I ask him if he’s aware that the Commissioner of Insurance in Florida is investigating Great Benefit. He does not know this. How about South Carolina? No, again, this is news to him. What about North Carolina? Seems he might’ve heard something about that one, but hasn’t seen anything. Kentucky? Georgia? Nope, and for the record, he’s really not concerned with what the other states are doing. I thank him for this.
Drummond’s next witness is another nonemployee of Great Benefit, but just barely. His name is Payton Reisky, and his daunting tide is Executive Director and President of the National Insurance Alliance. He has the look and manner of a very important person. We quickly learn his outfit is a political organization based in Washington, funded by insurance companies to be their voice on Capitol Hill. Just a bunch of lobbyists, no doubt with a gold-plated budget. They do lots of wonderful things, we’re told, all in an effort to promote fair insurance practices.
This little introduction goes on for a very long time. It starts at one-thirty in the afternoon, and by two we’re convinced the NIA is on the verge of saving humanity. What fabulous people!
Reisky has spent thirty years in the business, and his resume and pedigree are soon shared with us. Drummond wants him to be qualified as an expert in the field of insurance claims practice and procedure. I have no objection. I’ve studied his testimony from one other trial, and I think I can handle him. It would take an exceptionally gifted expert to make Section U sound good.
With virtually no prompting, he leads us through a complete checklist of how such a claim should be handled. Drummond gravely nods his head, as if they’re really kicking some ass now. Guess what? Great Benefit stuck to the book on this one. Maybe a couple of minor mistakes, but hey, it’s a big company with lots of claims. No major departure from what’s reasonable.
The gist of Reisky’s opinions is that Great Benefit had every right to deny this claim because of its magnitude. He explains very seriously to the jury how a policy that costs eighteen dollars a week cannot reasonably be expected to cover a transplant that costs two hundred thousand dollars. The purpose of a debit policy is to provide only the basics, not all the bells and whistles.
Drummond broaches the subject of the manuals and their missing sections. Unfortunate, Reisky believes, but not that important. Manuals come and go, in a state of perpetual modification, usually ignored by seasoned claims handlers because they know what they’re doing. But, since it’s become such an issue, let’s talk about it. He eagerly takes the claims manual and explains various sections to the jury. It’s all laid out here in black and white. Everything works wonderfully!
They move from the manuals to the numbers. Drummond asks if he’s had the chance to review the information regarding policies, claims and denials. Reisky nods seriously, then takes the printout from Drummond.
Great Benefit certainly had a high rate of denials in 1991, but there could be reasons for this. It’s not unheard of in the industry. And you can’t always trust the numbers. In fact, if you look at the past ten years, Great Benefit’s average denial rate is slightly under twelve percent, which is certainly within the industry average. Numbers follow more numbers, and we’re quickly confused, which is precisely what Drummond wants.
Reisky steps down from the witness stand, and begins pointing here and there on a multicolored chart. He talks to the jury like a skilled lecturer, and I wonder how often he does this. The numbers are well within the average.
Kipler mercifully gives us a break at three-thirty. I huddle in the hallway with Cooper Jackson and his friends. They’re all veteran trial lawyers and quick with advice. We agree that Drummond is stalling and hoping for the weekend.
I do not utter a single word during the afternoon session. Reisky testifies until late, finally finishing with a flurry of opinions about how fairly everything was handled. Judging from the faces of the jurors, they’re happy the man’s finished. I’m thankful for a few extra hours to prepare for his cross-examination.
Deck and I enjoy a long meal with Cooper Jackson and three other lawyers at an old Italian restaurant called Grisanti’s. Big John Grisanti, the colorful proprietor, puts us in a private dining room called the Press Box. He brings us a wonderful wine we didn’t order, and tells us precisely what we should eat.
The wine is soothing, and for the first time in many days I almost relax. Maybe I’ll sleep well tonight.
The check totals over four hundred dollars, and is quickly grabbed by Cooper Jackson. Thank goodness. The law firm of Rudy Baylor may be on the verge of serious money, but right now it’s still broke.
Forty-seven
Seconds after Payton Reisky takes the witness stand bright and early Thursday morning, I hand him a copy of the Stupid Letter and ask him to read it. Then I ask, “Now, Mr. Reisky, in your expert opinion, is this a fair and reasonable response from Great Benefit?”
He’s been forewarned. “Of course not. This is horrible.”
“It’s shocking, isn’t it?”
“It is. And I understand the author of this letter is no longer with the company.”
“Who told you this?” I ask, very suspicious.
“Well, I’m not sure. Someone at the company.”
“Did this unknown person also tell you the reason why Mr. Krokit is no longer with the company?”
“I’m not sure. Maybe it had something to do with the letter.”
“Maybe? Are you sure of yourself, or simply speculating?”
“I’m really not sure.”
“Thank you. Did this unknown person tell you that Mr. Krokit left the company two days before he was to give a deposition in this case?”
“I don’t believe so.”
“You don’t know why he left, do you?”
“No.”
“Good. I thought you were trying to imply to the jury that he left the company because he wrote this letter. You weren’t trying to do that, were you?”
“No.”
“Thank you.”
It was decided over the wine last night that it would be a mistake to beat Reisky over the head with the manuals. There are several reasons for this line of thinking. First, the evidence is already before the jury. Second, it was first presented in a very dramatic and effective manner, i.e., we caught Lufkin lying through his teeth. Third, Reisky is quick with words and will be hard to pin down. Fourth, he’s had time to prepare for the assault and will do a better job of holding his own. Fifth, he’ll seize the opportunity to further confuse the jury. And, most important, it will take time. It would be easy to spend all day haggling with Reisky over the manuals and the statistical data. I’d kill a day and get nowhere in the process.
“Who pays your salary, Mr. Reisky?”
“My employer. The National Insurance Alliance.”
“Who funds the NIA?”
“The insurance industry.”
“Does Great Benefit contribute to the NIA?”
“Yes.”
“And how much does it contribute?”
He looks at Drummond, who’s already on his feet. “Objection, Your Honor, this is irrelevant.”
“Overruled. I think it’s quite relevant.”
“How much, Mr. Reisky?” I repeat, helpfully.
He obviously doesn’t want to say, and looks squeamish. “Ten thousand dollars a year.”