Ugh health insurance companies

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**garret**

http://news.yahoo.com/s/ap/20091122/ap_on_re_ca/cn_canada_facebook_insurance

Sun Nov 22, 1:20 pm ET
BROMONT, Quebec – A Canadian woman on long-term sick leave for depression says she lost her benefits because her insurance agent found photos of her on Facebook in which she appeared to be having fun.

Nathalie Blanchard has been on leave from her job at IBM in Bromont, Quebec, for the last year.

The Canadian Broadcasting Corp. reported Saturday she was diagnosed with major depression and was receiving monthly sick-leave benefits from insurance giant Manulife.

But the payments dried up this fall and when Blanchard called Manulife, she says she was told she was available to work because of Facebook.

She said her insurance agent described several pictures Blanchard posted on Facebook, including ones showing her having a good time at a Chippendales bar show, at her birthday party and on a sun holiday.

Blanchard said Manulife told her it's evidence she is no longer depressed. She's fighting to get her benefits reinstated and says her lawyer is exploring what the next step should be.

Blanchard told the CBC that on her doctor's advice, she tried to have fun, including nights out at her local bar with friends and short getaways to sun destinations, as a way to forget her problems.

Manulife wouldn't comment on Blanchard's case, but did say they would not deny or terminate a claim solely based on information published on Web sites such as Facebook

Is this just wrong or not. I have dealt with plenty of people with depression and it doesnt mean they have to be sad all the time. This is why i hate health insurance companies sometimes.

**dogma**

When clinically depressed you cannot have a good time. If you have a good time you are not clinically depressed.

The woman lied, knowingly or not, in much the same way that 4-chan lies about its Aspie percentage.

**sebster**

dogma wrote:When clinically depressed you cannot have a good time. If you have a good time you are not clinically depressed.

The woman lied, knowingly or not, in much the same way that 4-chan lies about its Aspie percentage.

She appears to have been receiving professional advice that said she was depressed, which is much stronger evidence than a facebook entry where it looked like she was having fun. It is a grey area and its fair enough the insurance company had doubts, but they should have spoken to her and had her see further medical specialists, not just cut her funding and then make her take it to court.

**JEB_Stuart**

I probably would have had her see another doctor for a second opinion, but then again, she could fake it. This is a tough call for sure, but I am inclined to side with the insurance company. I mean seriously, why should they have to pay for medical leave? And should depression really be considered for disability?

**warpcrafter**

Some people try to deny that they're depressed, even to the point of trying to fool themselves. They can usually be spotted because they are the ones who are trying waaay to hard to have fun, and making it painfully obvious that they're more happy than any actually happy person would be. It's really irritating, to tell you the truth. I've experienced it with one of my friends, his girlfriend was that way. But the worst thing is if you confront them and ruin the illusion of their happiness. Then a five foot tall eighty pound girl puts dents in cars and breaks their windows with her bare fist while screaming at over a hundred decibels. So, if you are at a party and somebody there is being waaay to happy, smile, back away slowly and the moment they're out of sight, RUN!!!

**sebster**

JEB_Stuart wrote:I probably would have had her see another doctor for a second opinion, but then again, she could fake it. This is a tough call for sure, but I am inclined to side with the insurance company. I mean seriously, why should they have to pay for medical leave? And should depression really be considered for disability?

I think if its clinical depression due to a chemical imbalance in the brain then it's no difference to any other physical injury. It'd also be pretty hard to fake.

It gets a bit harder with non-physical depression, but it needs to be understood that it is very real and very hard to recover from.

**JEB_Stuart**

I know, I have been clinically depressed. I never took meds though, and I did minimal counseling. It took a few months, but I worked my way out of it. I was very blessed to have a good network of friends and family to help me out as well. But in all aspects it was not like having a physical disability. I still forced myself to go to work and go to school. Sure there were a few days where I couldn't do anything, but the vast majority of the time it just took a degree of self control and discipline to make life happen. As a person who once suffered from it, I am not sold on the boohoo stories that generally surround it...

**Wrexasaur**

JEB_Stuart wrote:As a person who once suffered from it, I am not sold on the boohoo stories that generally surround it...

Umm... okay? Exactly how much does your personal experience reflect others?

Forcing yourself to go to work when you are sick is sick. Just as with something like the flu, a very negative attitude glossed over with a false sense of security, and a strong work ethic can spread to others. You can hem and haw as much as you want, but no one wants to work with a depressed, AND forceful person. By all technicalities, I would not be surprised if you were misdiagnosed.

I have very, very little faith in professionals from the psychiatric field; that said though, emotions are extremely real. Every single emotion you have, has a direct effect on the people around you. The fact that you had/received the support you needed, only speaks to your lack of insight into other peoples situations.

**sebster**

JEB_Stuart wrote:I know, I have been clinically depressed. I never took meds though, and I did minimal counseling. It took a few months, but I worked my way out of it. I was very blessed to have a good network of friends and family to help me out as well. But in all aspects it was not like having a physical disability. I still forced myself to go to work and go to school. Sure there were a few days where I couldn't do anything, but the vast majority of the time it just took a degree of self control and discipline to make life happen. As a person who once suffered from it, I am not sold on the boohoo stories that generally surround it...

It's great that you were able to work your way out of the problem, but one case of depression is not like all cases of depression. I know that there are cases that are overstated or outright fabricated (it's become the RSI of this decade) but I think it is dangerous to dismiss or even to be sceptical of a case of depression without knowing any further details.

I do think that getting out and working is a lot better for the individual as they keep active and problem solve and thereby build self esteem, so really instead of spending money debating these things in court we'd be better off helping to get these people into jobs they can handle. But that goes for all kinds of disabilities and is kind of the core of my leftist ways, I think helping people to be useful as possible is about as good a thing as government can do.

**JEB_Stuart**

Well it was simple really. I had bills to pay, and I wasn't going to pay them sitting around crying all day. And my personal experience is of course going to reflect on my opinion of anything. You know that whole existentialist idea that experience creates value and such...Anyway, to say that just because I have a different opinion then others because of my personal experience it is invalid is just plain wrong. Its my opinion and I am deriving it from what I know. I am no professional or medical expert, but that is what I think about it.

**Wrexasaur**

sebster wrote:I do think that getting out and working is a lot better for the individual as they keep active and problem solve and thereby build self esteem, so really instead of spending money debating these things in court we'd be better off helping to get these people into jobs they can handle.

How would this work exactly? Someone with severe clinical depression does not need to go out and work, to fulfill what you see as a positive self esteem exercise. I won't say that it cannot help, but in general I feel you are clearly wrong on this. Keeping active is great, being social is probably one of the best ways to work ones way out of a depression. This has absolutely nothing to do with tying responsibility universally to every single person with a pair of hands.

They are responsible to get up and see the light, or go on a hike or some such. Anchoring a very unstable person to a flight of fancy regarding a job, is a fantastic way for them to develop a false sense of well being tied to that job. The responsibility will become the reason that they get up, and while a few people may be able to handle that; someone specifically with clinical depression needs nothing of the sort. At all...

JEB_Stuart wrote:Anyway, to say that just because I have a different opinion then others because of my personal experience it is invalid is just plain wrong. Its my opinion and I am deriving it from what I know.

Never said that you were automatically wrong because you had an opposing opinion. Calling other people situations "Boohoo stories" is plain offensive, and I took it as such.

**sebster**

JEB_Stuart wrote:Well it was simple really. I had bills to pay, and I wasn't going to pay them sitting around crying all day. And my personal experience is of course going to reflect on my opinion of anything. You know that whole existentialist idea that experience creates value and such...Anyway, to say that just because I have a different opinion then others because of my personal experience it is invalid is just plain wrong. Its my opinion and I am deriving it from what I know. I am no professional or medical expert, but that is what I think about it.

Which is perfectly sensible, but needs to be taken with a heavy dose of 'but my experience of something will not be the same as everyone's experience of that thing'.

Automatically Appended Next Post:

Wrexasaur wrote:How would this work exactly? Someone with severe clinical depression does not need to go out and work, to fulfill what you see as a positive self esteem exercise. I won't say that it cannot help, but in general I feel you are clearly wrong on this. Keeping active is great, being social is probably one of the best ways to work ones way out of a depression. This has absolutely nothing to do with tying responsibility universally to every single person with a pair of hands.

They are responsible to get up and see the light, or go on a hike or some such. Anchoring a very unstable person to a flight of fancy regarding a job, is a fantastic way for them to develop a false sense of well being tied to that job. The responsibility will become the reason that they get up, and while a few people may be able to handle that; someone specifically with clinical depression needs nothing of the sort. At all...

Sure, but you seem to be assuming I'm talking about sticking someone back into a 9-5 and leaving it at that. It could be one day a week volunteer work, as part of an overall process towards recovery.

**Wrexasaur**

sebster wrote:Sure, but you seem to be assuming I'm talking about sticking someone back into a 9-5 and leaving it at that. It could be one day a week volunteer work, as part of an overall process towards recovery.

That sounds rather reasonable sebster. I would have a hard time calling that a job, but within this context that extra boost could help a bit. Calling it therapeutic volunteer work makes more sense to me at any rate though. The main point in this, would be to provide a positive environment where (as you said) someone can be as useful as possible; really meaning that they could see real worth in themselves.

I have seen some real horror stories, that is the main reason I am a bit aggressive on this subject. People are emotional creatures, and the depths of that go far beyond what I could ever hope to actually understand completely.

**dogma**

sebster wrote:...I think helping people to be useful as possible is about as good a thing as government can do.

And agreement was had! Angels sang from the heavens, and rose petals fell at the feet of the lord.

**sebster**

Wrexasaur wrote:That sounds rather reasonable sebster. I would have a hard time calling that a job, but within this context that extra boost could help a bit. Calling it therapeutic volunteer work makes more sense to me at any rate though. The main point in this, would be to provide a positive environment where (as you said) someone can be as useful as possible; really meaning that they could see real worth in themselves.

Cool. I didn't explain it very well, but I think working would be part of an overall strategy to get them feeling good about themselves, and about the effect they can have on the world.

My concern really, and this goes for all kinds of disabilities, is that they leave work, collect a cheque each month and are otherwise left cut adrift to struggle through their issues alone. It would be better for them and better for society if we were to have more active recovery programs.

I have seen some real horror stories, that is the main reason I am a bit aggressive on this subject. People are emotional creatures, and the depths of that go far beyond what I could ever hope to actually understand completely.

No, I think you've been pretty reasonable in this thread. It's an emotional topic and one that a lot of people don't fully understand (myself included).

**Horst**

I side with the insurance company here. sick leave for long term depression, while it may be real, should not be covered under health insurance. Its just bs. If it can be proven with quantifiable evidence from a legitimate medical doctor (not a psychiatrist) that there is a chemical imbalance in the brain, that is causing depression, then fine. thats a disability. Without it, its just a person looking for a free ride.

**Wrexasaur**

Horst wrote:I side with the insurance company here. sick leave for long term depression, while it may be real, should not be covered under health insurance. Its just bs.

"While it may be real", and "It is just BS", should not even be in the same paragraph. If the insurance covers it through their plan, and you paid for that plan, it is neither "possibly real", or "possibly BS"; it is a legal contract that has been signed and paid for. No more and no less.

If it can be proven with quantifiable evidence from a legitimate medical doctor (not a psychiatrist) that there is a chemical imbalance in the brain, that is causing depression, then fine. thats a disability. Without it, its just a person looking for a free ride.

How would scientific data on the subject change an entire group of peoples intentions? Limiting this further to a hypothetical imbalance, is simply close-minded. You have to prove to me that you are chemically balanced, through scientific data, before I could possible ever know that you were happy. No other way to know that at all.

**Horst**

see wrex, I don't need evidence i'm happy. there's nobody trying to collect insurance for being happy. If you can't actually prove your sick, medically, with quantifiable scientific data, then well guess what, your not sick. Insurance shouldn't have to cover that.

**Wrexasaur**

Horst wrote:If you can't actually prove your sick, medically, with quantifiable scientific data, then well guess what, your not sick.

I am going to take this as a statement of an ideal, rather than an actual situation. Your not happy BTW, no worries though, you can think you are.

Insurance shouldn't have to cover that.

Insurance covers whatever the plan entails.

**Kilkrazy**

JEB_Stuart wrote:I probably would have had her see another doctor for a second opinion, but then again, she could fake it. This is a tough call for sure, but I am inclined to side with the insurance company. I mean seriously, why should they have to pay for medical leave? And should depression really be considered for disability?

The report says she lost her medical benefits. These may or may not have included paid sick leave. If they did, it was part of the benefits of the insurance plan, so clearly the company should pay them unless the cause of taking leave is actually false.

Should depression be considered a disability? The insurance company certainly thinks so, because their judgement is that she isn't really depressed, and should be denied benefits. They were paynig benefits under the plan when they thought she was depressed.

I bet she's depressed now!

**MeanGreenStompa**

There should be a Canadian version of the Financial Ombudsman Service (FOS) that we have in the UK, they can provide an impartial adjudication on the case.

**Horst**

to hell with impartial adjudicators.

we need Judge Dredd style enforcers here to deal with this crap.

**sebster**

Horst wrote:see wrex, I don't need evidence i'm happy. there's nobody trying to collect insurance for being happy. If you can't actually prove your sick, medically, with quantifiable scientific data, then well guess what, your not sick. Insurance shouldn't have to cover that.

Umm, she had received doctor's advice, while the insurance company had had a look at her facebook page. If, like you claim, you're all about the evidence, then you'd either side with her, or (like most of us) make no comment on her condition and criticise the insurance company for taking a combative stance before establishing if she really was depressed.

But you didn't, instead you just assumed the insurance company was right and she was faking it.

**Horst**

insurance companies need to take combative stances. insurance fraud hurts everyone, making all our rates go up. people who screw the system out of money hurt those of us who pay our dues, and sicken me. There are no free rides in america, and anyone who tries to take one is no better than a thief. She should be denied claims from the insurance company until her claim can be verified by a legitimate doctor,and if she has no legitimate reason, she should be made to pay reparations to the insurance company for any disbursments from said insurance company. That should give her something to be depressed about.

**dogma**

You should be punched. Just sayn'.

**Horst**

quite right, I should be punched for voicing my opinion. hell, why stop there, you should lynch me!

and if I ever wrote any books, you should gather them up and burn them! while your at it, you should form a club to do it with you. you know, for social purposes.

you could make a club banner even! hmm... a black windmill on a red background would look fun!

sounds like a great club. Nice try, Hitler, but I caught you in the act. go back to argentina.

**dogma**

Horst wrote:quite right, I should be punched for voicing my opinion. hell, why stop there, you should lynch me!

Because a punch is a reasonable expression of dissatisfaction?

Do you feel like running this all the way into hyperbole; claiming that my disagreement is infringing on your freedom, or do you want to be someone who isn't an idiot?

Horst wrote:
and if I ever wrote any books, you should gather them up and burn them! while your at it, you should form a club to do it with you. you know, for social purposes.

Well, at least your answer was prompt.

Is this going into Godwin land?

Horst wrote:
you could make a club banner even! hmm... a black windmill on a red background would look fun!

sounds like a great club. Nice try, Hitler, but I caught you in the act. go back to argentina.

Yes, yes it is. Try harder next time.

You have exactly as much information about this case as I do, and your conclusion is horribly unfounded. Everyone loves catharsis, including me, but extending it beyond a single post just makes you look foolish.

**sebster**

Horst wrote:insurance companies need to take combative stances. insurance fraud hurts everyone, making all our rates go up. people who screw the system out of money hurt those of us who pay our dues, and sicken me. There are no free rides in america, and anyone who tries to take one is no better than a thief. She should be denied claims from the insurance company until her claim can be verified by a legitimate doctor,and if she has no legitimate reason, she should be made to pay reparations to the insurance company for any disbursments from said insurance company. That should give her something to be depressed about.

What? When, and how, did you decide that a combative stance is needed to resolve a claim's issues? There are very big differences between contacting a claimant and telling them there are doubts over their claim and that they need to see additional specialists (which addresses concerns over the claim without being combative) and cutting their payments and daring them to take it to court (combative and more expensive for everyone without actually increasing the chance of an accurate outcome).

What's going on to make you post all that? Because it isn't about a woman who's facebook page led to a disputed disability claim.

Automatically Appended Next Post:

dogma wrote:Everyone loves catharsis, including me, but extending it beyond a single post just makes you look foolish.

I think when someone has such a great need for release that they'll read the OP's story and start sounding off about thieves costing us all higher rates then they're going to look very silly, whether it's one post or more.

**Kilkrazy**

Horst wrote:insurance companies need to take combative stances. insurance fraud hurts everyone, making all our rates go up. people who screw the system out of money hurt those of us who pay our dues, and sicken me. There are no free rides in america, and anyone who tries to take one is no better than a thief. She should be denied claims from the insurance company until her claim can be verified by a legitimate doctor,and if she has no legitimate reason, she should be made to pay reparations to the insurance company for any disbursments from said insurance company. That should give her something to be depressed about.

This woman isn't in "America", she's in Canada.

**reds8n**

If users could refrain from, you know, threatening to hit each other, comparing each other to nazis (whilst we're still on page 1 of the thread anyway) and you know, try and be a little politer then we won't have to lock this thread and no one will get suspended.

That does cause depression BTW.