This AGREEMENT entered into by and between ____________________________________ having its principle place of business in ___________________________________________________________________ hereinafter referred to as the "CLIENT" and Questar Recovery Group of 10592-A Fuqua, Ste. 285, Houston, Texas 77089, hereinafter referred to as "QRG”.
WHEREAS, QRG is in the business of obtaining Worker’s Compensation premium savings due to the misapplication of rules, procedures, classifications, experience ratings, audits, or other errors resulting in overcharges to the CLIENT on its’ Workers Compensation policies; and
WHEREAS, QRG does not guarantee or warrant to CLIENT that it will discover any overcharges of premium or that QRG will obtain an adjustment, refund or credit for the benefit of CLIENT;
NOW, THEREFORE, in consideration of the mutual covenants hereinafter contained, QRG and CLIENT hereby agree as follows: 1. CLIENT shall provide and make available to QRG all pertinent information, as QRG shall reasonably deem necessary to analyze CLIENT's Worker’s Compensation Insurance premiums and to implement a program for the recovery or reimbursement of insurance overpayments. QRG may, at its sole discretion, review policies, endorsements, rates, auditor's worksheets, experience rating data, final audit invoices, retrospective rating adjustments and any other documents or data to accomplish its review. 2. CLIENT grants authority to QRG to contact CLIENT'S insurance carrier, agent, broker or employees, as QRG shall reasonably deem necessary, to confirm, discuss or assist in the recovery of any premium adjustment, refund, or credit, by the insurance carrier, agent, or broker. 3. CLIENT agrees to compensate QRG for its services and efforts at a sum of fifty percent (50%) of all premium adjustments, refunds, or credits applied to CLIENT'S account that stem from QRG's efforts or information. CLIENT shall pay such compensation to QRG within Five (5) business days of receiving said premium adjustment, refund, or credit. For the purpose of this AGREEMENT, a premium adjustment, refund or credit shall be defined as the amount by which Earned Premiums on past or current policies are reduced, whether by endorsement or audit. Time is of the essence. 4. QRG acknowledges that if CLIENT receives no premium adjustment, refund, or credit as a result of QRG's efforts or information, then QRG will be entitled to no compensation whatsoever, regardless of the extent, nature, or scope of services performed. 5. This AGREEMENT shall terminate when all pending premium adjustments, refunds, or credits are received by CLIENT. The obligation to compensate QRG in accordance with the stated terms above shall survive any termination of this AGREEMENT. 6. This AGREEMENT shall be governed and construed in accordance with the laws of the State of Texas. In the event that QRG is required to institute any collection action against CLIENT, CLIENT agrees to submit to the jurisdiction of the Courts of competent jurisdiction in this state. 7. CLIENT agrees that any premium adjustments, refunds or credits received after commencement of work by QRG that relates to the subject matter of QRG's review shall have resulted from QRG's efforts or information. 8. CLIENT agrees not to assign, pledge, or otherwise encumber any and all premium adjustments, refunds, or credits received from or paid by the CLIENT'S insurance carrier(s), agents or brokers that may be due to CLIENT as a result of QRG's efforts or information. 9. In the event that the CLIENT fails to pay QRG its compensation, as provided herein, CLIENT agrees that QRG will be entitled to charge interest on such compensation at the rate of 1% per month on the unpaid balance due to QRG from its due date until paid in full. In addition, if and when QRG is required to turn this matter over to an attorney for collection, the CLIENT agrees to pay to QRG any and all reasonable attorney fees and costs in connection with the collection action. 10. This AGREEMENT constitutes the full and complete understanding of the parties, superseding any and all oral and prior understandings and communications, and may only be amended by the mutual consent of QRG and CLIENT, in writing. This AGREEMENT shall be binding and inure to the benefit of the parties hereto, their successors and assigns.
In AGREEMENT THEREFORE, QRG and CLIENT, the parties hereto, have set their hands in mutual agreement and consent to the terms and conditions of this AGREEMENT on the date stated below.
Questar Recovery Group Client ___________________________
By: _________________________ By: _________________________ print name print name
