Texas Mutual Insurance Company - Providers of Workers' Comp Insurance

Employer

Frequently Asked Questions

To help employers do business with us efficiently, we put together this list of frequently asked questions.

If you need additional assistance, please feel free to call us at (800) 859-5995.

When should I report an injury?

You should report all on-the-job injuries to Texas Mutual Insurance Company the same day they occur, if possible. The law allows employers up to eight days to file the Employer's First Report of Injury or Illness; however, the sooner you report the injury to us, the sooner we can help with the claim.

Note: If you do not file an initial report of injury within the eight-day period, you waive the right to reimbursement for voluntary payments.

How do I report an injury?

You can submit Form DWC-1, Employer's First Report of Injury or Illness:

  • Online: texasmutual.com
  • By phone: (800) TX-CLAIM (892-5246)
  • By fax: (877) 404-7999
  • By mail: Texas Mutual Insurance Company, Attn: Claims; P.O. Box 12029; Austin, Texas 78711-2029

Visit the Employer Forms page to download Form DWC-1.

How do I get a list of Texas Star Network doctors?

Visit our Health Care Network section and select Find a Network Doctor. You can also contact Texas Star Network at (800) 381-8067.

Where do I send a medical bill?

If you or the injured worker receives a medical bill from a provider, you can send us a copy of the invoice. We will send a letter to the provider requesting they bill us on the proper workers' compensation billing form. You should also contact the health care provider and ask them to bill Texas Mutual Insurance Company directly.

Bills can be sent:

  • By mail: Texas Mutual Insurance Company, Attention: Claims, P.O. Box 12029, Austin, Texas 78711-2029
  • By fax: (512) 224-3889
  • By email: claims@texasmutual.com

Where can I get the Notice to Employees Concerning Workers' Compensation in Texas (Notice 6) to provide to my employees?

You can download the form in English and Spanish in the Employer Forms section.

How do I request reimbursement for a medical bill?

An employer may request reimbursement when they have paid out-of-pocket for health care provided for a compensable injury and provided notice of injury.

The employer's request for reimbursement must include:

  • Form DWC-2 (Employer's Report for Reimbursement of Voluntary Payment)
  • Copy of the health care provider's bill on the required billing form
  • Any supporting documentation submitted by the health care provider
  • Documentation of the payment to the health care provider

Employers can send reimbursement requests:

  • By mail: Texas Mutual Insurance Company, P.O. Box 12029, Austin, Texas 78711-2029
  • By fax: (512) 224-3889
  • By email: claims@texasmutual.com

How can I find an agent?

The agent who handles your auto insurance, homeowners insurance, general liability and other coverage might be able to help with your workers' compensation insurance, as well. If not, he or she may refer you to another agent. You can also retrieve a list of agents in your area by going visiting the Independent Insurance Agents of Texas.

How can I change my agent?

Texas Mutual needs a written request signed by the policyholder or an authorized representative of the company, as well as a completed ACORD 130 from the new agent, to change the agent on an active policy or quote.

The request should not be more than 30 days old and should include:

  • The name of the new agent and their Texas Mutual producer code
  • The contact information for the new agency
  • The date and the policyholder's signature
  • The effective date of the change

Requests can be sent:

  • By mail: Texas Mutual Insurance Company, Attn: Underwriting, PO Box 12058, Austin, TX 78711-2058
  • By fax: (800) 359-0650
  • By email: apps@texasmutual.com. Please include "AOR" in the subject line

How do I obtain loss runs?

Go to texasmutual.com, click on Loss Run and Claim Detail under the Employers tab, enter your Texas Mutual online username and password, or click "New User."

If you need access to other states loss runs, you must submit a written request via any of these methods:

  • By mail: Texas Mutual Insurance Company, Attn: Underwriting, PO Box 12058, Austin, TX 78711-2058
  • By fax: (800) 359-0650
  • By email: underwriting@texasmutual.com

What is the final audit process?

Workers' compensation policies are written and premium is calculated based on estimated payrolls. Texas Mutual conducts a final audit after the policy expires to verify actual payrolls and premium developed on the policy.

How do I dispute final audit findings?

A policyholder or agent can submit a written dispute if they do not agree with the final audit findings. The dispute should include the specific reason(s) for the dispute, along with verifiable supporting documentation.

The policyholder should submit the undisputed portion of any additional premium generated by the final audit or 50 percent of the additional premium if the undisputed portion cannot be determined.

Disputes can be sent:

  • By mail: Texas Mutual Insurance Company, Attention: Premium Audit Dispute Unit, 6210 East Hwy 290, Austin, Texas 78723-1098
  • By fax: (512) 224-6785
  • By email: finalauditdispute@texasmutual.com

Where can I get a Certificate of Insurance?

Contact your agent to request a certificate of insurance.

How can I submit a payment?

  • Online: www.texasmutual.com
  • By regular mail: Texas Mutual Insurance Company, PO Box 841843, Dallas, TX 75284-1843
  • By overnight delivery: Texas Mutual Insurance Company, 6210 E. Highway 290, Austin, TX 78723-1098
  • Wire transfer

Which payment methods do you accept?

  • Check by mail
  • Online payment using Automated Clearinghouse (ACH) transaction from your checking or savings account
  • Wire transfer (contact Texas Mutual for more information)
  • Money orders and cashier's checks
  • Note: Credit card payments are not accepted at this time.

How do I make an online payment?

  1. Go to texasmutual.com, and select Log in.
  2. Enter your email address and password, or select "Need an Account?". We process new requests for access to Texas Mutual online services on business days between 8 a.m. and 5:30 p.m.
  3. Select Payments.
  4. Complete the payment transaction by providing the requested information.

Why is my policy set up for interim reporting?

Texas Mutual assigns Interim reporting to businesses in industries that frequently have fluctuating payrolls. Interim reporting allows a policyholder to make a deposit on a policy, report their payroll as they go, and pay premium based on actual payrolls for each reporting period, rather than paying the estimated annual premium in full.

How can I get set up for online interim reporting?

Please contact us by phone at (800) 859-5995 to request online interim reporting.

How can I revise an interim report submitted online?

Please print the interim report you submitted online, and make your corrections on the document.

Revisions can be submitted:

  • By fax: (512) 224-3090
  • By mail: Texas Mutual Insurance Company, Attention: Interim Unit, 6210 East Hwy 290, Austin, Texas 78723-1098

What is an e-mod, and how do I qualify for one?

Experience modifiers (e-mods) are designed to give businesses a financial incentive to prevent workplace accidents. E-mods predict an employer's future losses by looking at their past loss experience.

E-mods are based on payroll and claim information for the past three policy years, excluding the current policyyear. Actual losses are compared with expected losses for other businesses with similar job classifications and payrolls. In general, employers with better-than-average experience receive a credit, and employers with below-average experience receive a debit rating.

An employer qualifies for an e-mod if:

  • The payrolls developed during the last year of the experience period produced a premium of at least $10,000 or
  • The payrolls developed during the last two or more years of the experience period produced an average annual premium of at least $5,000

How do I report an out of state claim?

Out of state claims are handled by Argonaut claims staff:

  • Via number provided with Argonaut's policy (state-sensitive) online at http://online.argonautgroup.com
  • Fax at 888-329-3764
  • Claims may be reported using Texas Mutual's toll-free number: (800) TX-CLAIM (892-5246)
  • Direct questions or concerns to claims@texasmutual.com

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