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Social Media and Claims Investigations

Claims professionals may have much to gain from using social media, but must take care with the tactics used.

Two years ago, at an insurance association session on social media, the presenter asked if anyone was using social media for business.  A  half dozen people (out of 50 or so) raised their hands.  One was a broker.  The rest worked in claims.  When asked what the claims people were using it for, the room became quiet. Clearly, this was NOT something they wanted to talk about.

Now, the word is definitely out:  insurers have an interest in what claimants  reveal on social media sights about activities that might have impact on an insurance claim.  In November 2009, Manulife halted disability income payments for an insured who was on disability leave.  Manulife  found information on the employee’s personal Facebook page, suggesting the employee was not disabled to the point of being eligible for the benefit payments.    The case stirred up controversy, and the insured sued Manulife.  The case is now headed for trial.

In a recent Ottawa Citizen article, Shan Li, a McClatchy-Tribune News reporter, wrote:   “Social-networking sites have become such ‘standard tools’  that Peter Foley, vice president of claims at American Insurance Association, said that investigators could be considered negligent if they didn’t conduct at least ‘a quick scan of social media to check for contradictions.'”

However, use of social media is not an unlimited treasure trove of information.  There are a growing number of articles on the legal and ethical issues of prying into information that either is not, or is not intended to be in the public domain (see “Using Social Media in Claims Investigations” in PropertyCasualty360.com for a recent example).

That said, insurance organizations are definitely recognizing the power of social media as a tool and some are actually recruiting individuals with social media skills to work in claims departments.  US Based Secura Insurance recently recruited for an social media intern in the claims department.

This recruitment is not without controversy.  Secura’s ad created some push back from people concerned that a low level employee would be engaged in potential invasion of privacy.  Scott Huiras,  Secura’s VP of claims felt required to post clarification of the actual role: “We’re now recruiting for a Social Media Claims Investigation Intern, a paid position, that is more a claims role than a social media role. The Intern will be using social media as a research tool. As a new position, we are still exploring how much time and depth of knowledge in social media a good candidate will need. However, because the intern will not be engaging with others in social media, it is fitting for an intern who will be trained in various facets of claims, and who could possibly move into a full-time claims position with SECURA.”

There are clear benefits to the use of social media in claims investigations, but as with any tool, there needs to be care in use.

2011 Insurance-Canada.ca Technology ConferenceKaren Pauli, Research Director, TowerGroup, will be speaking on Claims Operations Performance Excellence at the Insurance-Canada.ca Technology Conference, February 28, 2011 in Toronto.

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