“Both of these men are married?”
“Yes, with families. They were known to prey on the young girls in claims. I could give you a lot of names. And these weren’t the only two hotshots who traded promotions for sex.”
Again, all eyes turn to Underhall and Aldy.
I pause here to check something on my desk. It’s just a little courtroom ploy I’ve sort of learned to allow juicy testimony to hang in the air before moving on.
I look at Jackie, and she dabs her eyes with a tissue. They’re both red right now. The jury is with her, ready to kill for her.
“Let’s talk about the Black file,” I say. “It was assigned to you.”
“That’s correct. The initial claim form from Mrs. Black was assigned to me. Pursuant to company policy at that time, I sent her a letter of denial.”
“Why?”
“Why? Because all claims were initially denied, at least in 1991.”
“All claims?”
“Yes. It was our policy to deny every claim initially, then review the smaller ones that appeared to be legitimate. We eventually paid some of those, but the big claims were never paid unless a lawyer got involved.”
“When did this become policy?”
“January 1, 1991. It was an experiment, sort of a scheme.” I’m nodding at her. Get on with it. “The company decided to deny every claim over one thousand dollars for a twelve-month period. It didn’t matter how legitimate the claim was, it was simply denied. Many of the smaller claims were also ultimately denied if we could find any arguable reason. A very few of the larger claims were paid, and, again, only after the insured hired a lawyer and started threatening.”
“How long was this policy in effect?”
“Twelve months. It was a one-year experiment. It had never been done before in the industry, and it was generally viewed by management as a wonderful idea. Deny for a year, add up the money saved, deduct the amount spent on quickie court settlements, and there’s a pot of gold left.”
“How much gold?”
“The scheme netted an extra forty million or so.”
“How do you know this?”
“You stay in bed long enough with these miserable men and you hear all sorts of trash. They’ll tell everything. They’ll talk about their wives, their jobs. I’m not proud of this, okay? I didn’t get one moment of pleasure from it. I was a victim.” Her eyes are red again, and her voice shakes a little.
Another long pause as I review my notes. “How was the Black claim treated?”
“Initially, it was denied like all the rest. But it was a big claim, and coded differently. When the words ‘acute leukemia’ were noticed, everything I did was monitored by Russell Krokit. At some point early on, they realized that the policy did not exclude bone marrow transplants. It became a very serious file for two reasons. First, it was suddenly worth a ton of money, money the company obviously didn’t want to pay. And secondly, the insured was terminally ill.”
“So the claims department knew Donny Ray Black was going to die?”
“Of course. His medical records were clear. I remember one report from his doctor saying the chemo went well but the leukemia would be back, probably within a year, and that it eventually would be fatal unless his patient received the bone marrow transplant.”
“Did you show this to anyone?”
“I showed it to Russell Krokit. He showed it to his boss, Everett Lufkin. Somewhere up there the decision was made to continue the denial.”
“But you knew the claim should be paid?”
“Everybody knew it, but the company was playing the odds.”
“Could you explain this?”
“The odds that the insured wouldn’t consult a lawyer.”
“Did you know what the odds were at the time?”
“It was commonly believed that no more than one out of twenty-five would talk to a lawyer. That’s the only reason they started this experiment. They knew they could get by with it. They sell these policies to people who are not that educated, and they count on their ignorance to accept the denials.”
“What would happen when you received a letter from an attorney?”
“It became a very different situation. If the claim was under five thousand dollars and legitimate, we paid it immediately with a letter of apology. Just a corporate mix-up, you know, that type of letter. Or maybe our computers were to blame. I’ve sent a hundred such letters. If the claim was over five thousand dollars, then the file left my hands and went to a supervisor. I think they were almost always paid. If the lawyer had filed suit or was on the verge of filing, the company would negotiate a confidential settlement.”
“How often did this happen?”
“I really don’t know.”
I step back from the podium, say, “Thanks,” then turn to Drummond, and with a pleasant smile say, “Your witness.”
I sit by Dot, who’s in tears and sobbing quietly. She’s always blamed herself for not finding a lawyer sooner, and to hear this testimony is especially painful. Regardless of the outcome, she will never forgive herself.
Fortunately, several of the jurors see her crying.
Poor Leo walks slowly to a spot as far away from the jury as he can stand and still be allowed to ask questions. I cannot imagine what he might ask, but I’m sure he’s been ambushed before.
He introduces himself, very cordially, tells Jackie that of course they’ve never met. This is an effort to inform the jury that he hasn’t had the benefit of knowing what in the world she might say. She gives him a blistering look. She not only hates Great Benefit but any lawyer sorry enough to represent it.
“Now, is it true, Ms. Lemancyzk, that you have been committed recently to an institution for various problems?” He asks this question very delicately. In a trial you’re not supposed to ask a question unless you know the answer, but I have a hunch Leo has no idea what’s coming.
His source has been a few desperate whispers during the past fifteen minutes.
“No! That’s not true.” She’s bristling.
“I beg your pardon. But you have been receiving treatment?”
“I was not committed. I voluntarily checked into a facility and stayed for two weeks. I was permitted to leave whenever I wanted. The treatment was supposedly covered under my group policy at Great Benefit. I was supposed to be covered for twelve months after my departure. They, of course, are denying the claim.”
Drummond chews on a nail, stares down at his legal pad as if he didn’t hear this. Next question, Leo.
“Is that why you’re here? Because you’re angry with Great Benefit?”
“I hate Great Benefit, and most of the worms who work there. Does that answer your question?”
“Is your testimony here today prompted by your hatred?”
“No. I’m here because I know the truth about how they deliberately screwed thousands of people. This story needs to be told.”
Better give it up, Leo.
“Why did you go to the treatment facility?”
“I’m struggling with alcoholism and depression. Right now, I’m okay. Next week, who knows? For six years I was treated like a piece of meat by your clients. I was passed around the office like a box of candy, everybody taking what they wanted. They preyed on me because I was broke, single with two kids and I had a nice ass. They robbed me of my self-esteem. I’m fighting back, Mr. Drummond. I’m trying to save myself, and if I have to seek treatment, then I won’t hesitate. I just wish your client would pay the damned bills.”