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Article Excerpt
The sign at the edge of town said Hosmer, SD, population 287." But we didn't see any signs of life anywhere, except for one old store front with a beer sign hanging over a windowless door. The sign said "Hamm's Beer." You used to see Hamm's Beer advertised all the time in the Dakotas back in the 1960s. They said it came "from the land of sky blue waters," which must have been Minnesota. But that was 40 years ago. You never hear anything about Hamm's Beer anymore.
But we didn't go inside. We had come to this town looking for the old folks' home, and for a man named Rudolph, who they said lived there.
We found his name on the second to the last door, at the end of a long, lonesome hallway. Inside the little room sat an old man in a chair, in front of a little television. He motioned for us to sit on the bed. After awhile he spoke, in a German-Russian accent from a hundred years ago.
"I am 93 years old, and I have lived too long," he said. "What do they expect me to do?"
He meant the insurance company.
He was born in 1914 on a farm 24 miles due northeast of where he now sat. After he got married, he and his wife, Lucille, lived and worked on that same farm their whole lives. They raised two kids, who grew up and moved away years ago. Then, after they were married for 63 years, Lucille died.
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Rudy lived out there alone after that, but it got harder and harder. One day, the doctor told him that he ought to be in a nursing home. Rudy knew it, too. He had lived too long.
So the kids came home and helped him go through his belongings. As is the custom in those little farming communities, one Saturday morning, neighbors came from miles around for a sale. By the end of the day, they had auctioned off everything Rudy owned, except his chair and television.
Rudy was glad about one thing, though. Years ago, a salesman had come to the farm, telling him about the awful time people have when they can't take care of themselves anymore. The salesman wanted to sell Rudy insurance. That way, he said, you won't be a burden on anyone or need help from the government. The company would pay $100 a day for as long as Rudy needed it.
So Rudy took the salesman's advice and bought the insurance. For years after that, each time he got the premium notice, Rudy put his check in an envelope and mailed it off.
Now Rudy needed help. At first, the company paid just fine--all through the first three years at the nursing home. But then something happened.
One day, Rudy got a letter from the insurance company. It said it was no longer "medically necessary" that Rudy receive nursing home care, and benefits would end. As he told his story, he propped himself on his cane, rose from his chair, and shook his fists in the air. "I have lived too long," he said again. "What do they want me to do?"
Rudy finished his story. It didn't have any ending, so he just trailed off and then sat there, in that way that old people do, waiting for time to pass.
It could have ended there, and it usually does. Rudy didn't have a big case; the insurance company owed him only about $13,000. With little claims like that, only one person in a hundred will get a lawyer, and only one lawyer in a hundred will see beyond that one person's situation.
When nursing home residents get their benefits cut off, they may not be thrown out, but they are forced to deplete their savings. When their savings are gone, they go on welfare. So the insurance company gets the premiums but escapes the obligation to pay the claim, which falls to the policyholder, and later the taxpayer.
The party, the hangover, the cure
Rudy didn't know that the company had mailed the same letter to a lot of other people living in nursing homes. The lawyers who had already turned down his case didn't know it either. They might have suspected it if they had looked a bit closer at the letter. Letters like that have a certain quality to them, kind of like the smell of formaldehyde.
When you see an insurance company doing something that makes no sense, slow down and look again. The real story is taking place behind the curtain. And a story that someone has deliberately hidden from view is usually the best story of all. (1)
"The long-term care party of the 1990s gave us one hell of a hangover in the 2000s." That's how one company executive put it in an internal company memorandum pondering what direction to take next. The party he refers to was a hoopla of sales and profit-taking...
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