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NOTICE TO POLICYHOLDER AND THEIR LOSS PAYEES/MORTGAGEES STArE BOARD OF I~SURANCE LYNDON L. OLSON, JR., Chairman DAVID H, THORNBERRY, Member CATHERINE BROWN FRYER, Member DOYCE R. LEE, Commissioner UQUIDATlON DIVISION OFFICE OF THE RECEIVER JAMES T. ODIORNE Liquidator - Receiver HEe :~VED November 14, 1986 NOTICE TO POLICYHOLDERS AND THEIR LOSS PAYEES/MORTGAGEES om ,1'(~\ _ RE: - - - - - - ----- -- --- TEXAS FIRE AND CASUALTY COMPANY, Dallas, Texas, in State of Texas vs. Texas Fire and Casualty Company, in the 53rd Judicial District Court of Travis County, "'" 1,17{~1\T -." '-!~~-~,-.~~ _l,-:L';-<i--<?J~~. Receivership; The Cause No. 396,246 Texas. Dear Policyholders and Your Loss Payees/Mortgagees: IMPORTANT NOTICE: Earlier this year we started liquidation proceedings for this company. Those proceedings were suspended when we were contacted by a group with the apparent ability to purchase and rehabilitate Texas Fire and Casualty Company. We negotiated with that group because your coverage would not have been cancelled and your pending claims would have been limited by the terms of your policy, not by the receivership statute. It is now very clear, and the potential purchaser agrees, that this sale of Texas Fire and Casualty Company will not take place. We appreciate your understanding, patience and cooperation as we have attempted to rehabilitate this company. THANK yOU. We have instructed our staff to assist you in every way possible in claims payment and final liquidation. PLEASE read the rest of this notice very carefully so that you can protect your rights. The 53rd Judicial District Court of Travis County, Texas, temporarily enjoined Texas Fire and Casual~y Company, a Texas orga!!i~ed and_,d()1ll.icil~(:1 company;-and-pia-ced---rr-In-Temporary -Receivership on--May 15, 1986. All subsequent proceedings regarding the affairs of this company in the State of Texas are thereby governed by Arts. 21.28, et. seq. of the Texas Insurance Code. That District Court order appointed me as Receiver of Texas Fire and Casualty Company and directed me to assume its affairs in the State of Texas. The 53rd Judicial District Court ordered cancellation, effective on the 7th day of December, 1986 at 11:59 p.m., of all the inforce policies, contracts of insurance and bonds of Texas Fire and Casualty Company. It is therefore imperative that you seek to obtain new insurance coverage as soon as possible. hw--~~~ 7901 CAMERON ROAD, BUILDING #1 AUSTIN, TEXAS 78753,6717 TELEPHONE 512/339,1900 MAIL ADDRESS p,O, Box 16619 Northeast Station Austin, Texas 78761,9998 I I The 53rd Judicial District Court has set a claim filing period and ordered that any and all claims against Texas Fire and Casualty Company must be presented on or before December 7, 1987. This deadline may vary in your state. Please contact your State Insurance Department or State Guaranty Association for further information. Residents of Florida should submit their claims to: Mr. Fred Washington Division of Rehabilitation and Liquidation 325 John Knox, Bldg. L, Room 102 Talahassee, Florida 32303 Residents of Michigan should submit their claims to: Patrick H. McGuire State of Michigan Receivership Division 611 Ottowa Tower N Lansing, MI 48909 Residents of all other states should submit their claim forms to: James T. Odiorne, Receiver Liquidation Division P. O. Box 16619, Northeast Station Austin, TX 78761-9998 If you have any questions in regard to handling of claims or law suits in which you are involved, please contact your State Department of Insurance or State Guaranty Association. T. ODIORNE, Receiver of Fire and Casualty Company JTO/RN/rd ENCL. NOT/POL/OTH I I PROOF OF CLAIM FOR RETURN OF UNEARNED PREMIUM IN THE MATTER OF TEXAS FIRE AND CASUALTY COMPANY IN RECEIVERSHIP 321- (For Receivers use only) POLICY NO. CLAIMANT'S NAME (PLEASE PRINT) MAILING ADDRESS PHONE /1 BUSINESS # CITY STATE ZIP POLICY PERIOD: FROM TO TOTAL PREMIUM PAID $ AGENT'S NAME: ADDRESS: Have you or any person on your behalf received any money from any source that is included in the amount for which you are making claim? ( ) NO () YES Amount $ . Source Have you assigned any portion of your claim to any other person? ( ) NO () YES To Whom? Name Address AGENT ADDRESS IS PREMIUM FINANCED? ( ) NO ( ) YES NAME & ADDRESS OF COMPANY BALANCE OWED TO FINANCE CO. $ If proof of claim is filed by anyone other than the insured, an assignment of interest made out by the insured to the claimant must be furnished. Claim upon my oath is hereby made for the unearned premium. Subj ect to the penalties of perjury, the foregoing information is true and correct. SIGNATURE OF CLAIMANT IF CORPORATION, TITLE OF OFFICER SUBSCRIBED AND SWORN TO ME, on this the day of , 198 . NOTARY PUBLIC STATE OF COUNTY OF MY COMMISSION EXPIRES PROOF OF CLAIM MUST BE FILED WITH THE RECEIVER NO LATER THAN DECEMBER 7. 1987. PLEASE READ THIS lRM CAREFULLY AND NOTE THAT YOU ~ MAKING THE STATEMENTS TJNDER OATH: .. . P ROO F OF CL A i ~ " against TEXAS FIRE AND CASUA.LT"fCOMPANY, IN RECEIVERSHIP BEFORE ME, the undersigned notary public,'appeared the person whose name is subscribed hereto, who stated on OATH: That Texas Fire and Casualty Company, after deduct~ng all offsets and counterclaims is indebted to him as follows; CLAIMANT'S NAME (Party who is executing 'this c'laim'and to' whom payment is to be made) .. I,;, "~ , "'.' ~~ , CLAIMANT'S ADDRESS (Street or Box Number) (City) (State) (Zip Code) NAME OF TEXAS FIRE & CASUALTY CO. POLICYHOLDER: POLICY NUMBER: CLAIM NUMBER: TYPE OF LOS S : DATE OF LOSS: TOTAL AMOUNT CLAIMED DUE: '$ NATURE OF CLAIM (BRIEF EXPLANATION OF FACTS): .'> WITH THE EXCEPTION OF THE FOLLOWING, I ALONE AM ENTITLED TO FILE THIS CLAIM, NO OTHERS HAVE ANY INTEREST THEREIN. (Show here the names of any persons or firms who have an interest in this claim and state what their interest is. If there are no others, write "NONE".) HAVE YOU EXHAUSTED ALL EFFORTS TO COLLECT FROM ANY OTHER INSURANCE COVERAGE AVAILABLE TO YOU ON THIS LOSS, including Uninsured Motorist, Medical Pay, PIP and Collisi~~? YES (,) '.. .. . NO ( ) That the above account is TaUE and CORRECT and \10 'part "<6f the amount claimed due has been paid. .. . CLAtMANT SUBSCRIBED AND SWORN TO BEFORE ME, this the day of 198 . , , ':~ NOTARY PUBLIC The Receiver is governed by Article 21.28 of the Texas Insurance Code in all matters of procedure. BY COURT ORDER, CLAIMS MUST BE FILED ON OR BEFORE DECEMBER 7, 1987. (See Further Information on Reverse Side) 1 . I CLAIM fILING INFORMATION I If the company ia ~".b'.4 c~ you, fill in all applicable spaces on the of this form, ailn ch, f.~ b.fo~. . notary public, who will also sign his seal, and th.n .... C.. fora vith aupportinl evidence attached to: ..' reverse side it and affix JAMBS T. ODtORl'E, RECEIVER Cl.l.. Division P.O. lox 16619 Au,tin, T.x.. 78761 2. The followinS ,~..f.f ,II. .....tcl.1Md clu. will be required for the respective types of 10..... COLLISION: PIOPIa'I"Y DMIlCIa CONPURDSIVl: At l.ast two repair estimates or the "PAID" bills c.".r.....'.p.l'.,. BODILY INJURY. p~ IJJQaY PROfI~IO.: Current narrative medical reports, Medical expena.'....,...... .,.t.....C..oclptoof of 10s8 of time. OUTSTANDING CHEC:I8 .....me !h. OllGllAL check or draft. OTHER CLAIMS; SSM1... .....ua~. ,r~f. ,-.... :>, r-1 .. j:; it 0 5 ,.. . .... Q) x : I CJ) I :::> H .. i Q) < C,) ~ ,.J i .. .. .. .. ~ 1 B & ~ u 0 "" 5 ~ iC lD B ~ I-l ~ d J g :> 0 iC 'P'l ~ H ~ 0 III ~ '-" 00 u - III S ft ~ N .. ~ . ~ iC t"'l 0 ., z 0 ~ .. = 0 ! 0 ! II ~ z .... III ~ r.. ~ CD r-t ~ Z . U g., ~ 8 .. .. H '"' U .. a Q ~ Q) :>, - ! ~ > s:: 1I1 ~ ~ III g i ~ Q) Ii C,) a = ~ QI 0 ~ ~ u .. 3. To reduce ex,..... eM ~1.... f...t. _t .clmovl.dled, and notice of the Receiver's decision on a cl.~ t. at... OILY If th. clata i8 rejected in whole or in part. , , ' 4. If your clat. ,. a .CIVIIID loa.el.ta, fu", for its payment in the amount approved by the Receive, v111~. .... ...tlable uncl.r tbe provisions of Art. 21.28-C of the Insurance Cod. .t T.....,~.. the Toxa. Property and Casualty Guaranty Act. 5.' If you chan.o you~ ...,... 10U ~.t DO~lfythe Receiver in writing. 6. BY COURT ORDlll. C~DIS MUS1"1I nLID O~ 01\ BEFORE DECEMBER 7, 1987 L/POC