Another day @ my office

8:00 : Coffee and a bagel. And translation of Korean medicals.
After reviewing the first page of the medical, I realize this medical is rather perplex.
Without going into any specific and rather nasty details, let's just say that a young girl
ended up between two cars..
Girl has been admitted for seven months and counting, so go figure the amount of
medicals that we have and are in need of reviewing so that we may extend our cover
a little and save the poor girl's life. I end up discarding the bagel, no more appetite.
Who could've known that the word comatose and intracranial bleeding are so simple?

11:00 : Diet coke and edamame. Hong Kong Gossip
Working ages on finding evidence of an illegal organ transplant which will cost us a great
deal less we find some hard evidence we can hammer in the face of the surgeon. Kind of
difficult, when the surgeon seems eternally out of office.
Calling up my colleagues in our Hong Kong office. We end up chatting more about
Michael Wen's scandalous night out with the boss' secretary than the legal issues of
prosecuting a very well-renowned surgeon.
I end up transferring our conference to the local authorities. Now it's time to pretend to
be better familiar with organ transplants than the surgeons itself, talking to the Head
Director of the Medical Association and Affairs in HK. He is convinced, however.
Talked to a hospital where supposedly we had our insured admitted. They confirm that
the surgeon works there but that he did not perform transplant surgery.
He is chief surgeon there. That sucks. He is going to be tough to bring down. And I am
not going to go all the way to Hong Kong to prove that is in the wrong and should be
prosecuted for dealing with illegal organ trades.
Too bad I have his signed fraudulant medicals lying right here on my desk...

12:15 : Carrots and a water. Male bonding...
Male colleague from the Travel Claims department, approximately 45-50 years old
walks into my office and I get the impression he wishes to see me for a specific case that
was handed over to my Recovery & Fraud project. But no..
I watch as he fiddles nervously with the cup of coffee in his hands and he manages to
ask another colleague to close the door so that we may have some privacy.
He starts complaining about his work load and that he feels offended, being asked to
deal with specific types of cases, wanting to know if it is by coincidence of if I am aware..
Aware of what?
Apparently, he has a hard time distinguishing his private life from the type of claims he
works with in here. He has always told himself that he should always keep work and sex
separated.
You see, he explained, he has a fetish with women wearing casts/plaster and he finds it
extremely hard to focus on doing his job when dealing with such claims here when he is
sexually aroused at the same time.
I had a meeting subsequently with his supervisor and asked him to keep an eye out for
my poor colleague in his 'extreme conditions'.

13:30 : Ice latté and a phone conference. The US Law
Apparently, it is very difficult to throw a man in jail in the US. You wouldn't believe so,
right? Me neither. But just a phone call won't cut it.
The procedures are insane as we would be crossing borders and the papers that need to
be administered, translated and whatnot in order for us to put just one guy in prison is
a lot of pain.
In short, the guy has faked bills for more than USD 200,000 and used several known
clinics and facilities, which makes the charges even heavier.
Now here is the paradox - We must notify the man before pressing charges, that we will
press charges, and are familiar with his fraud. Imagine what happens if a man is told
that he will be sued for fraud of that caliber? He will run!
As we simply cannot send the police chasing until we have told him that we know he's
committing fraud, we are trying to find several loopholes but the Florida State Law
seemingly won't let that happen.
After an hour on the phone with one of our plaintiffs, he is more exhausted than I am
just listening to the intensity of fraud this man has comitted. He is sure that it will hit
the news - this guy is a pro tennis player after all.
We still haven't found a loophole, so our plan is simply to wait for him to call my office
again and I will let him know that his latest claim is being investigated by the authorities
and see how many seconds it takes for him to hang up.
Once he has hung up, I will have to call the police department immediately in Florida in
his area and send out an arrest form, filed and signed by our attorneys.
Hopefuly he won't flee the country.. Then it is going to be nasty.

15:00 : No carrots and no coffee. Clinical Trials
We are being sued for denying cover of a chemical only administered in trials.
So I went to court with two of our doctors who would back up any medical issues and I
would wisely announce our policy conditions and the legality behind them.
We won.


:55 : Chocholate milk and a banana.
Received phone call from plaintiff in Florida. No problem with our case.
In fact, we have to report the fraud to Attorney's General Office or they
will sue us, for not sueing the guy. What a strange world. I sign out of my
phone, no more time for phone calls.

17:10 : Chocolate candies and soda.
Visited our Emergency Department with the taskforce team, wanting to update their
procedures for faster and better service. Difficult when I am not so familiar with their
schedules. I fake many smiles and eat a lot of candy while listening to an intensely boring
associate explain the office etiquettes.
I grab my bag and enter the conference room where I can powernap in front of the tv.
They have insanely comfy sofas over there and I think I should try and have one trans-
fered to my office so I can sleep when I get tired of hearing the word 'fraud'.

18:30 : Panda Eyes
Time to go home. After I finish the Korean medical...