Do insurers have the right to check your social media posts to find out whether you've submitted a fraudulent claim?

When insurance litigation attorney Maria Philippides posed that question at an insurance seminar hosted by law firm Norton Rose Fulbright in Durban recently, it was clear that most of the several hundred delegates were unsure of the answer.

And that answer is yes.

Philippides said insurers may access social media platforms both at the underwriting stage to assess an applicant's risk and at claims stage to verify their version of events.

"For example, if someone uses 'shouty' capitals in their posts, does that mean they are probably aggressive, which may make them a potentially risky driver, and therefore accident-prone?" she said.

Facebook, in particular, gave insurers access to invaluable information, Philippides said, and they had a right to use it because it had been put in the public domain.

And given that "public" is the default privacy setting for Facebook, a lot of Facebook "bragging" had unintended consequences.

"In the US, for example, a woman claimed for the loss of her wedding rings while swimming in the ocean, but her insurer found photos of her flaunting those rings on social media."

Philippides also shared a local example of Old Mutual's iWYZE turning to Facebook when, not long after a middle-aged client had insured a new BMW, she claimed she had written it off while driving it.

But a suspicious investigator checked the Facebook page of the woman's 21-year-old son and saw his "my new BMW" post and then the photo of it after he had written it off - plus his status updates revealing that he'd been driving under the influence at the time.

Unsurprisingly, the claim was denied.

Regular driver

Could insurers go so far as to invent a Facebook profile and sending a friend request to a policyholder in order to access their personal information when investigating a claim? "No, I don't believe any of them would do that," Philippides said. "That would be unethical."

The problem of the "regular driver" of a car - the main user of the vehicle - is one motor insurers are all too familiar with.

Because newly licensed teenage drivers are statistically the most likely to be involved in an accident, their premiums are high. As a result, many parents insure the vehicles on their policies to save money.

If a claim arises, insurers will invariably investigate who the regular driver was. Traditionally this has involved interviewing neighbours, colleagues, employers, petrol attendants and friends, but now there is likely to be some social media snooping too.

And if insurers find that the regular driver of the car was, in fact, the child, and not the parent - on whose profile the lower premium was based - the consequences are dire.

Says short-term insurance ombud Deanne Wood: "While the insured may appear to be saving a few hundred rand every month on a cheaper premium, there is in fact no valid cover, because the majority of insurance policies exclude cover" when information needed for the correct underwriting of the risk was "misrepresented or not disclosed".

WhatsApp justice

She adds: "This rejection will also extend to third-party liability cover, leaving the insured out of pocket in respect of his or her own damage as well as a liability claim which may be submitted by a third party."

On the flipside, your social media communication may help you get justice.

The ombudsman for long-term insurance's annual report for 2016 featured a case where WhatsApp messages sent by an insured woman to her partner just before her death helped prove that she hadn't committed suicide, as the insurer was alleging.

Life insurers generally have an exclusion policy which states that if a person commits suicide in the first two years of the policy, a claim will not succeed.

On the evening of the woman's death, she took her prescribed medication, including antidepressants and anti-inflammatories, then got into a hot bath. She apparently fell asleep and drowned.

The insurer argued that she'd taken a lethal dose to commit suicide, but the WhatsApp messages did not show that she had any intention of harming herself.

As a result, the insurer paid the claim.

Please sign in or register to comment.