| Summer 2008
Fraud-Fighting Corner
By Tim Riley • Manager of Special Investigations
Texas Mutual is doing its part to stop workers' compensation fraud. In 2007, our investigators uncovered $8.6 million in fraud. That is:
- $720,000 per month
- $23,671 per day
- $986 per hour
- $16 per minute
The following cases are part of our zero tolerance for fraud policy.
Fraud schemes cost business owners $133K
SENTENCED— Jerry Don Calicutt of Arp and Sue Tennison of Lewisville were ordered to pay a combined $133,212 in fines and restitution to Texas Mutual Insurance Company as a result of workers' compensation premium fraud schemes.
Calicutt, owner of ZIPCO Services Inc., and Tennison, owner of All Metroplex Landscape Services Inc., misrepresented the size of their payrolls to Texas Mutual.
Because workers' comp premium is based in part on payroll, the schemes allowed the employers to lower their premiums and gain an unfair advantage over their honest competitors.
Claimant leaves Texas, can't evade fraud team
SENTENCED— A Travis County district court sentenced Frank Tisdale of Los Fresnos on workers' compensation fraud-related charges.
The court sentenced Tisdale to five years' probation. It also ordered him to pay $6,849 in restitution to Texas Mutual Insurance Company, $1,380 in extradition costs necessary to return him to Texas from Georgia for prosecution, and a $300 fine.
Tisdale reported a job-related injury while working as a market clerk for Richann Ltd., a grocery store in McAllen. He claimed he was unable to work as a result of the injuries, and Texas Mutual began paying him disability income benefits.
Meanwhile, Texas Mutual uncovered evidence that Tisdale was working as a butcher in a Georgia grocery store while receiving disability 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.
In other claimant fraud news
SENTENCED— A Travis County court sentenced Donald Miller of Yoakum to one year of probation. It also ordered him to pay $2,132 in restitution to Texas Mutual, plus a $500 fine.
SENTENCED— A Travis County district court sentenced Hector Cuellar of Los Fresnos to two years' deferred adjudication. It also ordered him to pay $2,775 in restitution to Texas Mutual and complete 100 hours of community service.
SENTENCED— A Travis County district court ordered Charlotte Blair, formerly of Grand Prairie, to pay $3,088 in restitution to Texas Mutual, plus court costs.
Fraud-fighting resources on the Web
Visit the Fighting Fraud section to read our fraud-fighting success stories, report suspected fraud, learn the red flags for fraud and get a
Fraud StoppersSM poster in English and Spanish.
COMPNEWS - Summer 2008
Texas Mutual Pays $150M in Policyholder Dividends
Ten Things You Should Know About Dividends
Keep Your Employees Well Grounded
Online Injury Reporting Even Easier to Use
President's Message:
Dividends: What do they mean to you?
You Need to Know:
Control your claim costs, improve your productivity
Sunset Commission reviews TDI
State to release network report card
DWC to implement new ASC fee guideline
You need to know more
Fraud-Fighting Corner
Important Reminders