Fighting Fraud

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Workers' Compensation Fraud Hurts All Texans

The majority of workers' comp claims filed in Texas and other states stem from real instances of on-the-job injuries. Unfortunately, the people who cheat the system drive up costs for employers, consumers and insurers.

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. Indeed, according to the National Insurance Crime Bureau, workers' comp fraud totals $7.2 billion a year—more than Yahoo! Inc.'s revenue in 2007. The Texas Department of Insurance notes that insurance fraud is the second most profitable crime after drug trafficking.

Some insurance carriers write off workers' comp fraud as merely one cost of doing business. Texas Mutual, on the other hand, takes workers' comp fraud seriously. We employ three teams of full-time investigators dedicated to protecting your premium dollars, and they get results.

We're in this for the long haul.

Richard Gergasko
President & CEO

Case Activity 2013 2014 2015
Claimant referrals to SID 1,560   1,704   1,632  
Claimant fraud convictions 4   9   8  
Claimant fraud discovered 193   187   246  
Claimant fraud $ discovered $577,726   $843,639   $902,637  
Estimated future savings from claimant fraud discovered $3,950,476   $3,887,291   $4,017,564  
Health care fraud   (criminal cases) 4   5   3  
Indictments for health care fraud 0   0   0  
Convictions for health care fraud 0   2   1  
Premium fraud discovered   (million) $5.6   $5.3   $3.1  
Premium fraud indictments   4   2   1  
Premium fraud convictions   1   3   3  

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