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Zero Fraud
Fraud steals money from the workers’ compensation system and honest employers like you. Texas Mutual Insurance Company works hard to stamp it out, but we need your help.
Fraud Is
Fraud is lying for financial gain. Claimant fraud is the most common type of fraud. Claimant fraud happens when workers:
- Fake or exaggerate injuries
- Collect benefits for injuries that were not work-related
- Double-dip, or continue to collect benefits after returning to work
- Engage in activities that are inconsistent with their injuries
Fraud Is Not
Delayed recovery. Some injured workers take longer than expected
to recover and return to work. This is not fraud. Injured workers do
not have to return to the job until their treating doctor releases them.
Recreational activities. Injured workers can participate in
recreational activities that are consistent with their medical
restrictions. Suspicion without evidence. To prove fraud, Texas Mutual Insurance Company must have evidence that the injured worker knowingly collected benefits he or she was not entitled to. Evidence includes medical records, witness testimony, business records and surveillance video.
Our Role in Fighting Fraud
Unlike some insurance carriers, Texas Mutual Insurance Company does not accept fraud as a cost of doing business. We dedicate the resources necessary to fight it. Our three teams of seasoned in-house investigators prevent millions in fraud every year. Fighting Fraud
Your Role in Fighting Fraud
Educate your employees. Teach them that when they commit fraud, they don’t just cheat the insurance carrier; they cheat their employer and their co-workers. Make it clear that the company has zero tolerance for fraud.
Red Flags for Fraud
Contact us immediately if you identify two or more of
these indicators in a claim:
- Tip from a credible source
- New or disgruntled worker
- No witness to alleged injury
- Inconsistent or illogical description of incident
- injured worker difficult to contact
- Injured worker acts upset when contacted
- Suspicious injury that happens on Monday or Friday
We will maintain your confidentiality whenever possible.
Texas-National Insurance Agency - Workers' Comp Insurance - Serving all of TX, DFW and Texoma - 972-377-9700 ext. 104
Texas-National Insurance
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