Former Insurance Company President Makes TDI’s Top 10 Fraud List

April 19, 2006

  • April 19, 2006 at 8:33 am
    Political Observer says:
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    A few facts for you to chew on.

    1) The ONLY venue named in this list of 10 is Austin. Many of the others may well be Austin, since TDI can bring suit in Austin / Travis County under state law.

    Austin and Travis County are called the People\’s Republic of Austin because it is seen as liberal. In fact, it was one of the \”Blue\” areas in the \”Red\” state. Democrats still run politics in Austin.

    2) The District Attorney in Austin is Ronnie Earl, the Democrat DA proscuting Tom Delay for campaign finance law violations.

    3) John Cornyn was in Washington DC when the recent WC law was passed. He had very little to do with it. I have jheard more rumors that Toyota in San Antonio ruled the roost on the WC law. And I know of 2 large contractors Toyota has put into bankruptcy because they don\’t pay bills.

    4) Money, as always, rules all justice in the courts. Have it, hire a good attorney. Don\’t have it, get hammered. It happens all over.

    So, I would like to know where you got the fact that all of these courts and judges are Republican.

    A Political Observer

  • April 19, 2006 at 12:59 pm
    D. Tuck says:
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    Most of the people in the top 10 should have received jail time.

  • April 19, 2006 at 1:01 am
    Joyce says:
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    I\’m not sure I understand the penalty for D. Bauer. It sounds like he ended up on the positive side. Stole more than $344k and paid back less than $70k??

  • April 19, 2006 at 1:06 am
    dothetime says:
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    What a pattern of corruption of our judicial syatem this report reveals. Slammer time for small time crooks, deferred adjudication for white collar, big time crooks.

    Steal a few thousand and the man comes after you. Steal a few hundred thousand and its deferred adjudication for you along with (probably infinitely deferred) restitution. Repulicans run Texas.

    \”Wake up and smell the Republicans.\”

  • April 19, 2006 at 1:50 am
    Rational Thinker says:
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    Hey dothetime,

    Judges in Texas are either elcted by the voters or nominated by politicians who were elected. Until recently, Texas has been a historically Democratic state.

    I\’d like to see the empirical evidence used to base your assertion that Republicans are to \”blame\” for the sentences handed down.

  • April 19, 2006 at 1:54 am
    Cut the Crud says:
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    Evidence?!!! Everyone knows Democrats don\’t have evidence for their arguments. Regardless of the issue, they refuse to let the facts get in the way.

  • April 19, 2006 at 2:18 am
    dothetime says:
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    I have anticipated your objection. Hence \”Wake up and smell the Republicans.\” Evidence is gathered through reading, fair and balanced media , eyes, ears, etc.

    Make the effort to learn the party affiliations of the judges on the Texas Supreme Court and in most concentrations of populations. The evidence is there. O\’Reilly and Rove won\’t be giving it to you. Prime example: Senator John Cornyn, lap dog, mouthpiece Texas Senator for Tom Delay. Former chief justice Texas Supreme Court. Elected by moneyed interests as a point man on Workers Compensation reform. (And he delivered. now, let\’s talk about legislating from the bench by activist judges…). And his friends delivered–he is now junior senator. Present your own evidence to the contrary instead of parroting Fox News. Disillusion yourself from thinking you are living in a democracy. \”Follow the money…\”

    Avoid simple polarized thought. Democrat?–no, Libertarian.

  • April 19, 2006 at 2:31 am
    Joe says:
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    Thank you Time ……..
    Facts instead of rehortic ……..
    Something some folks are not use to …..

  • April 19, 2006 at 3:49 am
    BILLY says:
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    SENATOR CORNYN GREATEST COMMENT: \”THAT\’S THE PROBLEM WITH THIS COUNTRY…TOO MANY ELECTIONS!\” WHOA THERE NELLY!!!!!!!!! HE THINKS HE\’S ENTITLED TO…THAT\’S RIGHT, ENTITLED TO — A \’REPUBLICAN KINGDOM\’\”. BEWARE OF WOLVES IN SHEEPS\’ CLOTHING. NOW, TO THE ISSUE OF DOLING OUT PUNISHMENTS…IF ONE CANNOT SEE THE DISPARITY, THEN THEIR HEADS ARE SCREWED ON BACKWARDS.

  • April 19, 2006 at 4:56 am
    A realist says:
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    To make a partisan issue of this list of bad men shows that your gene pool is so shallow an ant could wade in it.
    Yuck!

  • April 19, 2006 at 5:39 am
    Darlene says:
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    Insurance fraud drives everyones rates higher – if convicted they should do the time and pay back all received in the fraud act along with any fine given. If examples are made maybe people will think twice about the crime they are about to commit

  • April 19, 2006 at 6:15 am
    Clarifyer says:
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    Before we go into the legal definition of what deferred adjudication actually is, let\’s first be very clear about what deferred adjudication \”is not\”.

    Deferred adjudication is NOT a final finding of guilt and it is NOT a final conviction.

    Deferred Adjudication is a plea bargain agreement between a defendant, and a Texas Criminal Court in which formal judgment is withheld or \”deferred\” pending the outcome of the probation period. If an individual is given deferred adjudication and he or she successfully completes the probation and conditions assigned by the court, the charges are dismissed. In order to obtain DA from the court, the defendant MUST either enter a plea of \”guilty\” or a plea of \”no contest\”. Essentially, both pleas mean the same thing; with the exception being that a plea of \”no contest\” has certain advantages as far as protecting the defendant against any subsequent civil litigation proceedings related to the original crime he/she was originally charged with.

    More information available at
    http://www.tajlr.com/

  • April 20, 2006 at 11:46 am
    media mogul says:
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    Political Observer has got himself a future at Fox news! He uses their core methods: (1)denial of obvious truths, (2)distraction/foreign (d)evil(s) and (3)misinformation/disinformation (heck, this guy\’s a natural–maybe he\’s on staff already):

    Come on guy–Judges in Texas, with the probable exception of the southernmost, Hispanic regions, are predominantly Republican. Case closed. Unarguable. They have been working on it with tons and tons and tons of money for a decade. Saying it is not so in a loud voice like (luffa) Bill and Sean (ex-house painter, no education, pretty good hair, political expert) does not make it so. (Maybe Rush, recovering from his self-induced deafness arising from oxycontin addiction needed to hear? Hey–just where exactly is justice for Rush these days? I hear he and his lawyers have gotten all sorts of religion for his \”right to privacy\” all of a sudden. (I guess it\’s a different kind of right to privacy than that of pregnant women). Lots of money for lots of lawyers. I heard a rumor he is a Republican?). Hey, sorry, don\’t want to include you in that sort of company. Apologies.

    The man in Austin pled guilty–i.e. did not have a trial….maybe he couldn\’t afford a trial or a good lawyer like the $750,000 thieves. Well, just what are the facts? Get back to us on the venue, judge\’s affiliation, etc. of all the cases.

    Come on guy–Toyota???–distraction. Those dadburn foreigners interfering in our Texas suh-ciety. Drahving down our fahn contractors with their furrin bidness practices. But it is just a \”rumor\”–tsk tsk. Anyway, \”do the time\” was not talking about the recent WC reform, but the important one in the early 90s that everyone in Texas in insurance knows about.

    Finally, disinformation/misinformation:

    Cornyn was \”THE MAN\” on the Texas Supreme Court in the early 90s–the time of THE important Texas true crisis WC reform–(which everyone in Texas in insurance knows about). He was elected with gobs of Republican and Republican PAC money, including from the TAB–TAB is now part of the fulminating Tom Delay scandal in more recent times. The current reform is just window-dressing (folding the TWCC into the TDI), except for medical networks–which are eventually going to be seen as giving the insurance industry and employers excessive power over employees. A violation of the original truce that led to WC in the first place? Hopefully, just a swing of the old pendulum but it might be a pretty rough return swing. Maybe Toyota had a hand in that, but \”rumors\” are unworthy. Point to a published report, just one from a real journalistic enterprise–the kind that needs two independent sources. Hey, and that increasing power of employers over workers is part of the pattern we are supposed to be distracted from. Money, power, justice, even mere access to justice…access to politicians..no, look at them foreigners over there!

    Yep, how much justice can you afford? How many politicians can you afford? In Texas, all the major law firms along with other wealthy people can and do legally make campaign donations to the very same judges who will be hearing their cases. The very same judges. This is true. It is true that it is legal (guess who makes and decides the laws?) Follow the money–figure it out. Congress is run by lobbyists, Texas\’s little ole Supreme Court is beholden to rich contributors. Look at the mess in Ohio\’s government (collecting coins (??!!!) with the State WC Fund reserves and a good buch of them go missing? A Republican scandal again..).

    Finally P.O.\’s own words really do make the case for the other guy–

    He says:

    \”pros[e]cuting Tom Delay for campaign finance law violations\” (Tom is resigning \”for the good of the party\” and has $1.2 million in campaign contribtions he can legally convert to pay for lawyers). Oh, yeah, and that Jeff Skilling guy at Enron (wasn\’t that the company on whose plane our current president flew when he was campaigning?)has $26 million in personal assets for his lawyers. He expects to spend it all. I have heard a rumor he is a Republican. Let\’s see if a jury in exclusively Republican Harris County, Texas (most death sentences of any county in the nation–hoorah!) is going to convict and punish him. (Prove me wrong please!)

    and he says:

    \”Money, as always, rules all justice in the courts. Have it, hire a good attorney. Don\’t have it, get hammered. It happens all over.\”

    Republicans have higher incomes than Deomocrats. Or is this also untrue? Oh wait, HEY LOOK–there goes Yoko Ono on a moped. And now this just in–black IS white.

    Sheeshz–Whatever happened to critical thinking skills? Republican or Democrat, VOTE OUT INCUMBENTS. CLEAN UP GOVERNMENT. LOBBYISTS OUT OF OUR CONGRESS! LAWYERS OUT OF OUR JUDICIAL ELECTIONS!

    Exiting soap box now..until next time.

  • April 21, 2006 at 4:08 am
    Ray says:
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    It\’s simple: The more money one steals, the better lawyer he can hire! Democrat or Republican is not an issue here.

  • April 30, 2006 at 12:36 pm
    Roger Poe says:
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    Subject: TWIA Claim Underpayment Practices 2004 -2006
    Posted On: April 30, 2006, 12:16 pm CDT
    Posted By: Roger Poe
    Comment:
    4-30-2006 Update: TWIA Claim (Underpayment) Settlement Conduct Remains The Same

    -MS/B Structure Replacement/Reconstruction Data Cost Values Built Into Premium Values Are Being Kept By Major Insurers –

    Subject: TWIA Claim Underpayment Practices 2004
    Posted On: April 26, 2004, 8:18 am CDT
    Posted By: Roger Poe G.C.
    Comment: 4-26-2004

    Texas Windstorm Insurance Association
    5700 S. Mopac Expressway, Building E, Suite 530, Austin, Texas 78749
    Phone (512) 899-4900
    Fax (512) 899-4950

    Dear Mr. Wrather,

    Congratulations on your Safeco appointment to the Board of the Texas Windstorm Insurance Association.

    As a consumer, and construction professional, I have noticed disturbing TWIA claim settlement practices being used towards consumers in South Texas in the Rio Grande Valley area. Consumers are being set up to pay construction business costs that insurers reasonably, and intrinsically, owe.

    Please consider the following concerns and questions.

    TWIA claims adjusters are arbitrarily removing Roofing trade investment costs from G.C. (General Contractor) quantified [two trades+ needed] estimates AND THEN adding G.C. mark-up (business overhead and profit) of 10% / 10% to an estimates total. These estimates are then being given to policyholders so as to be able to present the estimate values to a G.C.

    This \”unique\” G.C. estimating methodology is consistently and unfairly underpaying claims [en masse] to unsuspecting Texas consumers, and creates / assumes a built-in financial hardship for those consumers. G.C.\’s, Builder\’s, Remodelers, etc. apply estimated business overhead costs toward ALL trades supported, and anticipate a reasonable [e.g.10%] profit on the value of the WHOLE estimated construction investment risk, not a partial piece of it.

    Many, many TWIA claims \”estimated\” this way produce greatly reduced / unrealistic business overhead and ZERO G.C. profit margins. Contractors and Insurers are well aware of estimating norms. However, most consumers are not construction estimators or accountants, and until informed, are usually unaware of TWIA\’s undervalued estimating practices.

    1. Why does TWIA, and its contributing members Allstate, Safeco, USAA, etc., feel this [artificial G.C. estimating methodology] is fair and reasonable G.C. estimating methodology?

    2. Do they all normally practice this [distorted] estimating methodology inside and outside of Texas?

    Even the MS/B IntegriClaim construction business estimating program / construction business data TWIA is using, and its program functions, allow for claim adjusters to easily duplicate G.C. commensurate / fair overhead and profit estimating norms.

    Please note that the hurricane season is almost here. Should consumers need general reconstruction contractors [en masse], TWIA\’s estimating practice will show up for many people / consumers to see…and experience.

    3. All said, why is TWIA collecting in policyholder premiums MS/B [Builder-General-Primary] construction contractor business costs estimating [dollar] norms data…and then avoiding disclosing those actual indemnification loss [dollar] values…at consumers\’ expense?

    http://www.tdi.state.tx.us/bulletins/b-0045-8.html

    In other words, why is the TWIA collecting premium-dollars that have MS/B defendable [Builder-General-Primary] Contractor replacement – reconstruction dollar value, (financially factored / calculated at an agents desk, to replace the whole structure), and THEN have another construction business estimating methodology during the claim settlement process, that leaves out [Builder-Genereal-Primary] business overhead and profit cost values, claiming they are (suddenly) now NOT part of Builder-Genereal-Primary Contractor (single or multiple specialty subcontractor trade scope) loss value?

    Simpler still;

    MS/B regionally calculated Builder-General-Primary Construction Contractor replacement – reconstruction business costs, built into premium values for coverage costs, is NOT being repaid to claimants, as owed, apples-for-apples.

    It was reasonable to collect those construction cost values, in the light of TDI Bulletin B-0045-98, and in the name of sensible and actuarially sound indemnification protocols, so why is it reasonable NOT to disclose and account for those replacement loss values to claimants?

    Why does the TWIA act as if Builder-General-Primary Contractor business overhead and profit costs should NOT be applied to all construction trade work they have fairly won?

    Premium dollars collected always anticipate necessary Builder-General-Primary Contractor involvement in replacing the structure, no?

    Builder-General-Primary Contractor AND subcontractor business overhead and profit construction costs are woven into virtually every [roofing, concrete, fencing, carpeting, plumbing, etc.) construction component, no?

    A roofing system loss ACTUALLY represents the Builder-General-Primary Contractor AND their subcontractors business overhead and profit construction costs woven into it\’s loss value, no?

    4. How does TWIA and insurance agents / brokers justify – explain those claim estimating practices to policy shopping or premium paying, and educated, consumers and [Builder-General-Primary, etc.] construction business investors?

    Please respond. Consumers need clarification regarding such financially critical issues.

    Sincerly,

    Roger Poe G.C.
    rogerpoe@acnet.net
    rogerpoegc@yahoo.com



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