Fighting fraud for Texas employers

Fraud-Meaning-and-Definition-What-is-Fraud.jpgTexas Mutual is committed to fighting workers’ compensation fraud because it ultimately hurts business owners in the form of higher premiums. As a corporate executive once noted, if workers’ comp fraud were a legitimate business in the United States, it would rank among the Fortune 500 companies.

Last year our fraud team received 1,698 fraud referrals and followed up on each one. Read about two of those recent cases below:

Humble, Texas man sentenced on workers’ comp fraud

A Travis County district court sentenced Michael Thomas of Humble, Texas on workers’ compensation fraud-related charges. The court sentenced Thomas to two years deferred adjudication, 50 hours of community service, and to pay Texas Mutual $2,630 in restitution. Thomas reported a job-related injury while working as a commercial truck driver for Casual Leasing Services, Inc. of Houston. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying him income benefits. Texas Mutual uncovered evidence that Thomas was working as a commercial truck driver for another company while receiving income benefits due to his alleged disability.

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.

Truck stop owner indicted for filing fraudulent claim

A Travis County grand jury indicted James Russell Williams of George West, Texas on workers’ compensation fraud-related charges. Texas Mutual insured Williams’ company, George West Truck Stop. Texas Mutual’s investigation alleged that in April of 2014, Williams reported a workers’ compensation claim for a person who was not an employee and therefore, not covered by Texas Mutual’s policy. The person was seriously injured while changing a tire at Williams’ shop. Texas Mutual paid the claim based on Williams’ misrepresentations about the injured person’s status.

Note: A grand jury indictment is a formal accusation – not a conviction – of criminal conduct.

For resources on fighting workers’ compensation fraud, visit texasmutual.com.

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