'I felt bullied and harassed': A Montrealer's fight to get insurer to recognize his depression
Montreal writer Samuel Archibald was on sick leave while insurer tracked his activity on social media
Samuel Archibald says he's getting his "fighting spirit" back, feeling better than he has in months.
The Montreal novelist and literature professor has been inundated by messages of love, support and gratitude since La Presse published his story last week of being denied disability insurance last fall, even though his doctor had ordered him to take medical leave for a major depression.
"I felt abandoned," Archibald says, recalling what it was like when UQAM's group insurance company, Desjardins, informed him it was denying his claim. "I felt bullied and harassed."
"It's not like you're asking for charity. You are paying good bucks as an employee for insurance, and like most people, you think that you're never going to have to use it."
"Then when you're in dire need of some help, you learn, 'Don't call us, we'll call you — and probably not."
Archibald said it was hard to get a straight answer from the insurance company about why it denied his claim, however, an agent did tell him they had Googled him and found out he had given a short radio interview while he was on medical leave.
"You are supposed to be totally unable to do anything related to your work," Archibald said.
Through his doctor, he later found out that the insurance company had also been tracking his activity on social media.
"They could see I was very active, posting: I have children; I looked happy; I was running — that kind of stuff."
He can't understand how the insurer could assess his mental health problems through his social media feeds — why, for example, Desjardins could take issue with the fact that he was running and posting about his runs on Facebook.
"Every doctor nowadays agrees that exercise is probably the best natural anti-depressant there is out there," he said.
Unable to work, and, as the family's main breadwinner, increasingly anxious about money, too, Archibald's mental health problems became worse.
"We borrowed money from our parents, skipped paying bills," he said.
He wrote the letter in La Presse about the harm caused by the insurance company's suggestion that he was committing fraud "out of sheer despair."
Story that's far too common, doctors say
Archibald's story has struck a chord with many people who have had to deal with insurance companies over disability claims for mental health issues.
Insurance companies are "intrusive and abusive" in how they treat claims when it comes to mental illness, the head of Quebec's College of Physicians, Dr. Charles Bernard, said Thursday.
Bernard accused the industry of placing unreasonable demands on clients seeking compensation for long-term disability.
In particular, some companies unnecessarily ask for complete medical histories and too often force clients to seek second opinions, Bernard said.
"Many companies don't trust the treating doctors," he told CBC and Radio-Canada.
Bernard characterized the industry's insistence on seeking second opinions as part of a "battle of experts." Insurance companies hire their own medical specialists to contest diagnoses or treatment plans offered by a client's own doctor.
Many of the doctors employed by the industry, Bernard said, are in fact retired. He questioned their competence: "I think you have to be in active medicine to be an expert."
He also said the repeated questioning of diagnoses amounted to a form of "harassment" that isn't conducive to recovery of mental health problems such as depression or anxiety.
Mental health more suspicious?
Disability claims related to mental health now account for around 50 per cent of all insurance claims, according to an industry association.
Given the high costs for insurers paying out long-term disability claims, the College of Physicians wonders if that is prompting an unreasonable level of scrutiny of clients who are otherwise in a vulnerable position.
"Mental health is more suspicious [for insurance companies]," said Yves Robert, a senior official with the college.
Lyne Duhaime, a spokesperson for the insurance industry in Quebec, denied that was the case. She said insurance companies should be treating all claims in the same manner.
Duhaime, who is Quebec president of the Canadian Life and Health Insurance Association, also said that while 95 per cent of disability claims are accepted, problems can arise from excess of caution.
"We are open to improving," she said. "Insurers want to be there for their patients."
Quebec's insurance industry accounted for 51 per cent of all complaints filed to a Canada-wide industry ombudsperson in 2017.
Of the 2,632 complaints filed across the country, more than 1,300 were from Quebec, compared to 737 from Ontario.
The OmbudService for Life and Health Insurance, which is funded by the insurance industry, said they haven't noticed a particular issue with how insurance companies treat those making mental health disability claims.
"The bad stories always get more publicity," said executive director Brigitte Kent. "In most cases insurance companies are making the right decisions."
'By not helping, they're doing harm'
As for Archibald, since his story began generating so much publicity, he has learned that Desjardins General Insurance is reopening his case. He suspects the denial of his benefits has already cost him and his family between $40,000 and $50,000.
He's hopeful that something good will come out of his experience for the many others who have written him — and that insurance companies will come to understand that by treating people with mental illness as potential fraudsters, they're exacerbating their problems.
"By not helping, they're doing harm," he said.
"A lot of people who have written me, they had everything they needed to get out of their depression: work, family support. But with insurance hassles, people decided to go back to work when they were not fully healthy."
With files from Sudha Krishnan, CBC's Daybreak and Radio-Canada