Sime~Gen Roleplaying on IRC: Snake River Dam Scenario
Episode #43: The Money-for-Pain Business (9/23/00)
Warlin and Glady arrive at Arat's office promptly for their appointment.
Warlin is a gawky, tall young Gen, while Glady is middle-aged, plump, and balding.
Warlin: Thank you for seeing us, Controller Arat. I'm Warlin, the benefits manager for Mr. Birch's company, and this is Glady from Employee Medical Underwriting.
Warlin: EMU has been disputing some of our claims, and....
Glady: Fraud, that's what it is!
Glady looks rather more like an indignant emu egg than an emu, but the ostrich-family bad temper is definitely there.
Arat looks from one to the other.
Glady: They're trying to collect on injuries that don't qualify for compensation; it happens all the time.
Warlin looks at Arat, somewhat apologetically.
Arat gestures for them both to take a seat on the pair of tuffets that have temporarily replaced the schoolhouse bench.
Arat's bench was urgently required elsewhere, for the afternoon.
Arat had allowed it to be used in the hopes that it would not be returned.
Warlin gives Arat a grateful smile; he has heard rumors that Arat can be very difficult, and had expected a worse reception.
Warlin: It appears that the work your channels are doing among the employees is making it very difficult to prove their claims.
Warlin: I realize that they mean well, but when an injury happens, we have a procedure to go through.
Warlin: And when it isn't followed, well, it creates complications.
Glady: Fraud, that's what it is.
Arat frowns.
Glady glares impartially at both Arat and Warlin.
Arat: Please, speak one at a time. What is at issue here?
Arat certainly hopes it isn't what it sounds like!
Warlin: Perhaps it would be easier if I give you an example.
Warlin: Two weeks ago, I put in a claim for one of the carpenters who had sprained her ankle while working on one of the new barracks.
Glady: Or so she claimed.
Glady obviously isn't buying it for a moment.
Warlin: Under our law, she is entitled to compensation for the injury, so I put in the claim. Mr. Glady, however, is disputing it.
Glady: She says she sprained her ankle, but she was back at work within two hours.
Glady: Claims are supposed to provide compensation to workers whose injuries prevent them from working, and she was drawing a paycheck.
Warlin turns to Glady.
Warlin: That's not how the contract is written. There is a standard compensation for specific injuries, and....
Arat is certain that interterritorial law has provisions covering this, and equally sure that he is not the one that should be dispensing said law.
Glady: So, prove there was an injury! If she was working, she can't have sprained....
Warlin: But she did!
Arat's frown deepens as he reaches for a thick volume resting on the end of his (alas, still not real) desk.
Warlin and Glady have obviously been arguing on this topic for some time.
Warlin realizes that he is getting sidetracked, and turns back to Arat.
Arat would have preferred a lifestyle that did not require keeping such a reference close at hand, but things have not been going the way he planned in that regard.
Warlin: You see, in order to get employees proper compensation for their on-the-job injuries, we have to have documentation of their severity.
Arat slips a tentacle into the notch for the appropriate chapter ("Regarding Temporary Crossing of the Border for Purpose of Business") and then pauses at Warlin's words.
Arat: So it is simply a matter of documentation?
Warlin: Your channels have been doing truly miraculous work, and believe me, we're grateful, but the current situation is cheating your patients of their rights.
Arat can arrange for his teams to fill out more paperwork if...
Arat stares at Warlin in astonishment.
Arat: Their rights to... money?
Arat would like to know who in their right mind would accept money instead of the health the money is supposed to buy, thus avoiding all of the pain and agony of being injured long term, the loss of work income, the loss of their position at the Dam site, etc.
Arat suspects this is more of a catfight between long term rival industries, than the result of specific worker complaints.
Warlin: They are entitled to compensation, when injured on the job. Our laws are clear on that.
Glady: That law is intended to replace income lost, and if they go right back to work....
Warlin: The law doesn't mention how long they have to be out of work, only how severe the injury is.
Warlin is something of a worker's advocate, and the idea of getting injured workers a little extra, even if the injuries are readily treatable by a channel, appeals to him greatly.
Glady: Yes, and that's where your claims fail.
Arat raises a hand.
Arat: You are arguing a point of Gen Territory law which has no context here.
Arat: According to our law, your workers (to Warlin) have a right to free medical care.
Arat: If they choose to take advantage of that, then all remaining issues must be resolved in a Gen Territory court of law.
Arat: I can provide you with additional paperwork if that will assist on a case-by-case basis.
Glady was looking smug at Arat's mention of courts: his company has sufficient influence to tilt a verdict in its favor.
Glady is much less happy about Arat's offer to substantiate claims.
Arat of course will faithfully report both the workers' initial condition and how they are after the healing process.
Warlin: That would be of great assistance. An independent medical evaluation is strong evidence in this sort of case.
Glady: But only if it's made by a licensed physician!
Arat opens the book and begins scanning the relevant interterritorial law.
Arat knows that channels are considered physicians, and vise versa, under interterritorial law, and wonders what else Gladys is glossing over. He has read this section many times before, but at times like this the precise words can be helpful.
Arat knows perfectly well that Glady's business is the business of taking people's money and giving little if any of it back, of course. There is similar insurance in Sime Territory for permanent injuries and long term disability.
Glady is aware that channels have honorary doctor-status in the legal sense, but as a practical matter, a Gen jury is likely to be skeptical about a Sime's word, and frankly, some of the things that Warlin claims the channels have done are unbelievable.
Glady and his company have not been exposed to the ravages of two Farris channels trying to keep a construction project moving, before.
Arat: According to Paragraph 8 of Section 23 of Part 5 of "Regarding Temporary Crossing of the Border for Purpose of Business", the titles of Physician and Channel shall be awarded equal status in either Territory."
Arat leaves off the bit about how this does not necessarily allow said channel and physician free rein to practice in one another's jurisdictions. That is not relevant here.
Glady: But without proper documentation of injuries, and without any evidence of time lost from work, how am I to believe that fraud has not taken place? Workers are always ready to exaggerate problems, so they can malinger while EMU pays their bills.
Arat: I am willing to provide proper and thorough [and when a Farris says thorough, he means thorough] documentation of both the injuries and what was done to heal them.
Warlin feels a burst of triumph, as Glady admits in principle that channels are legally able to count as physicians.
Warlin leans forward.
Warlin: I do appreciate your willingness to cooperate.
Arat: The latter, combined with an examination by an in-Territory physician at the time of any court action, should be sufficient to prove the worker's ability or inability to work at that time.
Glady gives a thin smile, as the subject of ability to work is emphasized.
Glady has faith that his company's legal staff can wring all sorts of damaging admissions out of a channel, by asking the channel to describe the injury in terms of its effect, rather than its actual severity.
Warlin: Now, how can we document Bess Lilton's claim? She was unable to give me the name of the channel who treated her sprain.
Warlin: I do have the time and place of the injury, if that would help.
Arat: Yes, if it was two weeks ago we will have accurate documentation of the incident. I could arrange for that information to be brought here now, if you would like.
Warlin brightens.
Warlin: That would be very helpful.
Arat: Very well.
Arat gestures for one of his body guard, who have been standing there unobtrusively, to call in a runner.
Arat has managed, with a good deal of assistance from the other channels and Donors, to whip together a large cadre of renSime clerical workers who had been plucked from the ranks of the unemployed.
Arat's clerks are housed in a shambling series of huts, lean-tos, open sheds and tents somewhat north of Arat's office and the "Sime Center".
Arat gives the runner his instructions and the renSime leaves.
Warlin settles back on his tuffet with an expression of anticipation.
Runner returns a short time later panting with augmentation and carrying a thin bundle of papers which he gives to Arat.
Glady eyes the thinness of the bundle optimistically; obviously, this couldn't have been serious, if there is so little documentation.
Glady anticipates a commendation for uncovering fraud when he returns to the main office.
Arat waits until the runner has exited, and then separates the bundle to examine the paperwork.
Warlin awaits vindication.
Arat sees that it is a patient that he himself treated, and a very straightforward case. He was not required in particular, it just happened to come up while he was on shift. Much of what Arat does is large volumes of minor injuries, as major injuries can't be happening constantly even on a site like this.
Arat finishes scanning the information and hands it to Warlin first.
Arat: If both of you will have a look at this now? I can arrange to have it copied when appropriate.
Warlin blinks at the squiggles on the page.
Warlin's eyes are being subjected to a bit more of a spectacle than usual, giving the ornate nature of Arat's handwriting.
Warlin: Um, what does it say?
Arat's eyes narrow. He questions the wisdom of Mr. Birch bringing in a benefits manager who cannot read the language of the vast majority of Mr. Birch's employees on the site.
Arat takes the papers back.
Arat: "On this date, the Gen Bess Lilton of nageric characteristics [translates the nageric characteristics into Genlan which takes some minutes as they were minutely detailed] permanently residing at [names an address in Gen Territory] and temporarily residing at [names a location within the official worker encampment] was healed of a [translates extremely detailed technical description of the exact nature of the sprain down to a cellular level into Genlan, which takes some minutes as well] with no permanent ill effects. Advised immediate return to work duties. Patient was difficult before treatment."
Warlin 's eyes start to glaze over.
Arat remembers the patent now that he has read the nageric description. She had come in screaming that she was done with this Godforsaken place and that all Simes could go to Hell, and she had seized a medicine bottle from a nearby table and hurled it at Arat's head, proving that although he doesn't have many opportunities to prove it, Arat's reflexes are just fine.
Arat was relieved when the patient's morale was improved by the healing.
Warlin did, however, manage to pick up from Arat's recitation the fact that the ankle was indeed injured.
Warlin: You see [to Glady], the injury was documented at the time, and was as severe as reported.
Warlin had not submitted his original claim with such detail, of course, but detail tends to be very convincing to juries.
Glady is not unaware of the detail factor, but has grasped another very important fact.
Glady: So the sprain was not severe enough to justify a claim for lost wages? She was able to go back to work immediately?
Arat: As I said, the detailed application of Gen Territory law must be addressed by a Gen Territory court. But she was able to go back to work immediately.
Arat: Most patients I treat can. [can't resist adding]
Arat's own morale on the subject of channelling work was lower than anybody had realized; at Capitol he only worked enough to prevent serious entran complications, and it was always the hardest and most hopeless cases. Now, he gets a lot of general healing work and it has become clear that he had been depressed about it before.
Glady's brow furrows as the implications of that statement strike home.
Glady: If the treatability of common injuries is so very different here, it is obvious that EMU's contract for this project requires a serious re-evaluation.
Glady starts to see possibilities for career-enhancement, if a certain vice-president of EMU is displaced for negotiating a bad contract on such a large project.
Warlin: Obviously, we will protest any changes in the contract, as agreed upon, signed, and witnessed by all parties.
Arat is following both of their nageric changes with this news, and thinks they are both greedy SOB's.
Warlin: ~~ smug ~~
Arat is glad that somebody (namingly the Tecton) actually cares about the wellbeing of these workers, or at least their physical wellbeing.
Warlin really likes the idea of EMU being a source of extra income for his clients.
Warlin thinks it is a great improvement on the usual situation, when after weeks of effort on his part, while his client is unemployed, EMU grudgingly shells out half of what is owed.
Warlin: Controller, I think that Mr. Glady and I have much to work out between us, and there is no reason to take up your valuable time while we do so.
Arat supposes that there will be some sort of personal bribe or private settlement involved to straighten it out. He is glad it will have nothing to do with him.
Warlin: Is there a contact we could approach for details on particular cases treated by your staff, when necessary?
Arat: You may submit your requests to my assistant, Jeniard.
Arat rather wonders why they haven't been requesting this information all along, to be honest.
Arat certainly has no problem providing it, so long as those requesting it are credentialed.
Warlin works on the assumption that EMU will pay a certain amount of claims (the cheap ones) without questioning his word, and will refuse to pay all the rest, and that therefore assembling detailed documentation at the time of submission is premature.
Warlin: We will do so, then. Thank you very much for your time.
Arat nods.
Warlin and Glady depart, breaking into another loud argument as they go.
Go on to Episode #44: Tea With Snake III
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