Court Orders Claimant to Repay $11K in Benefits to Texas Mutual

A Travis County district court has sentenced a Baytown woman on workers’ compensation fraud-related charges. The court ordered Pamela McCoy to repay $11,340 in benefits to Texas Mutual Insurance Company and serve five years’ probation.

McCoy reported a job-related injury while working as a warehouse supervisor for Sheff-Man LP of Cypress. She claimed she was unable to work as a result of the injury, and Texas Mutual began paying income benefits to her.

Meanwhile, Texas Mutual investigators uncovered evidence that McCoy was working for a chemical company in Houston, where she reported two additional job-related injuries and was again placed in off-work status.

Investigators call this type of scam double-dipping, because the claimant collects benefits for being too injured to work when he or she is, in fact, gainfully employed. Texas law requires claimants to contact their workers’ comp carrier when they return to work. Left unchecked, double-dipping and other workers’ comp fraud can lead to higher premiums for all Texas employers.

About Texas Mutual Insurance Company
Austin-based Texas Mutual Insurance Company is the state’s leading provider of workers’ compensation insurance. Since 1991, the company has provided a stable, competitively priced source of workers’ comp insurance for Texas employers. Texas Mutual maintains three teams of in-house fraud investigators. In 2009, they saved, identified or recovered $16 million through their claimant, health care provider and employer fraud investigations.

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