Texas Mutual Insurance Company - Providers of Workers' Comp Insurance

Texas Mutual Earns Accolades for Its Commitment to Being a Healthy Workplace

March 21, 2013 - Texas Mutual Insurance Company recently earned multiple awards for the company"s commitment to improving the health and well-being of its employees. The Austin Business Journal, Houston Business Journal and Dallas Business Journal recently named Texas Mutual a Healthiest Employer for 2013. Texas Mutual also earned the Well Deserved Leadership award from UnitedHealthcare, presented to UnitedHealthcare clients who promote a culture of wellness.

For the Business Journals" awards, Indiana-based Healthiest Employer assessed Texas Mutual, which is headquartered in Austin and has regional offices in Dallas and Houston, on criteria such as culture and leadership commitment, foundational components, strategic planning, communication and marketing, programming and interventions, and reporting and analysis.

Winners will be recognized at Healthiest Employers events in each city and profiled in the respective Business Journal.

UnitedHealthcare evaluated companies across the country for the Well Deserved Leadership award. Companies that earned this recognition had to promote wellness programs, demonstrate that wellness is part of the organization"s business strategy, and use innovative ways to engage employees in their wellness programs. Texas Mutual earned the Leadership award distinction for its sustained wellness program results and ongoing commitment to worksite wellness. Winners will be featured in future UnitedHealthcare communications that highlight program design and outcomes.

"Texas Mutual is proud to receive recognition for its wellness programs, which are a priority for the company," Richard Gergasko, president of Texas Mutual, said. "When employees have access to valuable wellness resources, they lower their risk of experiencing serious health complications, and we see the payoff of a healthy, productive workforce."

Texas Mutual"s employee wellness program includes online health improvement tools, health risk assessments, wellness coaching, fitness centers at each of its locations, onsite flu shots, yoga classes, a walking program, Weight Watchers at Work and wellness incentives.

Yurkovich Rejoins Texas Mutual as SVP of Strategic Planning

March 18, 2013 - Texas Mutual Insurance Company, the state"s leading provider of workers" compensation insurance, announced that Joe Yurkovich has accepted the position of senior vice president of strategic planning.

Yurkovich will work closely with senior management and the board of directors to establish organizational objectives, develop long-range and strategic plans, and identify strengths, weaknesses and business opportunities. He will also collaborate with business units to enhance organizational effectiveness, capacity utilization, operating cost containment, claim strategies and underwriting practices.

A graduate of Duquesne University, Yurkovich brings 35 years of insurance industry experience to Texas Mutual. He most recently served as region president for the Southern Region at SeaBright Insurance Company, where he led a team in building a 13-state territory in the Southern United States. Yurkovich had profit and loss responsibility for the region, with an emphasis on underwriting integrity and profitability, aggressive marketing, key account management and customer satisfaction.

Prior to joining SeaBright, Yurkovich served as senior vice president of underwriting at Texas Mutual. During his six years with the company, he was instrumental in developing many of the underwriting tools still in place today.

Texas Mutual Announces Second Sentencing
In Health Care Provider Fraud Scheme

February 22, 2013 - Texas Mutual Insurance Company announced today that Barbara A. Douglas of Denton pleaded no contest to felony workers" compensation fraud-related charges.

Douglas, her father, Howard T. Douglas, III, M.D., of Hurst and their company, Western Medical Evaluators, were indicted in 2010 on charges that they overbilled Texas Mutual for the time taken to perform functional capacity evaluations.

A Travis County district court sentenced Barbara A. Douglas to 10 years" probation and ordered her to pay $81,368 in restitution to Texas Mutual. The court also ordered Douglas to perform 125 hours of community service and to cease billing, directly or indirectly, for any medical services.

Court Orders Doctor to Repay $98K to Texas Mutual

February 21, 2013 - Texas Mutual Insurance Company announced today that a Travis County district court convicted Howard T. Douglas, III, M.D., of Hurst and his company, Western Medical Evaluators, on felony workers" compensation fraud-related charges.

Western Medical Evaluators, Douglas and his daughter, Barbara A. Douglas, were indicted in 2010 on charges that they overbilled Texas Mutual for the time taken to perform functional capacity evaluations.

Howard Douglas" sentence of 8 years" confinement was suspended, and he was placed on probation for 10 years. Douglas was ordered to pay $98,411 in restitution to Texas Mutual, in addition to a $500 fine, court costs and other fees. Western Medical Evaluators was fined $1,000.

The court also ordered Douglas to report his conviction to the Texas Medical Board and to cease performing or billing for functional capacity evaluations and designated doctor examinations. The court denied Douglas' motion for a new trial.

Ron Wright to Retire as Texas Mutual President and CEO; Richard J. Gergasko Named as Successor

February 5, 2013 - Ron Wright, who has served as president and chief executive officer of Texas Mutual Insurance Co. since 2009, has announced that he will retire. The company"s board of directors announced today that his successor will be Richard J. Gergasko, an insurance professional who most recently has worked with Seattle-based SeaBright Insurance Company.

"It has been an honor to serve Texas Mutual for 16 years," Wright said. "I have been blessed to see Texas Mutual become the most customer- and team-oriented insurance company one could imagine. Leading such a tremendously talented and dedicated team has been an extraordinary experience."

Wright had served as COO of Texas Mutual since 1997 prior to being named CEO.

Gergasko has been president and COO of SeaBright Insurance Company since 2009. He had previously worked as executive vice president of operations for the company from 2003 to 2009. He had a long career in various positions in the workers" compensation insurance industry prior to that. He is a fellow of the Casualty Actuarial Society and a member of the American Academy of Actuaries. He has a bachelor of arts in statistics from Rutgers College.

"Ron leaves big shoes to fill," Gergasko said. "But I"m excited about the opportunity to take the reins from Ron and lead the team that created the best workers" compensation company in the nation. I"m eager to get to know Texas Mutual"s staff, agents, policyholders and board of directors."

"We applaud Ron Wright for his invaluable contribution to this company over many years and wish him the very best in this well-deserved retirement. We welcome Rich Gergasko with great enthusiasm," Bob Barnes, chairman of the Texas Mutual board of directors, said. "Texas Mutual has been and remains in very good hands."

Texas Mutual Awards $300K in Safety Education Grants

February 4, 2013 - 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 near Houston. The grants will continue to fund free workplace safety courses for employers, employees and the general public through the colleges" risk management institutes.

Since 1999, Texas Mutual – the state"s leading provider of workers" compensation insurance – has awarded a combined $3.1 million in safety education grants, and more than 20,000 students have attended free safety courses at the three colleges over the past 14 years.

"We are grateful for the support that Texas Mutual continues to show Kilgore College and this safety institute, which provides a great value for East Texas employers and employees," said Gerald Stanglin, Ed.D., KC Vice President of Instruction. "Since the beginning of our partnership, we knew that the KC Risk Management Institute would be a valuable resource for our community. It has been instrumental in providing safety training for business and industry professionals that helps save lives and prevent injuries on the job."

Courses at the safety institutes include general topics, such as ergonomic safety and OSHA standards, but students may also choose to attend courses tailored to the dominant industries in the Houston, Midland and Kilgore areas.

"Workplace safety education is always a sound investment," said Jo Betsy Norton, vice president of public affairs at Texas Mutual. "These grants, along with other Texas Mutual safety programs, exemplify the company"s ongoing commitment to workplace safety and the prevention of workplace accidents through education. We recognize the value safety education provides to employers ndash; giving them tools to keep their businesses, and more importantly, their employees safe."

For more information about Texas Mutual"s various safety initiatives, visit texasmutual.com.

Court Sentences Texas Woman in Double-Dipping Scam

January 28, 2013 - Texas Mutual Insurance Company reported today that a Travis County district court sentenced Chindra Michael of Silsbee, Texas, on workers" compensation fraud-related charges. Michael was sentenced to four years' deferred adjudication. She was also ordered to pay $3,010 in restitution to Texas Mutual and complete 50 hours of community service.

Michael reported a job-related injury while working as a direct care provider for East Texas Community Services in Silsbee. 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 uncovered evidence that Michael was working as a state prison guard 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.

Texas Mutual Receives Top Honor in DWC"s Insurance Carrier Performance Based Oversight

January 16, 2013 - Texas Mutual Insurance Company was recently named a high performer by the Texas Department of Insurance, Division of Workers" Compensation (DWC) during the DWC"s fourth Insurance Carrier Performance Based Oversight (PBO) assessment.

Insurance carriers were assessed on the timeliness of:

  • Medical bill processing
  • Payment of the initial Temporary Income Benefits (TIBs) check
  • Reporting medical billing data
  • Reporting the initial payment of TIBs to the DWC

"Texas Mutual prides itself on setting the standard in compliance," Ron Wright, president of Texas Mutual, said. "This high-performer designation reflects our employees" hard work and dedication to ensuring the workers" compensation system effectively serves the people of Texas."

As part of the overall compliance plan, the DWC assesses the performance of insurance carriers in meeting the key regulatory goals established by the Commissioner of Workers" Compensation. The key regulatory goals align with the general regulatory goals of the DWC, such as improving workplace safety and return-to-work outcomes, supporting timely payment of benefits, and increasing communications among system participants.

Based on the PBO assessment, insurance carriers are placed into regulatory tiers: poor performers, average performers and consistently high performers. The DWC will focus its regulatory oversight on the poor performers, as well as offer incentives within each tier that promote greater overall compliance and performance.

A total of 110 insurance carriers were reviewed. The assessment deemed 21 commercial insurance carriers as high performers.

For a full list of the assessed insurance carriers and the results, visit the DWC at www.tdi.texas.gov/wc/pbo/pbo.html.

Court Orders Employer to Pay $35K to Texas Mutual

January 9, 2013 - Texas Mutual Insurance Company announced today that Everest Contract Services, LLC of Irving, Texas, pled guilty to workers" compensation fraud-related charges. A Travis County district court ordered the company to pay $35,000 in restitution to Texas Mutual.

Everest Contract Services misrepresented numbers of employees and payroll associated with a related company, Premrock Commercial Drywall Ltd. Co. Premrock Commercial Drywall of Irving, Texas, owned by Timothy Castonguay and Carlos Aguilar, obtained workers" compensation coverage through Texas Mutual from Dec. 26, 2006, to May 14, 2007.

Because workers" compensation insurance premium is based, in part, on payroll, this type of scheme results in an employer being charged a lower premium than it actually owes. By hiding payroll, an employer can gain an unfair advantage over competitors.

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