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The image of the industry undermined by the case of Samuel Archibald


Hubert Roy

February 20, 2018 11:30

In a publication became viral on social networks, Samuel Archibald, author and professor at theUniversité du Québec à Montréal (UQAM), said to have been denied his disability benefits after the Desjardins group has got wind of certain professional activities that would be held during his / her leave, then he was tending to a depression.

Patrick Lagacé, a columnist for The Press, has made mention in a chronicle. The life insurance industry, then, in the mode of crisis management. Desjardins group has indicated that it would be reviewed the case of Mr. Archibald, arguing that its refusal rate for cases of mental health falls under the 5% bar.

But the damage was done.

And the industry has taken for his cold.

In a second chronicle, Mr. Lagacé has claimed to have received a multitude of messages from people saying they have undergone a treatment similar to Mr. Archibald on behalf of their insurer. What has added fuel to the fire.

The union gets involved

The canadian Union of public employees(CUPE), which represents the employees ‘ union support of the UQAM (SEUQAM), has also taken a position. The two trade union organisations have made some revelations.

In a first time, CUPE has asked that an independent mechanism of review for disability insurance is set up. The union also asked the government to fix by law a reasonable time of response of the insurers.

A common case

Then, the SEUQAM, which represents more than 2,000 employees, took the floor to denounce the treatment records of its members by Desjardins. Its president, Thérèse Filion, says that the case of Samuel Archibald is not unique. “Desjardins has often behaved insistent and attitudes harassing face to face with people with problems, particularly of mental health,” she said.

Invited by the Journal of insurance to quantify the number of cases of refusal in insurance salary, she said she was unable to do so, since it is the insurer who receives the complaints. She said they believe this number is in constant increase.

To the unemployment insurance

Ms. Filion as proof that not a week goes by without an employee affiliated with the SEUQAM vienna in his office to ask for advice. The problem is that these people do not receive more salary before the time of treatment of the insurer. It therefore refers to the unemployment insurance, even if it is not the ideal situation.

“Quite often, a battle of doctors agrees. The employee in the work stoppage has in hand the diagnosis of his doctor. The insurer, however, contrevérifier and sends it in its expert to him. Unfortunately, during this time, the money is not in the employee. There is no support staff that are living this situation at UQAM. The teachers are also harassed. In addition, the response times are long. “

Desjardins did not wish to comment on the stand taken by the unions. “We remain very sensitive to everything that is expressed in this moment and we intend to see how we can improve,” commented his spokesperson Valérie Lamarre at the Journal of insurance.

The industry is also concerned

Also joined by the Journal of insurance, Lyne Duhaime, president ofCLHIA Quebec, said that the case of Samuel Archibald of concern to its members. “It allows us to realize the extent to which the group insurance goes to the heart of the life of the people. It is a subject that is emotional. It is not surprising that all resonates well with people, although we are concerned about some of the things that are said. “

CLHIA-Québec has put in place a communication strategy that its members can use to speak to insurance in the next few days. It agrees, however, that it is not simple to find the right way to deal with everything that is said.

“You can’t be closed to criticism. It is necessary to communicate well. There are good things being done. Insurers are investing heavily in mental health, either in chairs or by the adoption of policies in this sense. These are things unknown. It is necessary to make them known. “

The media storm extends outside of Quebec

The media storm has also resonated outside of Quebec. The officers and members of the CLHIA at the canadian level have been informed of developments at regular intervals, said Ms. Duhaime to the Journal of the insurance. “It will look as an industry what practices can be improved. We examine this in depth. “

A few figures

The CLHIA has also provided some figures on claims paid by the insurers of persons Québec :

• The insurance companies have paid $ 6.3 billion (G$) Quebec drug reimbursement. A portion of this amount covers the treatment of mental health problems, says the CLHIA.

• Even the CLHIA says hold little information regarding the types of claims submitted for disability insurance benefits. However, the agency asserts that the disability benefits paid in Quebec have doubled from 2000 to 2015, from $ 800 million ($M) to approximately 1.16 G$. This exceeds the growth in coverage during the same period, ” says the CLHIA.

• According to a study by thecanadian Institute of actuaries, 46 % of claims in disability were related to mental health between 2004 and 2008. This figure reached 31 % in the other provinces, according to the Institute.

• According to the CLHIA, less than 5% of disability claims submitted for health reasons, are rejected by the insurers.

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