How Facebook Can Affect Your Insurance Benefits
by Imei Hsu, RN, MAC, LMHC
With over 500 million users of Facebook worldwide, you shouldn’t be surprised who is on Facebook these days. Your dentist, your employer, your friends and family, and even your health insurance company may have a presence on Facebook. While it’s fun to set up events, get-togethers, and give your social network a slice-of-life status update a couple of times a day, you shouldn’t be surprised who is looking at your updates. Here’s how Facebook updates can affect your health insurance coverage. 
Enter Natalie Blanchard, a 30 year old IBM technician from Quebec. She has released her story The Los Angeles Times in 2009 about a medical leave she took in 2008 on the recommendation of her doctor. She was being treated for depression, and her doctor had suggested that she go on vacation. While on medical leave, had been receiving monthly disability benefits from her insurance plan, but these were severed without warning after the first year. Blanchard claimed that her insurance company had crawled her Facebook page, discovering pictures of her on her vacation. As you can guess, most vacation pictures include sunshine, smiles, eating and drinking, and what most of us would consider the “high life”. Her insurer considered her ready to return to work, and therefore benefits were terminated.
In the lawsuit that is scheduled to go to court in January 2012, Blanchard claims her insurer assumed this was a case of fraud based on her Facebook pictures and status updates, and that the insurer terminated benefits with studying the background of her benefits. She also claimed her doctor was not contacted before the benefits were terminated. If you don’t know this, it is standard practice in medical cases that the treating physician or nurse is contacted by an insurer case consultant (often times a medical practitioner) to determine the need for benefit based on the medical history of the client.
As a therapist, I find this trend alarming. But even if you’re not a clinician, you should be concerned. The original articles were released in 2009 and 2010, yet I consistently see people using their Social Media updates such as Facebook without an awareness of who might be tracking their posts. I also find it disturbing because disease and dysfunction does not follow a consistant pathway of suffering 100% of the time in ways that can be detected from the smiling face of a person on vacation.
Case in point: a friend of a close friend spent time skiing, running, and sharing meals with my friend all the way up to about a couple of weeks before she took overdosed in a hotel room. Her suicide note indicated that she had been planning her suicide for some time, but her friends and family were shocked. The months before her suicide had been filled with smiley-faced pictures of herself traveling around the world, a brief but intense romance, and dreams of the future. At her wake, the guests were still in a state of shock and grief, and to this day, I am sometimes haunted by her vibrancy and verve.
During the years of her struggle with depression, she had done what so many others do: they fight it, they get professional help, they try to live life the best they can, and when there are moments when the depression lifts, they go on vacations, eat and drink, fall in love, and struggle on. Those momentary lifts do not mean the depression is over and done with. Clinicians understand that a lift in depression can also be a time when a severely depressed person has just enough energy to plan a thoughtfully executed suicide.
While the insurer of Natalie Blanchard claims they did not terminate her disability benefits based on her Facebook status updates and photos, they are not denying that these updates and photos were viewed. What should you learn from this?
1. Insurers can and do look at your Facebook status updates and photos, and you cannot legally stop them from this practice. They have the right to search for evidence of fraud or foul practice. Any business can do the same thing. In January 2010, Mark Zuckerberg declared to the world that privacy in the online age was over.
2. You can change your privacy settings on Facebook to limit who can see your posts. However, you should understand that your Terms of Use on Facebook does not ensure your privacy, and Facebook’s position has never been to ensure your privacy.
3. Educate your physician’s office. If you are using insurance benefits for your healthcare and need special coverage based on a medical condition, discuss with your doctor your concerns. Your doctor should be directly contact anytime your benefits are increased, decreased, or terminated based on your medical condition.
4. Take a moment to consider what it is you are sharing on Facebook, Twitter, and other Social Media platforms every time you type. Notice what ads come up on your page when you type in keywords like cancer. At minimum, bots crawl your pages and emails on certain platforms, using keywords to generate ads that are sent to you. Test this: mention that you’re watching your weight, and see how many ads come up for everything from P90x to weight loss yoga. In a similar way, insurers can sift through your public posts to see what you’re broadcasting, and this can be used as evidence against you in a similar way lawyers are using this for divorce cases and employers are using it when interviewing a potential candidate for hire.
This post is not about scaring the bajesus out of you. It’s about educating users so that you can enjoy the best that the Internet has to offer while protecting your best interests. Now go: Skype, text, update, and post your photos. Only be careful, and if you’re not sure how something will be construed, save it for your private enjoyment.
For another link to the story about Natalie Blanchard’s case, take a look at this law blog.