Molly Muledbriar’s Investigative Instincts Aroused


Molly Mulebriar, investigative reporterette and forensic auditor is a frequent contributor (and reader) of this blog. Last night Mulebriar called our offices and left the following message:

“Hey guys, read your latest posting on San Benito schools. I watched the video, twice. Something caught my attention which aroused my investigative instincts.

A statement was made about a lawsuit the district filed some years ago against a stop loss carrier, TPA and an MGU. So, I checked online and sure enough I found it. I have read the documents  and there is enough there to write a “As The World Turns” novel which I am certain would be an insurance industry best seller .

Characters involved include two recently convicted felons (one is currently in the hokey serving time), a TPA which documentation shows asked for  a 2% monetary override from the MGU, and other fascinating documentation such as the original stop loss contract showing the policy to be in effect for only 24 hours (a typo the district, the district’s consultant, and the district’s insurance agent failed to notice – no one ever seems to read their contracts!). Expert testimony is interesting too.

One document, a hand written fax transmittal from the TPA the stop loss carrier reads ” The one (stop loss application) I had signed showed 10% but I should have had the 12% commissions one. They elected to use a 15/11 spec & agg contract $75,000 deductible to reduce the rates 10%. The other 2% we would like to go to Companion & then have that reimbursed to MBA as an override. Thanks. Have a new application sent to me.”

One may wonder if the stop loss contract awarded recently by San Benito includes more than a 10% commission. Most policies pay more, usually 15% with the proceeds divided between the broker/consultant and the TPA.

The difference in the allusion portrayed on the video and the actual lawsuit referenced is significant. Most learn from past mistakes, some don’t. San Benito may be the later.

I’m on this and will. publish my report in about a week on , unless, of course, you guys want to publish it”