Texas Mutual Announces Fraud Indictment
September 30, 2010 - Texas Mutual Insurance Company reported today that a Travis County grand jury indicted an El Paso man on workers’ compensation fraud-related charges. Carlos Macias allegedly obtained $5,459 in workers’ compensation benefits he was not entitled to.
Macias reported a job-related injury while working as a receiving department employee for J & M Sales Inc. and FP Stores in El Paso, Texas. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.
Meanwhile, Texas Mutual uncovered evidence that Macias worked for another company while receiving income benefits.
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.
Note: A grand jury indictment is a formal accusation - not a conviction - of criminal conduct.
Texas Mutual Announces Fraud Indictment
September 21, 2010 - Texas Mutual Insurance Company reported today that a Travis County grand jury indicted a Corpus Christi man on workers’ compensation fraud-related charges. Henry Sanchez allegedly obtained $3,456 in workers’ compensation benefits he was not entitled to.
Sanchez reported a job-related injury while working as a laborer for A & B Home Improvement in Corpus Christi, Texas. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.
Meanwhile, Texas Mutual uncovered evidence that Sanchez worked for another company while receiving income benefits.
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.
Note: A grand jury indictment is a formal accusation - not a conviction - of a criminal conduct.
Lumber and Wood Group Cuts Premiums, Earns Texas Mutual Dividend
September 16, 2010 - Texas Mutual Insurance Company announced a $151,743 workers’ compensation dividend to the Texas Lumber and Wood Products (TLWP) Safety Group today. The dividend was based largely on the group’s premium volume and loss ratio.
TLWP has earned $284,052 in group dividends since 2007.
By committing to workplace safety and helping injured workers return to productive employment, TLWP members improve their chances of qualifying for future dividends.*
In addition to potential dividends, TLWP members get:
- a discount on their workers’ compensation premium
- access to free, industry-specific safety materials, including online videos, pamphlets and DVDs
TLWP is open to qualifying loggers, sawmills and most forms of wood products manufacturing. Any licensed Texas agent can submit qualifying clients for consideration in the group. For more information, visit texasmutual.com/agents/pr_tlw.shtm.
*Past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.
Texas Mutual Awards $300K in Safety Education Grants
September 7, 2010 - Texas Mutual Insurance Company has awarded a combined $300,000 in grants to Kilgore College, Midland College and College of the Mainland in Texas City. The grants will fund free workplace safety courses for employers, employees and the general public.
Texas Mutual has awarded a combined $1.8 million in safety education grants since 1999. In addition, nearly 20,000 students have attended free safety courses at the three colleges over the past 11 years.
“Texas Mutual has been very generous, and the benefit to Midland and surrounding communities is tremendous,” said Midland College President Steve Thomas, Ph.D. “Each person who has participated in the program made possible by this partnership between Texas Mutual and Midland College has used the free classes to learn how to make their workplaces safer.”
In addition to the safety grants, Texas Mutual hosts free workers’ compensation workshops across the state. The workshops include a presentation by a Texas Mutual safety professional.
The grants and workshops are part of the company’s ongoing commitment to preventing workplace accidents.
“On-the-job injuries carry monetary and, more importantly, human costs,” said Ron Wright, Texas Mutual Insurance Company president. “As the state’s leading provider of workers’ compensation insurance, we take seriously our responsibility to promote safe workplaces. Any time we have the opportunity to help prevent accidents in the workplace through training and education, we consider it a sound investment.”
Sign Association Group Earns $93K Texas Mutual Dividend
September 3, 2010 - The Texas Sign Association (TSA) group discount program has earned a $92,638 workers’ compensation dividend from Texas Mutual Insurance Company. The dividend was based largely on the group’s workplace safety record.
The TSA group discount program has earned $273,275 in group dividends since 2006.
By committing to workplace safety and helping injured workers return to productive employment, group members improve their chances of qualifying for future dividends.*
In addition to potential dividends, members get a discount on their workers’ compensation premium, and access to free industry-specific safety materials, including online videos, pamphlets and DVDs.
The TSA group discount program is open to qualifying companies who manufacture, erect, install, repair or distribute on-premise sign products. Employers who are interested in joining the group should contact their insurance agent or visit www.tsa-compgroup.org.
*Past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.
CompGroup AGC Earns $1.4M Texas Mutual Dividend
September 1, 2010 - Texas Mutual Insurance Company announced a $1,350,293 workers’ compensation dividend to the CompGroup AGC Safety Group today. The dividend was based largely on the group’s premium volume and loss ratio.
CompGroup AGC has earned $14,810,548 in group dividends since 2002.
The Texas construction industry added 4,300 jobs in July, second to New York. The industry’s growth mirrors the national picture, which saw 26 states add construction jobs in July, compared with 19 in June.
Still, construction jobs in Texas are down 4.3 percent since July 2009, and The Associated General Contractors of America predicts modest growth going forward.
“The CompGroup AGC is pleased to pay this dividend to their members,” said CompGroup AGC President George Cumming. “The dividend will help reduce the cost of construction, promoting additional work in the future.”
In addition to potential dividends, CompGroup AGC members get:
- A discount on their workers’ compensation premium
- Access to free, industry-specific safety materials, including online videos, pamphlets, DVDs and a written safety plan
Any licensed Texas agent can submit qualifying clients for consideration in the CompGroup AGC. For more information, visit compgroupagc.org.
*Past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.
Texas Mutual Announces Workers’ Comp Fraud Conviction
August 16, 2010 - Texas Mutual Insurance Company reported today that a Travis County district court sentenced Martin DeLaRosa of Denton, Texas on workers’ compensation fraud-related charges. DeLaRosa was sentenced to brief jail time and ordered to repay $1,647 in benefits to Texas Mutual.
DeLaRosa reported a job-related injury while working as a truck driver for Texas Environmental Management of Justin, Texas. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.
Meanwhile, Texas Mutual uncovered evidence that DeLaRosa was working as a car salesman for a Denton car dealership while receiving income benefits.
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.
Doctor and Daughter Indicted on Felony Workers’ Compensation Fraud Charges
August 11, 2010 - Texas Mutual Insurance Company announced today that a Travis County grand jury indicted Howard T. Douglas, III M.D. of Hurst; his daughter, Barbara A. Douglas of Denton; and her company, Western Medical Evaluators, on felony workers’ compensation fraud-related charges. The indictments were the results of an investigation conducted by Texas Mutual.
Western Medical Evaluators provided functional capacity evaluations to injured workers in Texas. The indictments allege that between February 2007 and July 2008, Douglas, his daughter, and Western Medical overbilled Texas Mutual for the time taken to perform evaluations.
The Western Medical Evaluators investigation was part of the Texas Mutual zero tolerance for fraud policy. Texas Mutual maintains three teams of investigators permanently assigned to investigate every report of suspected fraud.
Note: A grand jury indictment is a formal accusation - not a conviction - of a criminal conduct.
Groups Earn Combined $840K in Dividends From Texas Mutual
August 3, 2010 - Texas Mutual Insurance Company announced today that four Safety Groups have earned a combined $839,151 in workers’ compensation dividends. The dividends were based largely on each group’s premium volume and loss ratio.
The dividend amounts for each group were: Texas Apartment Association, $324,894; Social Services Agencies of Texas, $273,876; Lone Star Energy, $174,925; Emergency Service Organization, $65,456.
Group dividends are separate from the $100 million in individual policyholder dividends Texas Mutual announced last week. Many Safety Group members qualified for dividends under both plans.
By committing to workplace safety and helping injured workers return to productive employment, Safety Group members improve their chances of qualifying for future dividends.*
In addition to potential dividends, group members get a discount on their workers’ compensation premium. They also have access to free industry-specific safety materials, including online videos, pamphlets, DVDs and a written safety plan.
Any licensed Texas agent can submit qualifying clients for consideration in these groups. For more information, visit texasmutual.com/agents/group.shtm.
*Past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.
Construction Group Earns $1.5M Texas Mutual Dividend
July 30, 2010 - Texas Mutual Insurance Company announced a $1,518,727 workers’ compensation dividend to the Texas Construction Association (TCA) Safety Group today. The dividend was based largely on the group’s premium volume and loss ratio.
TCA has earned $8,606,041 in group dividends since 2005.
By committing to workplace safety and helping injured workers return to productive employment, TCA members improve their chances of qualifying for future dividends.*
In addition to potential dividends, TCA members get a discount on their workers’ compensation premium. They also have access to free industry-specific safety materials, including online videos, pamphlets, DVDs and a written safety plan.
Any licensed Texas agent can submit qualifying clients for consideration in TCA.
*Past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.
Court Orders Employer to Repay $104K to Texas Mutual
July 29, 2010 - Texas Mutual Insurance Company announced today that a Travis County district court sentenced Cheryl Bussey of Mansfield, Texas on workers’ compensation fraud-related charges. The court sentenced Bussey to 10 years’ deferred adjudication and ordered to her repay $103,851 to Texas Mutual.
Bussey was the owner of Trans X Corp, a temporary employment agency in Arlington, Texas. Bussey was involved in a scheme to conceal the number of employees and annual payroll of Trans X Corp from Texas Mutual.
Because workers’ compensation insurance premium is based in part on payroll, such a scheme results in a business paying less premium than it actually owes. By paying less premium, an employer can gain an unfair advantage over competitors.
Texas Mutual Pays $100M in Policyholder Dividends
July 28, 2010 - Today, Texas Mutual Insurance Company began distributing $100 million in workers’ compensation dividends among approximately 38,000 policyholders. Dividends reward loyal policyholders who share Texas Mutual’s commitment to workplace safety.
Texas Mutual has paid $850 million in dividends during the past 12 years.
“We have a permanent, vested interest in helping Texas businesses thrive,” said Bob Barnes, chairman of the Texas Mutual board of directors. “In 1999, we were thrilled to pay our first dividend - $25 million. Today, that number has grown to $100 million. Our policyholders will use those funds to expand their businesses, create jobs, pay skilled employees and improve their safety programs.”
The amount of each qualifying policyholder’s dividend check will be based largely on its loyalty, premium size and workplace safety record.
Texas Mutual offers free services to help policyholders improve their safety programs. Employers can visit the Safety Resource Center at texasmutual.com to watch streaming videos on a variety of safety topics, evaluate their safety programs, correct the root causes of accidents, and get training materials from the multimedia resource library. The company also offers free workshops that feature presentations by Texas Mutual safety professionals.
This year’s dividend distribution comes as the economy continues to climb out of the worst slump since the Great Depression. Texas Mutual President Ron Wright said that the company’s 12th consecutive dividend is a sign of its ongoing financial stability.
“Texas Mutual’s strong customer retention, conservative investment philosophy and commitment to controlling our costs have helped us weather the recession,” said Wright. “We have not been immune to its effects, but we remain well-positioned to keep our promises to our customers long into the future.”
Texas Mutual notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends.
Texas Mutual Announces Claimant Fraud Conviction, Indictments
July 22, 2010 - Texas Mutual Insurance Company reported today that a Travis County district court sentenced Bobby Phifer of Greenville, Texas on workers’ compensation fraud-related charges. Phifer was sentenced to six months in jail.
Phifer reported a job-related injury while working as a laborer for JC2DC2 Enterprises of Austin. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.
Meanwhile, Texas Mutual uncovered evidence that Phifer was working as a general laborer for multiple staffing services while receiving income benefits.
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.
In other double-dipping news
Travis County grand juries indicted two claimants, in separate cases, on workers’ compensation fraud-related charges.
Thomas Mikulenka of League City, Texas and Chindra Michael of Silsbee, Texas allegedly collected $23,493 and $3,437 in benefits, respectively, from Texas Mutual that they were not entitled to.
Texas Mutual notes that a grand jury indictment is a formal accusation, not a conviction, of criminal conduct.
TxOGA Earns $3.5M Texas Mutual Dividend
July 16, 2010 - Texas Mutual Insurance Company announced a $3,566,002 dividend to the Texas Oil & Gas Association (TxOGA) workers' compensation Safety Group today. The dividend was based largely on the group’s premium volume and loss ratio.
TxOGA has earned $16 million in group dividends since 2001.
By committing to workplace safety and helping injured workers return to productive employment, TxOGA members improve their chances of qualifying for future dividends.*
In addition to potential dividends, TxOGA members get a discount on their workers’ compensation premium. They also have access to free industry-specific safety materials, including online videos, pamphlets, DVDs and a written safety plan.
Any licensed Texas agent can submit qualifying clients for consideration in TxOGA. For more information, visit texasmutual.com/agents/pr_txoga.shtm.
*Past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.
Texas Mutual Insurance Company Urges
Worker Safety During Gulf Shore Cleanup
July 15, 2010 - Now in its third month, the Gulf Coast oil spill has created many safety hazards for wildlife and for people involved in cleanup efforts. Texas Mutual Insurance Company, the state’s leading provider of workers’ compensation insurance, urges employers and employees helping out with the oil spill to take extra precautions during these efforts.
The April 2010 Gulf of Mexico oil spill released crude oil from the explosion of an off-shore drilling rig. During an oil spill cleanup, workers may encounter many types of crude oil—including fresh and weathered—which contain carcinogenic volatile aromatic compounds, such as benzene, toluene and naphthalene. The heavy and medium parts of the weathered oil are generally the focus of any cleanup.
“We commend these workers who are involved in the oil spill cleanup in the Gulf,” said Ron Wright, president of Texas Mutual. “But we also hope that they continue this process with their own safety in mind. It’s a job that presents many hazards, and we want to be sure they are aware of on-the-job dangers.”
Being aware of potential safety hazards will help workers know what to watch for during the cleanup process. There are a number of hazards employees and employers should be aware of during shoreline and vessel operations, including:
- Heat stress
- Sunburn and sun poisoning
- Skin and eye irritation or rashes from contact with “weathered oil”
- Cuts and lacerations
- Being hit by earthmoving equipment
- Bites from snakes, fire ants, mosquitoes, rodents and alligators
- Noise
- Lightning and severe weather
- Drowning
Because of the potential dangers posed by oil spill response and cleanup, it is important for workers to also receive the proper equipment and training for each job they will be expected to perform.
The following are examples of safe work practices and personal protective equipment that should be provided to each worker:
- Workers should be trained for each duty they are expected to perform, and in a language they understand.
- Rest breaks should be provided throughout a work shift to help control heat stress.
- Buckets, brushes, water and soap should be available, along with instructions about how to clean oily protective equipment before removing it.
- For jobs that involve contact with oil, such as removing debris along the shoreline, employers need to provide workers with work gloves.
- For jobs involving oil-contaminated debris and those involving contact with oil or other chemicals, employers need to provide additional protective equipment, such as oil- or chemical-resistant gloves, boots and overalls.
- For jobs involving work on vessels, docks or other areas with potential drowning hazards, employers need to provide life jackets.
“Worker safety has always been our top priority, and we know that education on safety hazards and proper practices are a part of that,” said Wright. “It’s a tough job that not a lot of people will line up for, but these workers have. We all owe them our sincere gratitude for their cleanup efforts.”
For more information about safety practices related to an oil spill, click here.
Home Builders Group Earns Third Texas Mutual Dividend
July 1, 2010 - Texas Mutual Insurance Company announced a $122,694 dividend to the Texas Home Builders (THB) Safety Group today. The group’s third consecutive dividend was based largely on its premium volume and loss ratio.
THB has earned $287,461 in dividends since 2008.
By committing to workplace safety and helping injured workers return to productive employment, THB members improve their chances of qualifying for future dividends.*
In addition to potential dividends, THB members get a discount on their workers’ compensation premium. They also have access to free industry-specific safety materials, including online videos, pamphlets, videos, DVDs and a written safety plan.
Any licensed Texas agent can submit qualifying clients for consideration in THB. For more information, visit texasmutual.com/agents/pr_thb.shtm.
*Past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.