by J. D. German
Chapter 39 – Agents of Mercy
Lynn was back at The Farm hanging up her clothes from the apartment when she heard the front door open. She froze until she heard Rick and Harriet laughing and knew it wasn’t Zarah. She finished what she was doing and went down to greet them. “The young lovers have returned! How was the vacation?”
“Absolutely fabulous. A nice mountain resort with a world-class chef, mountain hiking trails with wildlife at every turn, and a private cottage for our intimate moments that brought back all the old memories. It couldn’t have been better.”
“You’re making me jealous. I wish Jack and I had taken time for a honeymoon at a place like that. We had to settle for one night in a cheap motel that would take cash, and woke up to a serious political situation we had to deal with. . . . But that night was . . .”
“Well, we didn’t quite capture the bliss of our honeymoon. We no longer have the . . . stamina.”
Lynn laughed at that. “You two must be tired from the trip. I’ll fix us something for supper.”
“No need for that. We had the resort chef put together a wild game gourmet meal for three and put it in a thermal box to keep it warm. A couple minutes in the microwave and the house specialty will be ready.”
Lynn looked at Harriet quizzically. “Just what is the house specialty? Sautéed raccoon?”
“Close. It’s roast Bambi – venison.”
They were out on the deck sitting around the fire pit after the delicious supper. Rick brought out a bottle of dessert wine – a nice Spanish sherry – that they sipped contentedly in silence. After several minutes Harriet spoke up. “This reminds me of a quote I read somewhere that goes ‘True friendship comes when the silence between two people is comfortable.’ In this case it’s three people, but the principle still holds.”
Rick said “I’ll toast to that,” as they raised their glasses. He followed up with “Now that the silence is broken, we might have a new case for you, Lynn.”
“Yay, another villain to grind into dust. What’s it about?”
“The villain in this case is big, mean, and goes by the name of Ohio Consolidated Health Insurance, OCHI.
“I haven’t heard about them. How big are they?”
“All I know is the name. You’ll have to find the details on the web.”
“So, what’s the beef against them?”
Harriet took over. “Rick and I met this couple that works at the resort – he’s a maintenance man and she cleans rooms. We came back to the room after breakfast to find the woman, Myra, crying. She apologized and tried to leave but I asked her to stay and tell us what’s troubling her. She said her seven-year-old daughter was going to die unless she got medical care, and they couldn’t afford the cost. Rick asked if she had medical insurance, which they did, but the company wouldn’t pay for the operation.”
Rick continued the story. “Both Myra and her husband, Ozzie, are covered by their employee health insurance plan from OCHI. The girl’s liver and lungs are deteriorating and she needs a combined liver and lung transplant to replace them.”
“Why won’t the insurance cover it?”
“They claim that, because it’s an inherited genetic problem, it’s a pre-existing condition.”
“Has she had it all her life?”
“No. She inherited the genetic structure from both of her parents that left her highly susceptible to the condition, but the symptoms didn’t show up until she turned six. The insurance paid for the diagnostic tests that confirmed what she had, but OCHI cut her off once they discovered it was genetic.”
“What’s the operation going to cost?”
“Over a million and a half dollars.”
“No wonder they don’t want to pay. Have there been any court cases that support their position that a genetic disease is a pre-existing condition?”
“That’s something I’ll have check on. So what’s our plan of attack on this?”
Lynn thought for a minute. “Let’s do it this way. Rick, you investigate the legality of their position. Find out if Ohio Consolidated can get away with this. Harriet, why don’t you dig up everything you can about this alpha-one antitrypsin thing and see if other insurance companies have covered the operation. Meanwhile, I’ll examine OCHI’s records and find out what I can.”
Harriet and Rick agreed. Lynn held up her wine glass. “How about another round, bartender?”
Lynn woke up with a headache from too much wine, and when she went to the kitchen found that Harriet and Rick were both suffering the same fate. “It was that last glass of sherry you called for that did this to us, Lynn.”
“You’re right Harriet. I forgot that sherry is fortified with added alcohol. What have you got to cure us with?”
“I could prescribe a ‘hair of the dog that bit us,’ but it’s too early to start drinking. How about some strong coffee and a couple of Aleve?”
“Okay, but let’s get those into our system quickly so we can start working on the new case. What’s the daughter’s name?”
“Emma, Emma Boswick.”
“Alright. I officially name this case ‘operation Emma.’ Should we let her parents know that we’re trying to help?”
“I don’t think we should just yet. It might get their hopes up, and we don’t know if we can deliver.”
“You’re right Rick. We’ll wait until we know more. . . . Where’s that coffee, Harriet?”
A short time later they were all working on their assignments. They agreed to meet before dinner and share what they found. Lynn started out at the company’s public web page and found nothing of interest until she clicked on the ‘About Us’ link at the top. That gave her half a dozen photos of smiling corporate officers with short biographies on each. She decided to search for more information about them on the Darknet. If I can find some bad stuff on any of them we might be able to use that as leverage, which is a fancy name for blackmail.
After an hour she gave up on that approach. The CEO was involved in a class-action lawsuit a few years ago for misrepresenting the terms of health insurance policies he was peddling, but there wasn’t enough proof to find him guilty. All Lynn could do with that was conclude the guy was dishonest, which covers about 95% percent of salesmen in the world.
Next she pulled up the company file on Emma. She read through the policy but found too many whereas’s and wherefore’s to make sense of anything. She decided to send Rick a copy to see what he could make of it. Continuing through Emma’s file she saw the letter the company sent the Boswicks informing them that Emma’s operation wasn’t included in the policy coverage. She also found five letters from the Boswicks – first questioning the company’s decision, then begging them to reconsider. She found no responses by the company to any of those letters.
Harriet was having better luck with her medical research. With alpha-one antitrypsin deficiency, a biochemical called trypsin starts breaking down the liver and lung tissue. Trypsin’s usual role is to devour unhealthy tissue at infection sites. Another chemical in the blood, alpha-one antitrypsin, is supposed to shut down trypsin activity in healthy tissue to keep it from being attacked. In patients with an antitrypsin deficiency there’s not enough antitrypsin produced to keep the trypsin from destroying healthy soft tissue in the liver and lungs.
The genetic combination that leads to the problem is very rare, and mostly occurs in people with Scandinavian heritage. There is no cure for it, other than the liver and lung transplant, but avoiding air pollution and smoking may keep it from showing up until later in life.
Harriet copied all this information in a document that the others could read. Poor Emma. Even if she gets the transplant she will have to suffer through months of painful recovery. And if the transplant is rejected . . . well, it’s not like they will give her another one. Let’s see how many cases of this are out there.
Lynn’s final try was to see what OCHI has done in the past with these kinds of cases. She hacked deeper into their records and f
ound a list of all the claims processed in the past ten years. She downloaded the list of several thousand claims, then wrote some software to sort them according to any criteria she chose. The first words she sorted on were inherited and genetic, and moved them to the top of the list. Then she sorted those on surgeries and the amounts paid for treatment. She ended up with a list twenty-three claims for genetic based conditions, of which eighteen were paid. She studied the five that weren’t paid and found that four of them had been denied during the past nine months. Interesting. It seems that they had no problem paying for treatment of genetic problems up until nine months ago. What’s up with that?
Lynn went back in to the records department files and pulled the four that were denied payment. Each file had a letter exactly like the one sent to the Boswicks. “Hmmm. It seems like a decision was made earlier this year to deny genetic claims based on a new pre-existing condition edict. And if a decision was made, then someone had to make that decision. And I’m going to find out who. But I won’t find them in the case files. Time to get into the corporate email archives.”
There were so many emails exchanged during the past year that it took Lynn almost three hours to scan through them. But she finally found what she was looking for. An email exchange between the CEO, Carl Morris, and head of the Claims Settlement Division.
Bill,
I have been going over the claims figures and we have to find a way to reduce the total we pay out annually. If we don’t, it will sink us. Can you come up with any ideas on this?
Carl
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Carl,
I have been considering this myself and I think I can come up with a way to do this. On average, we pay out 14% of the total to patients with inherited diseases or conditions. What if we label these cases as pre-existing conditions because they began at birth, and deny coverage on that basis?
Bill
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Great idea, Matt.
I’ll send a memo to the claims division establishing this as our new policy. Maybe there’s a raise in this for you if it pans out.
Carl
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Carl,
One of the genetics cases coming up is really big – it will cost us a couple million if we have to pay it. In spite of your new policy, this one is big enough that the claimants might get lawyers and take us to court. I just want to know that you’re certain about the new policy.
Bill
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Bill,
I looked over the patient’s case file and her condition – alpha-one something – will kill her long before it gets to court. Don’t worry about a lawsuit. We’ll have our lawyers drag on the court proceedings until the claimants give up or the girl dies. It will be cheaper to pay the lawyers than to pay a claim that big.
Carl
“This is awful. The CEO is a cold-hearted bastard. How can I stop this? . . . Time for a pow wow with Rick and Harriet.” She sent them an email calling for a meeting in the kitchen in five minutes.
“What’s up, Lynn. It sounds important.”
Lynn gave them a printed page. “It is. Here’s what I found on the CEO’s computer.” She watched their expressions change from curious to angry as they read the emails. Then she turned to Rick. “What do you think we should do, Rick?”
“I would need to see the Boswicks policy and read the fine print to see if it allows them to take this position. But in the absence of specific language about genetic diseases that don’t show up at birth, I think they’re vulnerable to a legal challenge.”
“That’s what I thought, but with their willingness to delay a law suit indefinitely, it could last for years. By then Emma will have died. On top of that the Boswicks can’t afford the legal costs of a lengthy litigation. We have to find a way to take care of this now.”
Harriet spoke up next. “I think we should threaten the company with an immediate negative publicity blitz if they don’t reverse their position on this. It would be nice if we could make the emails public but there’s no way to prove that they’re authentic. He could claim that we made them up.”
Lynn mulled this over and hit on an answer. “If I hack into The CEO’s computer and send the emails directly to media and Government recipients, they can be traced back to the IP address of his computer. That will guarantee their authenticity. Will that work Harriet?”
“Brilliant, Lynn. But I think we should send the CEO a message telling him what we’re about to do before we actually do it. Maybe that will be enough to convince him to make the change.”
“Good approach, girl. We could be open to some lawsuits ourselves if we release the emails.”
“We’re safe from that possibility, Rick. If I erase the hacking trail to his computer no one can ever trace it back to us.”
“That’s what I love about you, Lynn. Your devious mind. You could be a very successful criminal.”
“Except I’m on the side of truth, justice, and the American way.”
“Yeah. You and Superman.”
“I’ll go get started on this. See you at supper.”
“Umm, something smells good. Is dinner ready?”
“Almost. Did the CEO give in?”
“I don’t know yet. I gave him 48 hours to respond. He will need to talk it over with his legal staff first. But just to prove to him that my threat is real, I sent copies of the emails from his office computer to his wife’s laptop, so he’ll have some explaining to do when he gets home. . . . I’ll set the table.”
As Lynn started getting the dishes out her cell phone rang. She looked at the number but didn’t recognize it. It’s probably a sales call. I’ll let it ring . . . No, wait! That’s Matt Murdock’s number. She opened her flip phone just as it stopped ringing. Her finger hovered over the Call Back button. Do I want to talk to him? I don’t want to encourage him. I’m not ready to get interested in another man. I don’t think I ever will be. . . . But maybe he has some information about Zarah. She pressed the button and put the phone to her ear.
“Hi Lynn. This is Matt – Matt Murdock, the detective.”
“You had me at Matt. What’s up?”
“I have three days off this weekend. You said to call if I could get the time to come to The Farm for a visit.”
“Yes, I did. That would be great! So when can we expect you?”
I’m off Friday through Sunday, so I thought I’d drive over there first thing Friday morning. That would put me there sometime before lunch. Is that a good time?”
“Let me check with Harriet and Rick. They’re right here. Hold on.”
“Matt wants to come out for the weekend. Will that interfere with any of your plans.”
Harriet smiled. “If we had plans we’d break them for this. Tell him to come on.”
“Matt, it works for them. Do you know how to get here?”
“I have your address. My GPS will find you. Should I bring anything?”
“Just some warm clothes. The nights are still a bit chilly here.”
“I’ll pack my long johns.”
Lynn giggled at the thought of Matt standing there in nothing but his long underwear. “We’ll look for you Friday, then.”
“Okay. Bye.”
She turned to Harriet and Rick. “He’ll be here before lunch on Friday. I’ll make him something special.”
“We’ll need to do some shopping tomorrow. Just you and me. We’ll leave Rick here to guard the fort.”
“Sounds like a plan.”
As the girls left for Leesburg, Rick was on the lawn tractor giving the lawn a first spring cutting. As he mowed along the east fence he saw a car parked on the dirt road
that ran parallel to their property line. It was hard to make out through the thick hawthorn hedge, but it looked like a late-model SUV. I ought to drive over there to get a look at the license plate, but it’s most likely someone out for a hike. I’ll check back later to see if it’s still there. Rick went on with the mowing and by his third circuit of the property the car was gone, so he continued on, thinking about the great protection provided by the tall hawthorn bushes with their entwined wall of four-inch, razor-sharp thorns. The chain link fence inside the hedge was superfluous, but provided a stronger sense of security.
Lynn and Harriet were back by mid-afternoon with more food than they could eat in a month, and some new clothes. The two of them hurried upstairs to try on the new outfits, leaving Rick to put away the groceries. Harriet came down dressed in one of her purchases. “What do you think, Rick?” He looked at the yellow sun dress and smiled. “You look good in that, dear. Really good.”
“You sure know how to make a woman smile. I bought another outfit, but you’ll have to wait ‘til bedtime to see it on me.”
“And you know how to make a man smile – and fill his head with thoughts for the rest of the day.” Harriet gave him a hug and went back upstairs.
Ten minutes later she and Lynn came into the kitchen to a plate of assorted crackers and sliced cheeses. “I thought you might like a snack after working so hard at shopping.” He poured a glass of sweet tea for everyone and they sat at the kitchen bar crunching crackers and chatting. Rick wondered if he should tell them about the car he saw outside the fence but decided not to worry them. With the hedges and security cameras we’re living in a fortress. It would take a bulldozer to break through.
“Have you heard back from the insurance CEO yet Lynn?”
“I haven’t checked today – lets have a look.” She picked up her laptop and opened the link into the CEO’s computer. She had told him to send himself an email with his answer and she would see it. “Uh oh. Not good.”
“What?”
“He says that he won’t give in to extortion and he knows how to fight people like us. He had his public relations people release a statement to the news outlets that a smear campaign has been launched against them involving fake emails that discredit the company. In the release he hints that a rival insurance company is behind it.”
“Darn. What do we do now? Rick have you got any ideas?”
“Not yet, but let me shift my mind into that gear and see what it can come up with. I’m going out on the deck for some solitude.”
Lynn and Harriet chatted for several minutes before Rick came back. “I think I have something. How much control over the company’s computer system do You have, Lynn?”
“I can do pretty much anything I want to. My hack let’s me roam around inside the memory banks.”
“Here’s my idea. Compose a letter from the CEO to the Boswicks telling them the company has reversed it’s decision and will pay all expenses for the operation, and all medical care for their child for the rest of her life. Include an apology and blame it on an overzealous claims manager.
“Step two is another press release from OCHI to the media highlighting their humanitarian decision to pay 100% of the medical costs for poor little Emma Boswick. Include a photo of Emma if we can get one. . . . I’ll call the Boswicks and ask if they can email us some pictures. Once the press release hits the media they won’t dare go back to denying payment.”
“Ohhh, I like it. Who’s the devious one now, Rick.”
“I’m no match for your skills in that area, Lynn. But we do have a certain synergism, don’t we.”
“Yes we do. Rick, will you draft the letter to the Boswicks while Harriet puts together the press release? I’ll go back into the OCI computer and see if I can make it print the letter and send it out in their morning mail. That’s going to be a challenge.”
It was close to suppertime when Lynn finally found what she was looking for. OCHI had a central mail facility to process the large amount of outgoing mail generated throughout the company. All letters are forwarded in an email to the facility, where they are printed, folded, put in envelopes, and run through a postage imprinter – all automatically. A computer keeps track of every letter processed with an assigned code verifying the writer.
“Hallelujah. It couldn’t be easier. I’ll insert Rick’s letter into the CEO’s computer and route it to the mail facility under his authorization code. No one will ever read it. I hope the public relations department is that easy to fool.” Ten minutes later she had solved that problem too. Harriet’s press release would go through the PR department using the CEO’s code, then be released for distribution to the media. She pushed her chair back and headed for the kitchen, hoping there was enough leftover roast venison for a sandwich.
Rick and Harriet were ahead of her. They had made open-faced venison sandwiches with gravy to pour over them and some fresh corn on the cob. As they sat down at the table they both looked at Lynn expectantly. . . . “Well? What did you find?”
“I was going to hold you in suspense until after supper, but I’m too excited to wait. Sending out the letter and press release through OCHI is a piece of cake. How are you two coming?”
“We were done an hour ago. We’ve been waiting for you, slowpoke. I even got Myra Boswick to send me a recent photo of Emma. She’s in bed looking sickly, with tubes coming out of her. That will create widespread sympathy and make it certain destruction if OCHI tries to renege on the letter.”