Viral

by Robin Cook

  He had purposely not called ahead to schedule a meeting with Peerless, as he doubted that they would be willing to see him. These days, companies limited physical contact, often preferring phone or, better yet, impersonal email exchanges. Dealing with an unhappy customer like Brian was far easier at a distance, particularly online. Of course, there was still the problem about physically accessing the Peerless Health Insurance office with the security Manhattan commercial office buildings invariably employed. But Brian still had his duplicate NYPD shield and ID. The fact that his ID card had retired under the photo hardly limited its effectiveness in providing access to most everything in the city. Besides, he also knew that many of the NYC commercial office buildings employed retired NYPD officers as guards.

  As he negotiated the revolving door, he withdrew his wallet to have it ready. Similar to the street outside, the interior of the building was almost deserted. As he approached the security desk, he was encouraged to see, seated behind a plastic shield, a well-groomed, silver-haired, mildly overweight gentleman who looked the part of a retired cop with his crew cut and mustache. With practiced nonchalance, Brian flashed his ID quickly and the two men exchanged a convivial, knowing greeting, like members of a private club.

  “How are you, my friend?” Brian said.

  “Fine, thank you,” the security man replied with a broad smile. “Are you with Midtown North Precinct?”

  “No, ESU.”

  “Oh, wow!” the guard said. The ESU was highly regarded by the entire NYPD, since they were the ones called in whenever the regular patrolmen confronted a major problem. “How can I help?”

  “How about yourself? What was your last command?”

  “I retired from Midtown North. It’s how I got this job.”

  “Good for you, but it looks like you’re not very busy these days.”

  The security guard laughed. “It’s unbelievable,” he said. “It’s like a morgue around here. It makes me wonder if it’s ever going to go back to normal. So, what can I do for you?”

  “I need to talk to someone at the Peerless Health Insurance office,” Brian said. “Are many of them here or are they all working from home?”

  “A few of them come in. Mostly the brass. None of the secretaries or grunts.”

  “How about Ebony Wilson?” he asked. “Do you know her, by any chance?”

  “Of course I know Ebony. She’s one of the ones who comes in every day. Treats me like a person, and always says hello. Not like the Peerless boss lady.”

  “Are you talking about Heather Williams?” The eccentric and rather outlandish image of the woman in the pretentious foxhunting outfit popped into his mind.

  “I don’t know her name,” the guard said. “I made a point of not wanting to know it.”

  “Why is that?”

  The guard looked to both sides as if to be sure no one was listening, even though the expansive lobby was otherwise deserted. A janitor who’d been wiping down the turnstiles with disinfectant when Brian had first entered had disappeared. “She’s extremely snotty and thinks she’s better than everyone else. That’s my personal assessment. Not only does she not say hello, but she doesn’t even acknowledge that I exist. She waltzes through here with her entourage like she’s the pope.”

  “What do you mean, ‘entourage’?”

  “She’s always surrounded by three or four people rushing around her doing this and doing that, fawning over her. It’s ridiculous. She doesn’t even push her own elevator button. And several of them are armed bodyguards. I know because I had a conversation once with one of them. He’s a former marine.”

  “Armed guards? That’s rather surprising,” Brian observed. “But are you sure about that? Don’t you think maybe this former marine was pulling your leg?”

  “I swear on a stack of Bibles,” the guard promised. “I’m not exaggerating.”

  “But why?” It seemed excessive, to say the very least.

  “The ex-marine I spoke to says she’s become really wealthy. He bragged she’s been making ten million a year.”

  “That can’t be true.” The idea that the CEO of a small, up-and-coming health insurance company could make that kind of salary seemed ridiculous.

  “It’s not out of line,” the guard insisted. “As a small-time investor, I happen to know that some of the CEOs of the big health insurance companies that I’ve invested in make upward of twenty million a year.”

  “Really?” Brian questioned. He never knew that such salaries existed in healthcare, though Emma’s astronomical hospital bills were beginning to make more sense. Someone had to benefit.

  “It’s true. Health insurance companies are good investments. Mark my words.”

  “I’ll give that some thought,” Brian replied for lack of another response. He wondered if the security guard was exaggerating. Twenty million for running a company that sold health insurance seemed preposterous.

  “You learn a lot being one of the security guards in a building of this size,” the guard added.

  “I bet you do. How about today? Did you see Ebony Wilson?”

  “Oh yeah,” the guard said. “She’s upstairs.”

  “Well, she’s one of the people I need to talk to.”

  “Is she in trouble?”

  “No, no,” Brian said quickly. “I just need to chat with her about Peerless. What floor?”

  “Fifty-fourth. Do you want me to call up there and let her know to expect you?”

  “I’d rather you didn’t. You know the trick. It’s often better to catch certain people unawares, because you might learn more.”

  “Gotcha.” The guard gave him a knowing look and a thumbs-up. “Use the turnstile farthest to the left.”

  “Will do,” Brian said as a youthful, casually dressed man in jeans, polo shirt, and tennis sneakers entered through the revolving door. As he passed, he flashed a card at the security guard and headed for the turnstiles.

  “Hello, Mr. Bennet,” the guard called out. Then to Brian he whispered: “He’s with Peerless.”

  “Now, that might be handy,” Brian said, making a rapid decision. Quickly he headed for the visitors’ turnstile and pushed through. Hurrying after Mr. Bennet, who had boarded one of the elevators that served floors forty through sixty, he was able to catch the elevator door before it closed.

  “Sorry about that,” Brian apologized as he stepped in.

  “Not a problem,” Mr. Bennet replied graciously.

  “The guard happened to mention that you are with Peerless Health,” Brian said, making it sound like a casual statement.

  “I am indeed,” Mr. Bennet agreed. “Director of sales. And you?”

  “I run a security firm,” Brian said. “I’m impressed, and I hope you don’t find this offensive, but you look more like a college student than a health company executive.”

  “I’ll take that as a compliment,” Mr. Bennet replied with a laugh, tossing a bit of his blond hair out of his eyes.

  “I’ve heard that Peerless is doing very well.”

  “You heard correctly.”

  “So, you think the stock is a good investment?”

  “It’s an excellent investment,” Mr. Bennet said. “Especially with the coronavirus pandemic, we’re selling short-term health policies like no tomorrow. I’d certainly advise you to pick up some stock if you are in the market.”

  “Maybe I will,” Brian said, nodding his head. “Thanks for the tip.”

  “You’re very welcome.”

  The elevator came to a stop on the fifty-fourth floor and Mr. Bennet got off. Brian followed right behind. With an entry card, the man unlocked the door into the Peerless suite. A moment later they were standing in front of an empty reception desk in a posh lobby furnished with high-end leather furniture and with a view to the west over Sixth Avenue that included a tiny wedge of the Hudso
n River. But by far the most dominant object in view was the near life-size painting of Heather Williams dressed in her foxhunting finery.

  “Excuse me,” Mr. Bennet said, turning to face Brian. “Who are you here to see, if I may ask?”

  “Ebony Wilson,” Brian answered distractedly. It was hard to take his eyes off the painting, especially remembering the security guard’s impression of her personality and narcissism.

  “Is she expecting you?”

  “Absolutely,” Brian assured him. “Can you tell me where her office is?”

  “Of course. Follow me!”

  After skirting a number of empty secretarial desks, Mr. Bennet stopped at an open door and leaned in. “Ebony, there’s someone here to see you.”

  “Who is it?” Brian could hear her ask.

  Mr. Bennet turned to Brian, raising his eyebrows questioningly.

  “Brian Murphy,” Brian declared as he advanced to the doorway and looked in. In sharp contrast to Roger Dalton, whose deep baritone voice belied his appearance, Ebony Wilson and her assertive voice were well matched. She was an athletic-looking African American woman with a smattering of freckles over her face. Her dark hair was done in a braid, and she was sitting behind a monitor.

  “Nice chatting with you, Mr. Murphy,” Mr. Bennet called out before continuing on to his office down the corridor.

  “Likewise,” Brian called after him.

  Ebony leaned back in her chair and removed wireless earbuds she used for her phone conversations as a claims adjustment supervisor. She tilted her head to the side as she gave him a studied look. “Brian Murphy?” she questioned. “Do I know you?”

  “Somewhat,” Brian said vaguely. He stepped into the small office and sat down uninvited in one of two side chairs. “We spoke on the phone about a week ago.”

  “I speak to people all day every day. You’ll have to be more specific. Are you an employee of Peerless?”

  Brian laughed mockingly. “No, I’m not an employee of Peerless, and we certainly have never met. We spoke about Peerless denying a claim for an Emergency Department visit at MMH Inwood for my wife. You advised me to request a review, which I did, and which has again been denied. But that’s not why I am here.”

  “How on earth did you get in?” she demanded as she straightened up in her chair.

  “I walked in,” he said.

  “I don’t mean how you physically got in. I mean how did you get past security and into our office suite?”

  “Mr. Bennet was nice enough to get me in the office,” Brian said. “As far as building security was concerned, all I did was show the guard my NYPD ID. Would you like to see it?” Brian leaned forward to allow him to get out his wallet.

  “No, I suppose not since you are already here. Okay, so you are a Peerless customer. If you are not here about a claim denial, why exactly are you here?”

  “I didn’t say it wasn’t about a claim denial,” he corrected her. “In fact, it is. It’s just not about the Emergency Department claim we spoke about. It’s now the inpatient hospital bill that I’m concerned about. I’ve been told today that Peerless will not be covering that either, and I want to know why. This situation is the reason my wife and I made sure we had health insurance: in case one of us had to go to the hospital.”

  “Maybe you better show me your NYPD ID,” Ebony said. “None of this makes sense.”

  Brian complied, flashing the ID the way he’d done for the security guard, but she wasn’t to be fooled, and she demanded to see it up close.

  “I see. So you are retired,” she said, handing it back. “You hardly look old enough to retire.”

  ‘‘My wife and I started a security company,” Brian explained. “She was also an NYPD officer.”

  “Which I assume is the reason you purchased a Peerless policy.”

  “That’s correct. We were trying to be responsible because we couldn’t afford the COBRA premiums that would have allowed us to stay covered by the NYPD health insurance.”

  “Do you have your Peerless policy number with you?”

  “I do,” he said, and he gave it to her. She used her computer to bring up the record. As she read, Brian glanced around at the surroundings. Even this small office was opulently decorated, making him wonder what kind of sumptuous, over-the-top quarters Heather Williams occupied. It also made him wonder how such extravagance could be supported by the mere two-hundred-dollars-a-month premium he and Emma had been paying. But then he remembered that when they had bought the policy in December, they’d been told such policies like theirs were selling like hotcakes because a huge number of self-employed people couldn’t afford standard health policies that commercial businesses were buying for their employees. And that was before some twelve million Americans lost their jobs and their employer-based health insurance during the pandemic. Even if just a million of those people bought Peerless policies, that could mean $200 million a month revenue for the company.

  “Okay, I found your case and have read through the latest adjuster’s decision. It’s actually pretty simple. Did you carefully read your policy like I suggested during our phone call about the Emergency Department bill? I remember you said you hadn’t when you purchased it.”

  “No, I haven’t,” Brian admitted. “My wife’s illness has taken precedence since we talked.”

  “Okay, tell me this. Are you aware your policy has a sizable deductible?”

  “Of course,” he said. “The sales agent let us know that it was ten thousand dollars.”

  “How about the amount that Peerless would pay per day for hospitalization?”

  “I’m not sure I remember that.”

  “It clearly states in your policy on page thirteen that Peerless will pay a thousand dollars a day after the deductible is satisfied.”

  Brian suddenly felt embarrassed, realizing what fools he and Emma had been. Although a thousand dollars a day had sounded like a lot of money when they bought the policy, Emma’s stay in MMH Inwood had been well over twenty thousand dollars a day.

  “So now let’s talk about the deductible,” Ebony continued. “Are you aware how the Peerless deductible works?”

  “I assume so,” Brian said. “It means that we are responsible for the first ten thousand dollars. After that, Peerless steps in.”

  “No, that’s not how the Peerless short-term policy deductible works. This is why you should have carefully read your policy, Mr. Murphy. With Peerless Health Insurance the deductible relates to Peerless payments, not to the policy holder’s payments.”

  “I don’t follow,” he said, confused by all the semantics.

  “Peerless doesn’t pay the thousand dollars a day until it would have paid ten thousand if there was no deductible. Essentially that means the hospitalization has to be for more than ten days. Starting on the eleventh day, Peerless pays a thousand dollars a day. It is a permutation of the deductible concept devised by Heather Williams, our esteemed CEO, when she was our chief financial officer.”

  “But that’s totally crazy,” Brian managed. “That’s the opposite of what everyone understands about a deductible.”

  “Excuse me, but it is very clearly explained in the policy. It’s the reason you were advised to read it carefully. All our salespeople make a big point of making sure our customers understand their policies. And it is all spelled out in our extensive promotional materials, which I’m certain you were given.”

  “Maybe it was described,” Brian admitted, yet he still felt cheated and incensed. Actually, he barely remembered how he and Emma had ended up with their Peerless Health Insurance in the first place. Was he the one who had found it or had it been Emma? He didn’t know. All he could recall was talking with her about the need to have something for the rare “just-in-case” possibility and that they needed to look into the short-term policies the government was pushing. In many ways they were between
a rock and a hard place thanks to a screwy healthcare system dependent on corporate or government employment.

  “Is there anything else I can help you with?” Ebony asked. He could tell she was at the end of her patience with his unexpected appearance. “I really have to get back to work, and I have at least a dozen people on hold.”

  “I have a few more questions,” Brian demanded, his rising anger causing him to flush. “I’m staring at a nearly hundred-and-ninety-thousand-dollar bill and counting, which boggles my mind. I had no idea hospitalization was so expensive. But you and your friends here certainly knew since you’re in the damn healthcare business. Here’s my question: Above and beyond the screwy deductible business, how the hell can you people possibly justify selling a policy that’s going to bankrupt a family by only paying a thousand dollars a day? I mean, in contrast to all of us common folk with limited experience with hospitals, all of you insurance types surely know that a thousand dollars a day for hospital costs is equivalent to pissing on a forest fire.”

  “Just a minute, Mr. Murphy!” she stammered with obvious indignation. “I’m not going to sit here and allow you to verbally abuse me.”

  “Maybe I should be complaining to someone higher up,” Brian said, reining in his anger by recognizing he was talking with a mere functionary. “I apologize for singling you out. But try to understand my situation. I’m facing financial ruin, and maybe the details of my insurance coverage were spelled out in the small print, but as a member of the general public, this seems to amount to a type of fraud. Maybe I should file a complaint of unfair and deceptive business practices with something like the Better Business Bureau.”

  “Filing a complaint or even instigating a legal action is your right, as I told you a week ago on the phone,” Ebony said, partially mollified by his apology and the change of his tone. “But, as I also told you, the chances of anything like that going anywhere positive are just about zero. We here at Peerless are filling a needed niche, as the government has encouraged us to do, at the lowest possible price. Anyone can get health insurance that pays a higher portion, if not all of hospital costs, but insurance is like anything else: You get what you pay for.”