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Former County Jail Inmate Busted
for Workers’ Comp Fraud

SEPTEMBER 4, 2002—Travis County District Court sentenced James Webb of Houston to 18 months in state jail on workers’ compensation fraud-related charges. The court also ordered Webb to pay $3,560 in restitution to Texas Mutual Insurance Company.

Webb began collecting Temporary Income Benefits (TIBs) for a knee injury he claimed occurred while he was working for Texas MutualSM policyholder Coastal Personnel Consultants in Houston. A Texas MutualSM investigation revealed that the injury actually occurred while Webb was serving time in the Jefferson County Jail on an unrelated charge.

Webb also collected TIBs after returning to work for another company, Industrial Maintenance Corporation in Houston, without notifying Texas Mutual Insurance Company. Webb pleaded guilty, and Travis County Assistant District Attorney Donna Crosby prosecuted the case.

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Texas Mutual Website Takes Top Honors

AUGUST 23, 2002—Texas Mutual Insurance Company's website, www.texasmutual.com, placed first in an international competition hosted by the American Association of State Compensation Insurance Funds (AASCIF).

Since launching its website in 1996, Texas Mutual Insurance Company has introduced a host of online tools that streamline its processes. Policyholders can report injuries, create custom loss run reports, analyze loss data, and order workplace safety videos, brochures and posters from the company’s safety resource library.

Internet Quoting (IQ), the site’s newest feature, gives agents the ability to submit quotes for new business online, shaving valuable time off the submission process. If the client doesn’t meet the criteria for an online quote, the agent can still save time by submitting the application online to be reviewed by a Texas MutualSM underwriter.

Policyholder and agent response to the website has been positive, but the company won’t rest on its laurels, according to Keely Morgan, Texas MutualSM senior manager of Corporate Communications. “We’ve always been at the forefront of technology in the industry, and we are working hard to deliver a website that exceeds our customers’ needs,” said Morgan. “As we move further into the e-business revolution, we will continue exploring new ways to use the speed and power of the Internet to make it more convenient to do business with us. We’re proud of the recognition AASCIF has given us, and we will enter an even better Web site in next year’s communications contest.”

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Texas Mutual Expands IQ (Internet Quoting)

AUGUST 8, 2002—Texas Mutual Insurance Company continues to expand its online services for agents seeking workers’ compensation coverage for their Texas clients. Originally, the Texas MutualSM Internet Quoting (IQ) system handled policies with $5,000 or less in premium. Now, the IQ system gives online quotes for qualifying accounts with premiums of $15,000 or less.

To qualify, an account must have had continuous workers’ compensation coverage for the past two years, plus an acceptable loss history and an all-Texas payroll and operation. If a client doesn’t qualify for an online quote, the agent can still use Internet Quoting to submit the application for review by a Texas MutualSM underwriter.

The IQ system includes an edit feature that allows agents to save an unfinished quote and return to it later, and they can even update the information they submitted on a previous quote to request a “re-quote.” The review and print feature shows agents the status of all their new Texas MutualSM accounts and produces presentation-quality printouts of the quotes to show to clients.

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Purchasing Groups Earn Dividends

JULY 31, 2002—Several workers’ compensation purchasing groups earned special group dividends from Texas Mutual Insurance Company this summer. Today, the company announced it has presented group dividends to CompGroup AGC, the Associated Security Services and Investigators of the State of Texas, the Emergency Service Organization, the Texas Cattle Feeders Association, and the Texas Oil and Gas Association workers’ compensation purchasing groups.

“We’re very pleased with these groups’ safety efforts,” said Ken Lauber, Texas MutualSM vice president of Field Operations. “With continued focus on safe workplaces and accident prevention, as well as managed growth of the group, we’re optimistic that each of these groups can improve its overall loss ratio, increase its premium volume, and possibly earn future Texas MutualSM group dividends.”

A group’s volume and loss ratio are key components in determining whether it qualifies for a dividend. The greater the group’s volume and the lower its overall group loss ratio is, the higher its dividend percentage will be.

Purchasing group members are eligible for group dividends and general dividends that Texas Mutual Insurance Company has paid to select, longtime policyholders the past three years. Although state law prohibits insurance companies from guaranteeing future dividends, Lauber said that Texas Mutual Insurance Company’s philosophy is to reward its top groups when money is available.

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Hard Cash Despite Hard Market
Texas Mutual To Pay $22 Million in Dividends

JULY 31, 2002—Texas Mutual Insurance Company’s board of directors unanimously approved a general dividend plan today that will distribute approximately $22 million among qualifying policyholders. As in previous years, the 2002 plan includes an annual component for qualifying customers whose policies expired in 2001 and a retention component for select, longtime customers.

The announcement is particularly noteworthy given the current workers’ compensation insurance market. In the past year, some carriers have gone out of business, and others have restricted their coverage, reduced their services, or abandoned Texas business altogether in response to the hardening market.

“We began preparing for the hard market long before the market changed,” said Texas MutualSM President Russ Oliver. “Our efforts paid off, and now I’m pleased to announce that, for the fourth consecutive year, Texas Mutual Insurance Company will pay dividends to qualified policyholders.”

An estimated 22,000 policyholders are expected to qualify for at least one component of the plan, which still requires Texas Department of Insurance approval.

“The great thing about these dividends is that in the end, the money stays in our communities and ultimately helps improve the Texas economy,” said Texas MutualSM Chair Martin Young Jr. “Our dividend plan helps us reward our loyal policyholders whose low claim losses have contributed to our company’s success.”

Young also stated that dividends may reward customer loyalty, but they don’t guarantee it. He also attributed the company’s high retention rate to the company’s employees and their continued dedication to provide outstanding customer service.

According to state law, policyholders enrolled in the company’s insurer of last resort program (START accounts) are ineligible for dividends. State law also prohibits insurance companies from guaranteeing annual dividends; however, Oliver said that the company’s philosophy is to reward its good customers when money is available.

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Fraud By Any Other Name

JULY 26, 2002—A Houston company changed its name several times while trying to avoid prosecution for premium fraud, according to a Travis County District Court finding. A.C. Lath & Plastering Inc., owned and operated by Martin Geserick and Kevin Ball of Houston, must pay $450,000 in restitution to Texas Mutual Insurance Company as part of a plea bargain agreement.

According to the prosecution, Geserick and Ball transferred employees from one company to another and deliberately misrepresented its payroll to Texas Mutual Insurance Company in order to gain workers’ compensation coverage at a lower premium. The company originally applied for workers’ compensation coverage under the name Atlantic Partners L&P Trust. In subsequent years, Geserick and Ball changed the company name to Atlantic Partners, then to Atlantic Contractors Inc.

When Texas MutualSM auditors attempted to review the companies’ payrolls, Geserick and Ball refused to provide the necessary records. Texas MutualSM investigator Marti Rickard ultimately discovered two other companies, Stone Cast Inc. and A.C. Lath & Plastering Inc., during her investigation. The evidence suggested that Geserick and Ball were trying to develop other entities to avoid prosecution of premium fraud.

Rickard credits the “excellent work of the Travis County DA’s office” for securing the restitution. Travis County Assistant District Attorney Donna Crosby handled the prosecution.

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