Facebook Photos Lead To Cancellation of Quebec Woman's Insurance 645
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?"
Is she really sure it was locked? (Score:5, Insightful)
Second, is she the one that posted the photos? If someone else posted photos of her on a public page, anyone can see them.
Re:Is she really sure it was locked? (Score:5, Insightful)
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.
Re:Is she really sure it was locked? (Score:5, Insightful)
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.
Re:Is she really sure it was locked? (Score:5, Insightful)
Re:Is she really sure it was locked? (Score:5, Insightful)
Re:Is she really sure it was locked? (Score:5, Insightful)
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.)
Re:Is she really sure it was locked? (Score:4, Insightful)
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.
Re:Is she really sure it was locked? (Score:5, Insightful)
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".
Re:Is she really sure it was locked? (Score:5, Insightful)
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.
Re:Is she really sure it was locked? (Score:5, Insightful)
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.
Re:Is she really sure it was locked? (Score:5, Insightful)
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!
Re:Is she really sure it was locked? (Score:5, Interesting)
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.
Agreed. I wonder what that company would do with someone with say a bipolar disorder. "Oh he was exceptionally cheerful and friendly; therefore he can't possible have crippling depressive phases." Speaking from experience I can say that depression, at least in my personal experience and from dialogue with family members with a similar affliction, comes in varying intensity at sometimes random intervals. And during the summer months is it generally easier to have a prolonged positive phase, while during the winter the depressive phases can be harder to deal with.
A cousin of mine killed himself at the age of nineteen; it came as a total surprise to everyone except his absolutely closes friends and relatives "he always seemed like he was in such a good mood" someone said about him afterwards. Society seems to pressure people into hiding these types of problems, or at least people with these types of problems tend to keep them to themselves. One of the very worst things that can happen is to not be believed, or have people belittle what they don't understand.
I have no personal knowledge of this particular case, but this kind of shit from the Insurance Company in question can only add to problems that are already bad enough. Personally I hope the Canadian authority shaft this company hard.
Re:Is she really sure it was locked? (Score:5, Informative)
I have some experience working with Insurance companies (in Ontario), and I can say that usually, if they're paying out on a depression claim, they do so with a certain amount of good grace, up to a point. If treatment goes on longer than, say two years, the company is going to get suspicious and nosy, on the grounds that after two years the patient should have found a treatment that works and be on the road to recovery. Depression is a treatable illness.
This woman will either have an option to appeal the insurance company's decision, or sue them for the money. If all the company has is a few Facebook photos, they're not going to get very far against her. If, on the other hand, she's been depressed for 3 or 4 years, has been treated by her doctor and seeing a psychologist and psychiatrist for all those years, and she's still not better, they'll have a somewhat stronger case.
Re:Is she really sure it was locked? (Score:5, Informative)
Re:Is she really sure it was locked? (Score:4, Insightful)
Normally nitpicking drives me up the wall, but given the subject, I must say only this.
Sorry, of course you are correct.
Re: (Score:3, Funny)
Half the time they pay up, half the time they send a mailbomb?
Re: (Score:3, Interesting)
Yep. Giant and easily winnable lawsuit in 3...2...1....
Hell if we judged everyone by Facebook:
--I'm a 26 yr old underwear model
--I drive a Viper and vacation in Italy
--My ex is a really nice girl
--I spend 24 hrs a day playing Mafia Wars and Street Racing
Obviously none of that is true
Re:Troll me all you want. (Score:5, Insightful)
Re:Troll me all you want. (Score:4, Insightful)
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.
Re:Troll me all you want. (Score:4, Insightful)
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.
Re: (Score:3, Funny)
I thought for a moment you said warfarin.
On second thoughts take that back. It was more like I hoped it.
Re:Is she really sure it was locked? (Score:4, Insightful)
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.
Re:Is she really sure it was locked? (Score:5, Interesting)
There have been several cases in Sweden were the insurance companies have been spying on the beneficiaries video taping them, then hired a doctor to claim that the person is healthy. The problem is, there are many doctors, and you can always find one that will disagree with the first one.
If what you are suggesting is going to work, you would at least need some formalized appeals process, perhaps with government hired doctors from every medical field, that can review the cases from a neutral point of view.
Re:Is she really sure it was locked? (Score:5, Insightful)
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.
Re: (Score:3, Insightful)
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 af
Re:Then you can work, thief! (Score:5, Insightful)
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.
Re: (Score:3, Interesting)
The parent wasn't complaining about the insurance companies being robbed. It is your co-workers who pay for your insurance when you cannot. If enough people are so "depressed" that they can't work the insurance company will adjust its rates if it continues long enough. That is exactly why your insurance goes up, because your company is costing the insurance company more to cover you.
While I agree an insurance company has no business using Facebook for determining a case they do have the right to investigate
Re:Then you can work, thief! (Score:4, Insightful)
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.
The case for reform (Score:5, Insightful)
Oh, wait...
Re:Then you can work, thief! (Score:5, Informative)
This particular story is out of Canada, different health-care system, different incentives.
Re: (Score:3, Insightful)
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!
Re:Then you can work, thief! (Score:4, Insightful)
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.
Re:Then you can work, thief! (Score:5, Interesting)
Except that the doctor shortage is not a function of universal health care, it's a function of the self-regulated medical profession maintaining control over how many doctors are certified every year. They keep the numbers down, so everyone has to scramble for a doctor, and the doctors can pick and choose patients. If the gov stepped in and mandated more seats in medical schools, there would be more doctors and less of a shortage.
The Canadian system isn't perfect, hell it isn't even very good, but it covers everybody, and it's more than twice as efficient as the current US system. But hey, if you enjoy the taste of the shit that the insurance companies feed you, by all means, keep right on eating it.
Re: (Score:3, Insightful)
And a lower average quality of physician. The government can’t mandate skill or talent among its citizens.
Re:Then you can work, thief! (Score:4, Insightful)
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.
Re: (Score:3, Insightful)
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 w
Re:Then you can work, thief! (Score:5, Insightful)
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.
That's depressing! (Score:5, Insightful)
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.
Re:That's depressing! (Score:5, Interesting)
You're right on the money here.
When a person resolves to end it, there's a sense of relief; something to look forward to. It's perverse but having experienced it first-hand I can tell you its very true. I'd likely not be here if I had been living alone at the time.
One of the first things that comes back when you start taking antidepressants is your motivation. You still have the suicidal thoughts, but now you have the motivation and energy to go through with it.This is one of the reasons antidepressants are so dangerous to adolescents and kids. You combine motivation, negative outlook, and the impulsive nature of youth and you end up with a massive spike in suicides/attempts during the first months of antidepressant therapy.
Re: (Score:3, Insightful)
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 b
Psychiatry (Score:3)
NEW SICK LEAVE POLICY (Score:3, Funny)
TO: All Employees
SUBJECT: New Sick Leave Policy
SICKNESS:
No excuse...We will no longer accept your doctor's statement as proof. We believe that if you are able to go to the doctor, you are able to come to work.
AN OPERATION:
We are no longer allowing this practice. We wish to discourage any thoughts that you may need an operation. We believe that as long as you are an employee here, you will need all of whatever you have and should not consider having anything removed. We hired you as you are, and to ha
The agent's no expert. (Score:5, Insightful)
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).
Eh, they ain't denying cancer (Score:3, Interesting)
Cancer is a "simple" disease, not a mental condition. Why do you link the two?
Insurance agents ARE often experts in the field they insure. How else would they do their job? Car insurers know a LOT about cars, that is what they do. They collect as much data as they can and then determine what premium to charge so they can still make a profit by insuring against risks. And one part of it is knowing when a claim is bogus. Don't try to claim seagulls ruined the paint job on your car, in the mountains. Do not c
Re:The agent's no expert. (Score:5, Informative)
Keep in mind that this is a Canadian woman, so her insurance is going to look different than what you're used to. She's being insured privately for the time she misses from work, not for the treatment of the depression. The depression treatment is covered under her provincial health care. Here in Ontario that would mean she's covered for her doctor's appointments, regular appointments with a psychiatrist, access to free counseling if she's near a Community Mental Health Centre, and if she can't afford her meds there's a public drug plan with a $200/year deductible. I would imagine that Quebec's health coverage is better than Ontario's, and she might get her drugs covered %100 there.
The private insurer (depending on what kind of insurance it is) would cover a percentage of her lost income, travel to and from medical appointments as needed including travel to out-of-town clinics or treatment centres, etc.
As for whose call it is, you're right. Generally the Insurance companies won't cut payments unless the patient has been non-compliant with treatment or they have a doctor's opinion supporting their position that she's better/should be better/faking. In this instance (I guess, I haven't RTFA) either they have other evidence or their jumping the gun.
Comment removed (Score:5, Informative)
Re:Is she really sure it was locked? (Score:5, Funny)
Nah, probably it was a female "friend" that handed her pictures to the insurance company.
That reminded me of a joke where a man 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, and the wife call's every of her husband male friends. Everyone answer "yes, he was here all night" and five of them even responds "he's still here, in the bathroom"! :-)
Re:Is she really sure it was locked? (Score:4, Informative)
The women are brutally honest. The guys are covering for each other.
Re: (Score:3, Funny)
My (female) boss called home to talk about something or other and the wife picked up. She wasn't sure if it was OK that I stopped off at my folks so she said I was away on business but that she wasn't sure where I was which led my boss to believe that I was playing away.
The conversation the ensued had both women covering for me and was, by both accounts, both anxious
Re: (Score:3, Insightful)
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:Is she really sure it was locked? (Score:5, Interesting)
what do you mean locked down ? i used to work for a PI and we had access to everyones profiles all the time. facebook does not restrict information if you are a corp with a PI license. you dont need to friend anyone. its incredibly convenient. see the facebook tos :
We may also share information when we have a good faith belief it is NECESSARY TO PREVENT FRAUD or other illegal activity, to prevent imminent bodily harm, or to protect ourselves and you from people violating our Statement of Rights and Responsibilities. This may include sharing information with other companies, lawyers, courts or other government entities.
Re: (Score:3, Insightful)
Re:Is she really sure it was locked? (Score:5, Informative)
The receptionist at a bank doesn't have access to everyone's accounts. The teller does. I'm not sure why you would be surprised that access is granted on a need-to-have-it basis at facebook, just like most every other successful business in the US.
Re:Is she really sure it was locked? (Score:4, Informative)
Bullshit. I've got my PI license in Ontario. Why? Because it was an extra $80 on top of my $80 for my security licence and you'd be stupid not to pay for it. I don't get any special perks and I still have to follow every single law in existence in Ontario, and the rest of Canada. In fact they sent me an extra special booklet saying what I can, and can't do.
Having a PI licence does not entitle you to violate the law. You're just a normal citizen with an extra bit of paper up here, with more responsibility, being even more closely monitored.
Re:Is she really sure it was locked? (Score:4, Funny)
I'm more interested in knowing how a picture of someone smiling invalidates an insurance claim for depression?
* Miserable people can smile and look cheerful
* Miserable people can go to the beach
* People suffering from atypcial depression (Most people who suffer from depression do, despite the name) CAN actually be cheerful, and still be suffering from the illness.
Last medical history I gave didn't involve facebook. It isn't a medical diagnostic tool.
I'm outraged - and I'm not going to read the article in case it explains these points satisfactorily.
Her lawyer should pursue this. (Score:5, Informative)
*sigh* Well, speaking as a depressive I can say that a good part of the treatment that a psychiatrist suggests to their patients, besides their antidepressants, is to engage in social activities outside the home. They also say that staying cooped up at home and failing to get out can lead to a relapse and readmission to hospital. The Insurance company is not licensed to practice medicine, only to read a doctor's diagnosis and pay what's due.
Re:Her lawyer should pursue this. (Score:5, Insightful)
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.
Re:Her lawyer should pursue this. (Score:5, Informative)
Not to mention that a very close friend of mine has serious depression (she's not so bad at the moment, but has been hospitalised for her own safety before), and she can sound absolutely fine on the phone in the morning, and be totally withdrawn and uncommunicative in the afternoon. She can also be on a serious downer, yet sound fine on the phone to other people - in other words, put a brave face on things.
Re:Her lawyer should pursue this. (Score:4, Insightful)
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: (Score:3, Insightful)
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
Re: (Score:3, Insightful)
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
I wonder if the opposite is true? (Score:4, Interesting)
If Facebook photos are the standard by which we're judging whether or not people should be paid insurance claims for being depressed, I wonder if I can use that?
No, I'm not depressed. I mean, I have ups and downs like everyone else, but I don't think it's so severe to be classified as a medical condition. Still, I could certainly churn out a few photos when I'm feeling down one day and post them. Then maybe I could call my insurance company and tell them, "See? I'm depressed! It's right there on Facebook!"
Well yes... (Score:2, Insightful)
... 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.
Re:Well yes... (Score:4, Funny)
Re: (Score:3, Insightful)
>>>"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 h
Re: (Score:3, Insightful)
Re: (Score:3, Interesting)
I accepted that argument the first time about mammograms. It sounded reasonable that they based their recommendation on science.
I did Not accept that argument the second time.
Especially since the second time mirrors so exactly that story from the UK about the college-aged woman being denied a PAP smear, and then dying as a result of the undetected cancer. They DO ration care in the UK - there's no denying the obvious.
Re: (Score:3, Insightful)
The purpose of NICE is not to deny care, but to study the cost-benefit ratio of treatments. If
Re:Well yes... (Score:5, Informative)
Care is rationed in the U.S. as well, only the rationing doesn't necessarily take actual need (statistical or otherwise) into account. For every case like the U.K. woman you mention, there's several more where an under-insured American didn't see a doctor at all until too late because it was just too expensive.
The U.K. has nice, we have "insurance adjusters" whose job is to find excuses for not paying.
The best of both worlds (Score:3, Insightful)
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
Re:Well yes... (Score:5, Interesting)
That's a reason to destroy the greatest healthcare system in the free world?
How does Cuba come into this?
You think I'm joking, but for the dollars invested per capita, Cuba has the greatest health care system in the world. Look it up.
Re:Well yes... (Score:5, Informative)
> why people say the U.S. has the best healthcare in the world
Then why is USA ranked 37th in the world, whereas UK is ranked 18th?
Re:Well yes... (Score:5, Interesting)
My guess would be because the cure rates above are based on those who get treatment at all. Those who don't aren't counted. Only one of the systems listed above has people not get treatment once symptoms become apparent.
That and a carefully chosen ailment. Prostate cancer is generally slow. Watchful waiting is often advised for older patients.By the time it might cause death it will be a race between that and other ailments. If you're in the U.S. you'll get heroic (and expensive) efforts to make sure it's one of the other conditions that kills you (a month or 2 later while your quality of life sucks from the cancer treatment). It's a matter of having 3 more decent months of life or 5 more crappy months.
As for the wait times, in the U.S. if you are uninsured or your condition is "pre-existing", the wait time is effectively forever.
Re:Well yes... (Score:4, Insightful)
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.
Re: (Score:3, Insightful)
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.
Re: (Score:3, Insightful)
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.
Re: (Score:3, Insightful)
It's a good thing that no one has a fire until they are 80.
Re:Well yes... (Score:5, Informative)
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.
As a doctor I am disgusted by your remark. There's something called the Hippocratic Oath, you know. Insurance companies also have a vested interest in insuring only healthy people. Now I can't vouch for our cousins in the pharmaceutical industry who have ALWAYS been about the money, and make no allusions otherwise (hence their use of the Caduceus - the staff of Mercury god of Business, rather than the Asclepius or "healing" staff we doctors use). After all, the ideal situation for them is for all patients to become chronic, pill taking customers.
But those of us who actually provide the healthcare ONLY have the patient's full recovery in mind, when that's possible. The only thing we have to balance here is our own personal lives and time (doctors are people too - we have families, we have hobbies, and we get stressed - especially since most patients are ungrateful and we rarely hear the words "thank you" when we do our job well: we're just "expected" to do it). Being realistic, however, it's not always possible to "cure" everyone.
How? Could have been any "friend" (Score:2, Insightful)
Well.. (Score:5, Funny)
I guess she's feeling pretty depressed right now. Does that mean she can have the insurance back?
If she wasn't depressed before she must be now (Score:4, Insightful)
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.
Re:If she wasn't depressed before she must be now (Score:4, Interesting)
I think something like Facebook can be good but too many people think it's private. If you view it as never being private then you're probably going to be fine.
Evil (Score:5, Insightful)
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)
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:
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?
Re:Not Surprising (Score:4, Interesting)
There is quite a bit of money to be made as an insurance provider. Enough that it would be attractive even if it wasn't publicly traded. A turn-a-profit-at-all-costs attitude doesn't serve the customer. Capitalism uber alles doesn't seem to serve me as well as I thought it would when I was younger...
Re: (Score:3, Interesting)
I'd love to hear the insurance provider, in court, try to prove that said picture actually had been taken within the past six months.
The insurance company has all the power. All they have to do is cancel your insurance, citing the photos. It's up to you to haul them to court, which would likely take a lawyer costing a lot more than $250.
- RG>
Depressed or Bi-Polar? (Score:5, Insightful)
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!!!
Depression doesn't work that way. (Score:3, Informative)
Unless of course you argue that depression doesn't work that way.
It doesn't. Everyone has periods of highs and lows. A person with major depressive disorder has highs, as seen on Facebook in this case, but the highs are so short and the lows so long and deep that they interfere with the patient's ability to function for a significant period of time.
As someone that suffers from depression too.. (Score:5, Insightful)
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.
Re: (Score:3, Informative)
Side note: Not all depression meds are 'hard'.
Check out something like Zoloft, which works to balance the level of seratonin, to work to fix the problem, as opposed to a med that simply 'props' you up.
I had similar issues years ago, found Zoloft was a good fit for a few reasons:
1) As mentioned above, it helps fix the cause, not the symptoms
2) Taking anti-depressives is depressing. Taking one you know won't fuck you up helps lessen the blow.
Chat to a sensible doctor. There may be something that fits you.
Re: (Score:3, Interesting)
I've been on antidepressants. When one worked well for me, I was not an emotional zombie. The depression made me an emotional zombie, and the antidepressants helped that.
Insurance companies aren't doctors (Score:2, Insightful)
Re: (Score:3, Funny)
Yeah, we should pattern our health care system on Canada's. That way we won't get situations like what affected this Quebec woman.
In my experience, (Score:4, Informative)
people with depression, even deep depression, can smile, laugh, and be outgoing right up until the moment they commit suicide.
It's part of the syndrome that they want to act like a natural, happy person, even if they're on a brink - no matter what. Many won't admit they're ill until fatal results happen.
Insurance companies shouldn't have anything to do with diagnosis, they aren't qualified (not being doctors), and they have a conflict of interest, making money by denying illness. Frankly I think making money by denying health care to people is nearly as unethical as just shooting them up front.
I deal with depression. She should be dropped. (Score:3, Insightful)
(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.
As a nurse this disgusts me (Score:4, Informative)
I once had a patient come into the office. He was in near tears. I took him to the exam room, and found out that his insurance company (Molina in the US) had canceled his coverage for dialysis. He was a critically ill patient, and was panicking. I called the insurance to find out what was going on. I was told by the desk monkey that they did not cover 'elective' procedures. At this point I was incredulous. I tried a couple times to tell him dialysis was not a choice, and certainly not elective. No dice.
I had to argue for close to an hour to get a supervisor. This flunky was going to cut all coverage to this man's dialysis. No if's, and's, or but's. The supervisor reversed the decision on the spot, but damn. Most nurses don't have the kind of day they can devote an hour of arguing with an insurance company. The patient isn't medically trained, and certainly wasn't in a state to do it, what with being critically ill, and coming to grips that he was not going to ever get off of dialysis.
That's the worst of my experiences, but I can't say it was isolated. After ten years of nursing the episodes of crackpot crazy insurance company behavior just keeps happening more and more. It's not that uncommon.
Re:A great fraud story! (Score:5, Insightful)
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
Re: (Score:3, Interesting)
If she can function at a bar, she can function at a desk.
Clearly, you have never suffered from depression. Even though she's at the bar appearing functional, keep in mind that that may have been the first time she was able to leave the house in weeks.
Re: (Score:3, Informative)
As stated in a dozen comments in this topic, the article is about disability insurance to replace wages, not about access to health care.
If this person ends up a destitute bag lady, she'll still be covered by the Canadian universal health care system.
Re:Diagnoses from a Pic? (Score:4, Funny)
Me: Doc, Do I have rectal Cancer?
Doc: Email me a pic so I can tell.
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To: Doc
Subject: Rectal diagnosis photo
Attachment: hello.jpg (25 KB) [goatse.fr]
Here you go.
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