September 17, 2024
Help employees recognize and report fraud with new posters
Workers’ compensation fraud hurts employers and the insurance system by raising costs over time. At Texas Mutual, we have a zero-tolerance approach and are committed to protecting businesses from the cost of fraud. Our fraud team investigates all signs of fraud and abuse and works hard to stop bad actors from taking advantage of the system.
As an employer, you can help us take a proactive approach to identifying fraud by educating your management team and employees on common red flags. In fact, increasing awareness could result not only in an earlier detection of fraud, but also reduced claim costs. To keep common signs top of mind, we’ve created new posters with information on recognizing and reporting three types of workers’ compensation fraud.
These posters are available here as PDFs, so they can easily be downloaded, shared and printed. If you are a Texas Mutual policyholder and you’d like 11 x 17 posters mailed to your workplace, email fraudstoppers@texasmutual.com with the type and quantity.
Claimant fraud
Claimant fraud involves an employee who is receiving workers’ compensation benefits for an injury or illness. Fraud happens when an employee fakes or exaggerates an injury, collects income replacement benefits for an injury that was not work-related or continues to collect benefits after returning to work.
Download the claimant fraud poster (183 KB).
Health care provider fraud
Health care provider fraud can occur when medical offices use unlicensed providers, overbill Texas Mutual for services, bill us incorrectly or provide unnecessary treatments, supplies or tests. Other providers in the workers’ compensation system, such as claimant attorneys and pharmacies can also overbill for services or make unsolicited calls to injured employees.
Download the health care fraud poster (158 KB).
Premium fraud
Premium fraud can be initiated by policyholders or agents when they intentionally provide misleading or false information when applying for a businesses’ workers’ compensation policy, within the policy period or during a final audit. Fraud is committed when they underreport payroll, misrepresent the type of employees or work performed or create a new company to improve its safety record.
Download the premium fraud poster (187 KB).
Fight back against workers’ compensation fraud in your business by reporting any signs to Texas Mutual. We’re grateful for your partnership and are here to help you protect your business. To report suspected fraud, you can notify your adjuster or contact our fraud team directly at fraudstoppers@texasmutual.com or (800) 488-4488.