A couple of related pieces caught my attention today: @HealthPlan: How insurers use social media and Insurers are scouring social media for evidence of fraud. Slowly but surely health plans and other insurers are stepping into the world of social media and it’s interesting to see how they are doing it.
Health plans seem to be following along the lines of other big, bureaucratic organizations that cause customers a lot of frustration through poor customer service. Here’s an example of a Twitter exchange between Humana and a customer:
Sept. 23, 2010
@MrAndrewDykstra: Dear Humana, you’ve ruined my day. Worse, my wife’s day. Way to CYA. I’m paying you to cover mine. #NotHappy
Sept. 24, 2010
@HumanaHelp: @MrAndrewDykstra I’m sorry to hear about your frustration, is there anything I can do to help out?
@MrAndrewDykstra: @HumanaHelp You were kind and didn’t give my wife the run around, I appreciate that. 3/3.
Sept. 27, 2010
@HumanaHelp: @MrAndrewDykstra Thank you, let me know if you need any customer care.
This is pretty typical of what I’ve experienced from companies like Comcast and Honda. In contrast to what feels like impersonal help through traditional customer service channels (e.g., phone) with Twitter you get the feeling there’s a real live human taking an interest. I’ve had the Twitter folks check in with customer service on my behalf and on occasion get things unstuck. Even when they can’t do much it provides some relief because it feels like they’re trying. That response is out there for all of the customer’s Twitter followers to see, too.
It’s not all that exciting, however, and health plans aren’t going to dramatically change the customer experience with these sorts of efforts. There are a few other things they’re doing such as providing health tips, political messages, and promoting microsites for specific projects. Perhaps in the future they’ll move on to actively soliciting feedback and testing ideas, not just responding to gripes.
The insurance fraud article is a little more exciting. At least based on the article (which may not be representative) insurers are being a little less conservative in this realm than on the health plan customer service side. Not surprisingly, insurers are checking out the social media pages of people who’ve made disability claims. See someone out with a bad back bragging about running a marathon? Probably a reasonable trigger for a fraud investigation. But things get a little less straightforward from there. For example:
Mike Fitzgerald, a Celent senior analyst, said life insurance companies could find social media especially valuable for comparing what people will admit about lifestyle choices and medical histories in applications, and what they reveal online.
That could range from “liking” a cancer support group online to signs of high-risk behavior. “If someone claims they don’t go sky diving often, but it clearly indicates on their online profile that they do it every weekend they can get away,” Fitzgerald said, “that would raise a red flag for insurers.”
“The situation is coming up more and more in court where lawyers for insurance companies lay traps for the insured based on pictures or postings on Facebook or Twitter,” said Vedica Puri, a partner at Pillsbury & Levinson, a San Francisco law firm that specializes in insurance.
“Photos can be years old. People joke or write things in jest, but insurance companies use everything. Even if it’s not true, it can be very damning,” she said.
Lawyers and industry experts said that one of the dangers for consumers is people’s desire to present themselves in the best light, even if it hurts an insurance claim.
Or as Lavin puts it: “No one puts pictures of themselves crying in a dark room, even if that’s what they’re doing 18 hours a day.”
“The whole thing is just symptomatic of technology running ahead of the people who are using it,” he said. “It’s kind of like the early years of flight when planes are crashing all over the place. Society has not come to terms with how to manage social networking.”
The last point is a good one. I’ve read about –and noticed– that people tend to present the sunny side of life on their Facebook and LinkedIn pages and sometimes their blogs. That probably shouldn’t be used against them.
David E. Williams is co-founder of MedPharma Partners LLC, strategy consultant in technology enabled health care services, pharma, biotech, and medical devices. Formerly with BCG and LEK. He blogs regularly at Health Business Blog, where this post first appeared.
Categories: Health 2.0