When pursuing a personal injury case, it is important to be aware of the implications that social media activity can have on the success of a claim.
Impact of social media posts on a claim
Insurers often hire investigators to not only conduct physical surveillance but also may view your social media profiles to ascertain your capacity for employment or alternatively, to obtain evidence which conflicts with medical opinion.
Hellessey v MetLife Insurance Limited (2017) demonstrates the impact such social media posting may have upon the progress of a claim.
In this matter, the insurer Metlife denied the ex police officer Ms Hellesseys, claim on the grounds that her PTSD (Post Traumatic Stress Disorder) and Major Depressive disorder sustained in the course of employment had not rendered her Totally and Permanently disabled (TPD) pursuant to the Superfunds policy.
This policy stipulated that for an individual to be deemed TPD, the individual must be rendered unlikely ever to engage in any gainful profession, trade or occupation for which the member is reasonably qualified by reason of education, training or experience.
Ms Hellessey, prior to pursuing her TPD claim flowing from her First State Superannuation fund, was a constable in the Police Force from 4 May 2001. Throughout employment, she attended numerous traumatic incidents including fatal motor vehicle accidents, cases of death and abuse of children, murders, suicides, violent crime scenes and assaults, drug and alcohol abuse, aggressive behaviour from criminals, and other traumatic incidents.
Despite both medico-legal and treating specialist evidence indicating that it was unlikely Ms Hellessey would return to employment for which she was qualified for by way of training, education and experience, Metlife denied her claim. This denial was on the grounds of Metlifes surveillance of Ms Hellesseys Facebook posts from 3 April 2012 to 3 November 2012 which showed her attending horse showing events.
Metlife sought opinion from Ms Hellesseys treating psychiatrist regarding this attendance at these events with reference to the TPD definition. The doctor indicated that when attending these events Ms Hellessey is heavily medicated and with a support person. Her injuries are permanent and not curable.
Despite this medical evidence, Metlife denied Ms Helleseys claim stating that the Facebook posts were contrary to the social phobia that she was suffering. Fortunately, Judge Robb in this matter, handed down judgement on 25 September 2017, indicating that Metlife had erred in their interpretation of the significance of the Facebook posts, ordering payment of $788,753 plus interest to Ms Hellessey.
It is integral that when making a claim for insurance entitlements that individuals are careful with respect to what is posted to social media, social media usage and the overall impact it may have on the expeditious resolutions of claims.
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If your disability or insurance claim was rejected by the fund or insurer or the fund or insurer is taking too long to make a decision on your claim call us on 13 43 63 or get in touch via our online enquiry form. There are options available to you to challenge or dispute a rejected claim or speed up the process of decision making by your insurer or super fund.