November 22, 2009 @09:52AM (#30192950)
    Or possibly, it's because the scientific [bmj.com] evidence shows that reducing the screening age doesn't make much difference in reducing cancer rates, and the number of false positives at younger ages means that more people would have to go through lots of unnecessary stress and months of tests and unnecessary, potentially harmful treatments. It doesn't have anything to do with money.
  • Re:Well yes... (Score:1, Insightful)

    by Anonymous Coward on Sunday November 22, 2009 @09:56AM (#30192964)

    As opposed to the rationing we have now? You know, like in the goddamn article we're discussing?

  • by elecmahm (1194167) on Sunday November 22, 2009 @09:58AM (#30192976)
    I don't have severe depression, but that old black beast does occasionally roll around on me. At my worst time I would appear completely normal, and occasionally even have brief periods where I could smile and laugh. It just doesn't last though, when you're depressed. Shame on the insurance company, though. I think the most appropriate recourse would be to find the executives names on the annual report, look them up, and start rooting through their trash, and post anything embarassing found in a public place. Maybe even follow them around with a camera and record every little thing they do. If they want to invade privacy that much, then fair's fair.
  • Re:Well yes... (Score:2, Insightful)

    by jo_ham (604554) <joham999 AT gmail DOT com> on Sunday November 22, 2009 @10:10AM (#30193038)

    Ahaahahahahahahahahaha. Oh wait, you were serious, let me laugh even harder.

    Private healthcare is a very, very, very distant runner up to a properly managed universal system. Just ask someone in France or Sweden or Cuba (or gasp, even in the UK if they'd actually fix it properly) if they'd trade for the private system as it exists in the US.

    There's a reason the US is ranked 67th on the list.

    "Greatest healthcare in the free world, if you ignore the 66 other countries above us!"

  • by betterunixthanunix (980855) on Sunday November 22, 2009 @10:29AM (#30193148)
    Some people are not as able to cope with depression as you claim to be. I have a few friends who suffer, and if they were not receiving medication and therapy, they would never have the will to see daylight, let alone accomplish anything. For them, it is not a matter of biting the bullet, they need help, and thankfully they receive it.
  • by Alef (605149) on Sunday November 22, 2009 @10:31AM (#30193166)
    Exactly. The only effect this is going to have is that depressed people stay at home, never go to parties or beaches and make sure never to smile where they could be seen (in Sweden we have even had cases were insurance companies even hired private investigators hiding in the bushes with cameras). How is that for being counter-productive? One would think the insurance company would be interested in the person recovering. Isn't it a good thing she gets out in positive environments and tries to enjoy herself?
  • by tjstork (137384) <todd.bandrowsky@NOSpAM.gmail.com> on Sunday November 22, 2009 @10:32AM (#30193180) Homepage Journal

    I have a few friends who suffer, and if they were not receiving medication and therapy, they would never have the will to see daylight, let alone accomplish anything

    I'm not biting the bullet by myself. Wellbutrin is the greatest thing ever invented and I've got no problem writing out the 2 cents per paycheck to the FEds or my insurance so that people that need psych meds can get them. Without meds, its just aweful.

  • by IWannaBeAnAC (653701) on Sunday November 22, 2009 @10:35AM (#30193198)

    So if I get a doctors note for a sore back but Manulife have pictures of me enjoying a football match then they have no right to reverse the doctors' diagnosis?

    I think they should have no right to reverse the doctor's diagnosis. I think they do have the right to insist that you get another diagnosis from another doctor, and I think they do have the right to send the name of the doctor who performed the original diagnosis and the evidence to some kind of medical fraud tribunal. But I do not agree with a layman overturning an expert opinon. By all means question the qualifications of the expert, or second opinion, etc, but don't think that a layman knows best, even in cases where it would appear 'obvious'. In too many cases, 'obvious' turns out to be not obvious not at all.

  • by instantkamera (919463) on Sunday November 22, 2009 @10:42AM (#30193250)
    from my post on TFA:
    Here's the thing, it doesn't really matter if she is plain old lazy, or truly depressed.
    The issue here is that the insurance company is making the call, and it is not their job to make that decision.
    The insurance company's job is to collect premiums and pay out when the doctor says "this person has a bad back" or "this person has a broken leg" or "this person is clinically depressed".

    It is my assumption that this woman has regular meetings with a doctor at which time she is assessed to see - "is she still depressed?", "Has there been any improvement?", etc.
    THAT is the ONLY information the insurance company needs to make their decision.

    Anything else, such as info from FACEBOOK, does not tell the whole story, hell, it might not tell ANY part of the story. It may be irrelevant, and it may just be misinterpreted completely by someone who lacks the professional designation to be making decisions and pointing fingers in the first place.

    The insurance company no doubt will argue that the have to "protect their assets" and that "people scam insurance co. all the time". While that is no doubt true, we must not forget that the insurance companies make plenty of cash by ripping people off on a daily basis. It's a two way street.

    Bottom line, insurance companies HAVE to take the advice of "trusted" professionals, trusted or not, really. That is why we have doctors and lawyers etc - we must have someone who has the proper knowledge to make the ultimate decision.

    If they want to save money so bad, they can start by firing the person that is paid to browse facebook.
  • by mikael_j (106439) on Sunday November 22, 2009 @10:47AM (#30193276)

    As someone who has known several people with depression and bipolar disorder I'd like call bullshit on your kneejerk "FRAUD!" conclusion.

    Most people with depression can be just fine for an hour or two and then spend a long time not even leaving their bed, those who are bipolar can be even worse, they'll be at a party having a blast and in just a few minutes they'll switch over to seriously contemplating suicide right then and there.

    And even discounting this and trying to look happy for everyone else's sake there's also the fact that a lot depressed people do seem to really value those times when they can shake their depression for a few minutes or hours, and guess which image of themselves they'd rather show friends and family...

    /Mikael

  • by Anonymous Coward on Sunday November 22, 2009 @10:57AM (#30193354)

    "This is a HUGE part of the current problem in the States with health insurance."

    Right you are. Which is why the fact that this happened in CANADA should tip you off that there's something dramatically wrong with the reporting.

    This isn't really a story about health insurance, it's about DISABILITY insurance. It is 100% routine for insurance companies to launch investigations on long-term disability claims in order to prevent fraud. Whether this woman was, in fact, defrauding her employer and insurer I can't claim to know. But it really disturbs me that the U.S. coverage of this episode fudges it into a denial of health coverage which is a very different thing, practically, ethically and politically.

  • by NotBornYesterday (1093817) * on Sunday November 22, 2009 @11:10AM (#30193462) Journal
    She could do that. Chances are that the insurance company would a) offer her a lowball settlement to see if she will bite and hopefully lessen the bad press they get, and if it goes to court they will b) stonewall her, drag out the case, file continuances, and (if they lose) launch an appeal process that will either bankrupt her or force her to go back to work.

    Even if the lawsuit only takes a year, how is she supposed to live? They've taken away her disability, and what other income does she have? If she tried to get a job, what does that do to her chances of winning the lawsuit?
  • Re:Well yes... (Score:4, Insightful)

    by odourpreventer (898853) on Sunday November 22, 2009 @11:14AM (#30193498)

    Because those rankings are based upon OPINION

    Yeah, because the World Health Organization [photius.com] bases its studies on opinion. *snark*

    Besides, you're saying that because US citizens have a slightly higher chance of surviving cancer, USA has the best health care system. Please excuse me if I'm not impressed.

  • by PNutts (199112) on Sunday November 22, 2009 @11:14AM (#30193500)

    This is a HUGE part of the current problem in the States with health insurance.

    It was already pointed out this incident is in Canada. Moving on...

    Health insurance companies are not doctors.

    No, but in the US they typically have doctors on staff.

    You can't make a diagnosis by looking at pictures on someone's facebook account.

    Congratulations, you got one right.

    They teach you that in medical school, I think.

    I assume that is a first year course? You gotta weed out the slow ones somehow.

    Frankly, I think anyone who works for an organization as corrupt as an American health insurance company, has it coming, because nobody who works for one can possibly claim ignorance to the crap that goes on with them.

    You didn't go into much detail but it certainly can't be the profits since Farm and construction machinery, Tupperware, the railroads, Hershey sweets, Yum food brands and Yahoo are all more profitable than the health insurance industry: http://news.yahoo.com/s/ap/20091025/ap_on_go_co/us_fact_check_health_insurance [yahoo.com] I would start with the financial institutions that nearly plunged the US into another great depression. Also at the top of my list would be the companies that poison people by contanimating the air/ground/water. Companies like Wal-Mart with illegal business practices that take advantage of workers is also a good start. And don't get me started on the telco's and cable TV. And yes, the employees can claim ignorance because of some little things called federal laws that protect patient's information. The guy managing the routers does not know about Ms. Anderson's implants (ok, bad example but a lovely mental image). Heck, I know an Enron programmer who thought they were visionary until the wheels fell off.

  • by Anonymous Coward on Sunday November 22, 2009 @11:16AM (#30193506)

    Considering your political views and your outlook on the world, I'm not surprised that you don't get the joke. It really speaks volumes about you as a person.

  • by hkmarks (1080097) on Sunday November 22, 2009 @11:18AM (#30193532)

    Absolutely. If she's depressed, going to parties and taking a holiday is only going to get her healthy faster. Staying home and moping will only make her depression worse. Antidepressants and having fun are roughly equally effective, and work far better together.

    (Not that plenty of people don't scam the system.)

  • by Clover_Kicker (20761) <clover_kicker@yahoo.com> on Sunday November 22, 2009 @11:20AM (#30193540)

    One would think the insurance company would be interested in the person recovering.

    The insurance company doesn't care if you live or die, so long as they don't have to pay out.

  • That's depressing! (Score:5, Insightful)

    by tomhudson (43916) <.moc.nosduh-arab ... .nosduh.arabrab.> on Sunday November 22, 2009 @11:24AM (#30193588) Journal

    You know when the most dangerous time is for someone who has suicidal tendencies. It's when they cheer up - it might mean that they've made the final decision to end it all. They'll be happy, smiling, giving away their stuff, party-party-party - and then they kill themselves.

    Not only can you not diagnose whether someone's suffering from depression (it's NOT "gee, I'm depressed") by just looking at pictures - it's actually against the shrinks' professional code here in Quebec to proffer a diagnosis or ANY opinion without actually having examined the patient.

    The proper course for the insurance company would have been to get a second opinion.

  • by Anonymous Coward on Sunday November 22, 2009 @11:40AM (#30193708)
    Bullshit. I actually worked for Facebook for a while recently, and even employees don't have this kind of access.
  • by jedidiah (1196) on Sunday November 22, 2009 @11:41AM (#30193710) Homepage

    It's the insurance company's job to pay out claims. Period. End of story.

    That is what they exist for.

    If they don't pay claims then they might as well be all arrested for fraud.

    They do their best to avoid paying claims even when there aren't people around willing to make excuses for them.

  • Re:Well yes... (Score:2, Insightful)

    by anyGould (1295481) on Sunday November 22, 2009 @12:03PM (#30193876)

    now now, no one wants to destroy the Canadian healthcare system

    No-one except American owned insurance companies. And American fan-boy politicians. And locally, the rednecks who figure that since they've never been sick a day in their 20-year-old lives, they shouldn't have to pay taxes for healthcare.

  • by schon (31600) on Sunday November 22, 2009 @12:11PM (#30193952)

    The problem is that doctors are rather incented to declare people sick, so insurers will pay them.

    This. This is what is wrong with US health care. The only incentive doctors should have to declare people sick is that the people are sick. If your system is designed to encourage anything else then it's broken by definition.

  • by davester666 (731373) on Sunday November 22, 2009 @12:14PM (#30193978) Journal

    But if she can be artificially made happy by booze, friends and hot guys for a few hours, it's logical to assume she is happy 24/7 at home...

  • by m.ducharme (1082683) on Sunday November 22, 2009 @12:19PM (#30194024)

    Insurance companies hiring private investigators to spy on their clients is fairly common in Canada, where the payout looks like it's going to be long-term or the client seems a little suspicious. It's kind of a "dirty tricks" thing to do, but it's not entirely unjustified, depending on the illness, and the circumstances. For example, since we brought in contingency fee arrangements, auto insurance lawsuits have increased dramatically, and claims for things like chronic pain syndromes and whiplash are skyrocketing. One reason Insurance companies pay for surveillance (and they do pay, it's not cheap) is that they often do catch people faking illness or injury.

    The irony is, of course, that depression is not one of the illnesses that people are likely to fake. There's still a strong stigma around mental illness here in Canada (and the US as I'm sure you can tell from the comments here) and people will go out of their way to avoid being diagnosed with depression or any other mental illness. To further compound the irony, the "chronic pain syndromes"* that so many people suffer from are quite often symptoms of depression. But the sufferer refuses to acknowledge even being depressed, so the doctors are limited to treating the symptoms (and eventually enabling an oxycontin habit).

    My experience with Insurance companies has been that most of them will pay out on medically supported depression claims for a certain amount of time (probably up to 2 years) and after that time they'll start snooping on the client; the rationale being that after two years, the client should have found a treatment that works.

  • by EQ (28372) on Sunday November 22, 2009 @12:25PM (#30194082) Homepage Journal

    The problem is that doctors are rather incented to declare people sick, so insurers will pay them.

    This. This is what is wrong with US health care. The only incentive doctors should have to declare people sick is that the people are sick. If your system is designed to encourage anything else then it's broken by definition.

    2 things - 1 - didn't you READ what you quoted? The doctors have an incentive to declare the sick as such - regardless of motivation. Its much better that way than the other way around. And secondly - this is the CANADIAN system that is being discussed. The US system is somewhat different.

  • by skine (1524819) on Sunday November 22, 2009 @12:28PM (#30194106)

    Basically, dmbasso left out some details that help the joke make sense:

    That reminded me of a joke where [a woman stays out all night and] [her worried husband] calls every of his wife's female friends, asking each one if she had slept over with them, and receives the same "no, not here" answer. Another night the reverse happens[, where the husband stays out all night], and the wife calls every [one] of her husband['s] male friends. [Every friend] answer[s] "yes, he was here all night," and five of them even respond "he's still here, in the bathroom"! :-)

  • Re:Well yes... (Score:3, Insightful)

    by u38cg (607297) <calum@callingthetune.co.uk> on Sunday November 22, 2009 @12:32PM (#30194140) Homepage
    Please do not attempt to argue your point by using selected stories. I can assure you I can dig up as many horror stories due to the use of private medical care as from public. You may be right, but you would be better off citing statistical outcomes and population data. For any large population there will be a small number of individuals whose experience is many, many standard deviations away from the norm.

    The purpose of NICE is not to deny care, but to study the cost-benefit ratio of treatments. If a drug costs fifty thousand pounds a year to treat an otherwise fatal condition, there are half a million patients for whom its use is indicated, and it will save five lives, should it be used? Every system denies some level of care: the question is how and under what circumstances it happens.

  • by sjames (1099) on Sunday November 22, 2009 @12:36PM (#30194162) Homepage

    But I do not agree with a layman overturning an expert opinon.

    IMHO, that sort of thing by insurance companies needs to be legally treated for exactly what it is, practicing medicine without a license. That is, a felony. In the rare instance that an insurance adjuster happens to also be a licensed M.D. unless they actually SEE the patient in person first it is malpractice and grounds for losing that license. Just like the "pain docs" that prescribe strong opiates sight unseen for the scam pharmacies.

    She was attempting to follow her doctor's orders and may even have been making progress. Then the insurance company did it's very best to send her back to square 1 or worse.

  • by mikael_j (106439) on Sunday November 22, 2009 @12:44PM (#30194234)

    You missed my point by about a mile.

    There are definitely painful injuries where proper rehabilitation includes exercise and by insurance company logic you're rehabilitated if you can exercise (even if the exercise results in increased pain in the short-term). Much in the same way that a depressed person may very well smile and be happy on occasion without having recovered from his/her depression.

    Here in .se there was a scandal dealing with a similar situation, insurance companies labeled people as frauds after PIs had photographed them grocery shopping. That would be like my boss firing me for going to the pharmacy when I've called in sick with the flu, just because you can push yourself hard enough to get something necessary done doesn't mean you're healthy enough to work.

    /Mikael

  • Re:Well yes... (Score:2, Insightful)

    by odourpreventer (898853) on Sunday November 22, 2009 @12:56PM (#30194350)

    First of all, I never said anything about the EU.

    Secondly, you're still number 16. Quite a far way from number one, as you claim.

    Thirdly:

    > (17) Cuba (the have government healthcare; why aren't they higher?)

    I never said anything about private contra government health care.

    But nice try trying to make a straw man argument.

  • by m.ducharme (1082683) on Sunday November 22, 2009 @12:58PM (#30194382)

    IANAL, but I did work as a clerk in a law firm that defended insurance companies, and I am a law student. Investigators may take surveillance of claimants from off the claimant's property. They may not pass on to the claimant's property, take images of the claimant inside their home, tap phone lines. When recording video they may not record audio of the claimant simultaneously. In fact audio recording in public is a no-no as well.

    Basically, the law behind this is the notion that you have no expectation of privacy outside of your own home, but you do have a strong expectation of privacy inside that home. Keep in mind, this isn't a particularly new law, it seems to have roots in the common law and might predate large-scale insurance consumption by the masses (but I'm not going to do the research right now to back this up, so don't nit-pick me on this, mkay?).

    Who does it benefit? It benefits insurance companies to some extent, Google Streetview teams, and other people with an interest in recording what's going on in public. It benefits shopkeepers who can put up CCTV cameras pointing outside their stores for security. But your implication is right, it doesn't benefit everybody. But don't make the mistake of thinking that the Insurance companies bought and paid for these laws, they didn't (though they may stump up good money if those laws get threatened).

    DISCLAIMER: I'm not a lawyer, the above are not legal opinions, if you want a legal opinion please go talk to your lawyer!

  • by m.ducharme (1082683) on Sunday November 22, 2009 @12:59PM (#30194398)

    Normally nitpicking drives me up the wall, but given the subject, I must say only this.

    Sorry, of course you are correct.

  • by Runaway1956 (1322357) * on Sunday November 22, 2009 @01:01PM (#30194416) Homepage Journal

    Tjstork shouldn't be modded "troll". Our constitution guarantees us "life liberty and the PURSUIT of happiness". Happiness is not a given.

    Next thing to consider is, all of the medical practices are considered "arts". Psychiatry is not a science, with quantifiable, qualitative states. It's all guesswork. You can't plug someone into a freaking machine, and say, "I can measure x units of schizophrenia, x units of depression, and x units of whatever else".

    At least with physical health, much of what might be wrong with a patient is measurable. Blood pressure, pulse, respiration, blood chemistry, urine and stool specimens. You have nothing like that with psychiatry.

    Parent has a valid point, in that people with physical problems often have to work, unless that physical problem measurably impairs their ability to work. Psych problems? Fat chance. All we have is the doctor's word. How can we know this is NOT yet another scam to take the insurance companies for a ride?

    Part of the reason I'm skeptical of shrinks is, I've read and heard plenty of stories about people who had grave psych problems, who were admitted into various programs to "cure" them. Amazingly, many are "cured" just about the time that all available funding expires. What a coincidence, huh? IMHO, they were scams from start to finish.

    As for those who say the insurance companies are ripping us off, so they deserve to be ripped off - I ask, "Why not fix the real problem?" Here in the states, at least, we have healthcare reform on the table right now. Part of the goal is to limit the insurance company's ability to rip us off, and another part is to limit the ability of "customers" to rip off the insurance. Why the hell should 95% of honest, working people have to foot the bill for those 5% dishonest insurers, care providers, as well as customers? FFS, if we could eliminate the graft and corruption, ALL OF OUR BILLS could be cut by 20% or more!!

    Send all the thieves to jail, and stop trying to justify your favorite thief.

  • by Anonymous Coward on Sunday November 22, 2009 @01:06PM (#30194456)

    It's disability insurance, not health insurance. This happened in Quebec, not the States.

    Also, you can make a diagnosis based on someone's Facebook when the claim is that they're so depressed they can't do office work and it's full of photographs documenting their amazing mountain climbing getaway.

  • by AlamedaStone (114462) on Sunday November 22, 2009 @01:36PM (#30194724)

    I have a few friends who suffer, and if they were not receiving medication and therapy, they would never have the will to see daylight, let alone accomplish anything

    I'm not biting the bullet by myself. Wellbutrin is the greatest thing ever invented and I've got no problem writing out the 2 cents per paycheck to the FEds or my insurance so that people that need psych meds can get them. Without meds, its just aweful.

    If you really are on Wellbutrin as you claim then maybe you understand how complex and time-consuming it is to find the correct medicine and dosage for illnesses like depression. Based on your comments, I'm not inclined to believe that you are - and if you are, perhaps it isn't the correct medication for you. Lack of empathy doesn't really fall into the depression spectrum, it's more like borderline or even paranoid personality disorders.

    If you had a deeper understanding of mental illness, you would probably have some compassion for people who struggle for years after seeking treatment to have some positive results, and many others that find testing med after med leads to disaster as often as improvement.

    If you are satisfied with taking your pill and feel that is all that your illness requires, I strongly suggest you consider a more complete treatment program that includes weekly therapy sessions with someone that isn't a psychiatrist. Perhaps you will gain some coping mechanisms to deal with the issues that a pill will never solve.

    Good day, sir.

  • by KingSkippus (799657) on Sunday November 22, 2009 @01:40PM (#30194748) Homepage Journal

    I honestly don't see why we can't have the best of both worlds.

    For example, we have a thriving public education system which guarantees almost universal education. We also have a thriving private education system for those who, for whatever reason, don't want to take advantage of public eduction. Sure, right-wingers gripe about our public eduction system, and I know that there are people out there would like to see it systematically dismantled, but the truth is that it works pretty well. Especially when you get to the university level, such as state colleges and universities.

    Speaking of education, we have a fantastic student loan system as well. As a student, you can borrow money from the federal government to attend college. You can also borrow money from private lenders. You have a choice.

    I guess I don't understand why health care can't work the same way. We have a public system to take care of everyone's basic medical necessities. We have a private system to take care of what people want above and beyond that. (Private rooms, name-generic prescriptions, specialists who charge above the normal rates, elective procedures, etc.) No one has to go bankrupt because they get sick. No one has to decide between having a broken bone set or buying dinner that night. If for whatever reason you don't like the public health system, you're free to go spend money out-of-pocket on either a private plan, or if you have enough, pay the health care providers directly.

    It seems to me that those who are fighting against the public option are the ones who want to limit our choice, not the other way around.

  • by AlamedaStone (114462) on Sunday November 22, 2009 @01:44PM (#30194774)

    But if she can be artificially made happy by booze, friends and hot guys for a few hours, it's logical to assume she is happy 24/7 at home...

    It only seems logical if you have no understanding of mental illness. With a little effort you find that ignorance masquerading as logic is a poor substitute for real knowledge.

  • by Jawn98685 (687784) on Sunday November 22, 2009 @01:49PM (#30194816)
    So..., you're saying that some kind of evil bureaucracy is being allowed to get between a patient and his or her doctor? And meddle in the healthcare decisions that are made by patient and doctor? Why, that's scandalous! We should protest such bureaucratic meddling and demand that our rights as patients be protected from same.
    Oh, wait...
  • by log0n (18224) on Sunday November 22, 2009 @02:17PM (#30195004)

    (there are a lot of stickywickets here and not enough details.. but reading between the lines and going with my gut based on my dealings.. this is my take)

    Everyone want to rant about the evils of health care and I agree with damn near all of it. But as someone who has dealt with depression for a couple of decades and with (actually pretty good) healthcare assistance, I'm inclined to think she's taking advantage of the system and deserves to be dropped.

    As I understand it, sick leave in Canada is paid sick leave (like maternity leave here in the US) which over insurance premiums. Sick leave is designed for medical recovery that would inhibit your ability to perform you job.

    Now believe me.. coping with depression can definitely include going to the beach and smiling for pictures, but by doing those things in the capacity mentioned in the article, she's demonstrating that she is in fact capable of doing tasks where she had previously claimed her depression would inhibit her job performance. As she's being paid, she's now defrauding the system.

    I'll give her the benefit of the doubt that she is depressed. In her case, her sick leave is designed to allow her time to visit therapists, psychologists for medications, or even prolonged hospital visitation if required. She should be using the paid sick leave to take real advantage of her medical coverage.

  • by 93 Escort Wagon (326346) on Sunday November 22, 2009 @02:48PM (#30195244)

    Yeah, having dealt with a family member who suffered through clinical depression for several years - I can say with certainty that very few of the posts in this discussion show any knowledge of the disease whatsoever. Especially those that are claiming "going out and doing fun stuff" will have any affect on the disease whatsoever.

    Clinical depression has very little to do with what people normally experience when they're "feeling depressed".

  • by 93 Escort Wagon (326346) on Sunday November 22, 2009 @02:51PM (#30195262)

    This particular story is out of Canada, different health-care system, different incentives.

    But... but... I've been reading Slashdot for years - so I know this sort of thing only happens in America! The rest of the world is run by virtuous, thoughtful, caring, intelligent individuals who act only in their population's best interests!

  • by Anonymous Coward on Sunday November 22, 2009 @03:26PM (#30195510)

    This particular story is out of Canada, different health-care system, different incentives.

    Yes, but this sort of insurance is PRIVATE INSURANCE. Were it covered under the Universal health care, it would not be an issue. A private company has a profit motive, and therefore usually tries to come up with ways to DENY CLAIMS. Now, perhaps this is a wrong instance, perhaps it is a right instance... I'm not informed enough to know.

    But certainly, a fraud claim under the public system would require much more evidence than just "we saw some pictures of her smiling." This is more like the guy claiming he couldn't work cuz he has a bad back, and then people seeing him building a house (god I've seen this at last 3 times, fucking scammers). Those people need to be OUTED big time, because we are paying for those pricks to collect $$$ for nothing; and worse, they then work under the table on side jobs and pay no taxes BACK into the system!!!

    Manulife is acting EXACTLY like the US health care system. EXACTLY.

  • by ShiningSomething (1097589) on Sunday November 22, 2009 @04:22PM (#30195950)

    Any sort of work would require her showing up regularly to her workplace. Anyone with a history of depression will tell you this is hard. Can you summon the energy to go out and pretend to have a good time when a friend asks you out? Sure, especially if you know it means a lot to them. But to do that *every single day*? There will be days when you can't really get out of bed, because the world just feels too heavy, and it may ruin you company's presentation, or deadline, or whatever.

    So yes, your mental illness may be such that you can function at a party, but not cope with the responsibilities of a job. The point is, this is not up to the insurer: there are doctors to verify the diagnosis.

    As for the woman herself, if she lives in a system where she can get paid while she battles with depression, should she refuse it? Sure, she may be scamming them, but the photos don't prove anything.

  • by Anonymous Coward on Sunday November 22, 2009 @04:27PM (#30195996)

    The problem is that doctors are rather incented to declare people sick, so insurers will pay them.

    This. This is what is wrong with US health care. The only incentive doctors should have to declare people sick is that the people are sick. If your system is designed to encourage anything else then it's broken by definition.

    2 things - 1 - didn't you READ what you quoted? The doctors have an incentive to declare the sick as such - regardless of motivation. Its much better that way than the other way around. And secondly - this is the CANADIAN system that is being discussed. The US system is somewhat different.

    Please double-check your reading comprehension. Re-read it: "... doctors are rather incented to declare people sick, ...". It does not say "to declare sick people sick". It says "to declare people sick". Those people may not be sick at all. Your other points are valid, but your argument is flawed on this one.

  • by Anonymous Coward on Sunday November 22, 2009 @05:51PM (#30196604)
    Not all depressive conditions are continuous. There can be intervals of light and happiness between prolonged pits of despair.

    I know this since a former lover was bipolar (manic-depressive). She could be exuberant, playful, spirited, horny, full of life, and fun to be with in every possible way. But as it reached its crescendo, it would transform into helpless depression, and accompanied by a deep malevolence aimed with fearful precision at all those close to her - those she could hurt. Family and friends would suffer or flee until she could be checked into an institution for a month or so. Her medications probably helped a bit, but could not prevent the cycles or make much difference to the amplitude of her emotional oscillation.

    An insurance company could easily have arranged for photos to be taken during the good phases, when she was better than merely good, even better than ecstatic as she approached the brink. It would not have altered her progression into the abyss, or the depths she plumbed therein. It was more than 20 years ago, and I am still scarred by the memories.

    [posting as AC for personal reasons]
  • by Derleth (197102) <chbartsNO@SPAMgmail.com> on Sunday November 22, 2009 @06:08PM (#30196774) Homepage

    If the gov stepped in and mandated more seats in medical schools, there would be more doctors and less of a shortage.

    And a lower average quality of physician. The government can’t mandate skill or talent among its citizens.

  • by m.ducharme (1082683) on Sunday November 22, 2009 @06:29PM (#30196964)

    You're hilarious. Are you the kind of libertarian who wants just enough government to protect the rich from everyone else? Good luck with that.
    Private health care works great in the US, don't it? Where you have the least efficient health care system in the developed world. By a factor of two. No really. Basically you have the private sector insurance companies who spend 40-60 percent of their revenues on denying claims. How is that a good thing? Insurance companies can get away with this because when it comes to their health, people get desperate. So basically, left without regulation, the insurance companies can deny you services that you've already paid for. How is even less regulation going to fix this?

    The only part of your health care system that works reasonably well is Medicare. You know about Medicare, right? That government-funded insurance that pays for people who can't get insurance elsewhere?

    The fact is, the numbers just don't bear out the libertarian position when it comes to health care. The US spends $6000/person/year on health care, and 45 Million people go uncovered by insurance. The next best developed nation spends $3000/person/year, and has coverage for everyone. And for this horrible value, the US has one of the sickest populations in the developed world. Not exactly getting your money's worth, are you?

    Basically, your libertarian argument comes down to this: you want to live in a well-functioning, healthy society, but you don't want to pay for it. Well guess what, that doesn't work. When the poorest people get healthier, everyone benefits. That's why things like healthcare, education, public works, etc are worth paying taxes for, to make life better for everyone. But you guys are too selfish to see that.

  • by John Jamieson (890438) on Sunday November 22, 2009 @06:30PM (#30196974)

    Blame it on Canada, the theme never gets old here.

    The issue is much more nuanced than most arguments would indicate.

    Unlike most, I live near Canada, worked in Canada and even been to the hospital in Canada. Canadian Hospitals are not as comfy as the ones I go to in the US. They seem more institutional and less customer focused. That being said, they seem just as competent. (life expectancy and infant mortality are much better in Canada than here in the US)

    Anyone with real money (and suckers like myself who pay 10 Grand a year) will likely have a better experience in the US system than the government system in Canada.
    The other 60% would do much better in Canada. No more worries about loosing insurance when they loose a job, or worries about scrounging up insurance money, no more co-pays driving people to the brink.

    BTW, us IT workers need to learn from the Canadian Doctors. Imagine if we controlled who could enter the IT field? We also could create artificial shortages and boost our salaries as well.

  • Re:Well yes... (Score:3, Insightful)

    by AK Marc (707885) on Sunday November 22, 2009 @07:29PM (#30197402)
    Yeah but if you save $1000/year over 80 years of life, then you'll have $80,000 in the bank, or $200,000+ with compound interest, and can easily afford to replace the burned-out shell. You don't need the insurance scammers.

    It's a good thing that no one has a fire until they are 80.

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