Forklift Operator Indicted for Workers’ Comp Fraud
June 26, 2006 - Texas Mutual Insurance Company reported today that the Parker County grand jury indicted David Ray DeRusha on workers’ compensation fraud-related charges. DeRusha allegedly collected $9,288 in workers’ compensation benefits he was not entitled to.
DeRusha reported a job-related injury while working as a forklift operator for Smith Temporaries, headquartered in Fort Worth. His doctor placed him in off-work status, and Texas Mutual Insurance Company began paying him workers’ comp benefits.
Meanwhile, Texas Mutual Insurance Company uncovered evidence that DeRusha was working as a warehouse worker for another employer while he collected benefits. State law requires injured workers to contact their workers’ comp insurance carrier when they return to work.
The DeRusha investigation is part of the Texas Mutual® “zero tolerance for fraud” policy. Texas Mutual Insurance Company 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 criminal conduct.
Tip Results in Truck Driver’s Prison Term
June 19, 2006 - Texas Mutual Insurance Company reported today that Orville Ray Anderson of Amarillo pleaded guilty to workers’ compensation fraud-related charges. The Randall County 181st District Court sentenced Anderson to a one-year prison term.
Anderson reported a job-related injury while working as a truck driver for Golden Spread Redi-Mix. His doctor placed him in off-work status, and Texas Mutual Insurance Company began paying him workers’ comp income benefits.
Meanwhile, Texas Mutual Insurance Company received an anonymous tip on its Fraud StoppersSM hotline that Anderson was working for another employer while he collected benefits. The company opened an investigation and uncovered evidence supporting the tip. State law requires injured workers to contact their workers’ comp insurance carrier when they return to work.
The Anderson investigation was part of the Texas Mutual® “zero tolerance for fraud” policy. Texas Mutual Insurance Company maintains three teams of investigators permanently assigned to investigate every report of suspected fraud.
Texas Mutual to Pay a Record $100 Million in Dividends May 31, 2006 - Approximately 34,000 Texas employers will receive a share of approximately $100 million in dividends from Texas Mutual Insurance Company. This marks the largest dividend payout in the company’s history. The Texas Mutual® board of directors approved the company’s 2006 $25 million individual dividend plan, which includes an annual component and a retention component. The annual component is for qualifying policyholders with policies that expired in 2005. The retention component rewards qualifying policyholders for up to five consecutive years of low claim loss experience, ending with the policy that expired last year. The company is also awarding a $25 million special dividend and a $50 million anniversary dividend. The special dividend is a discretionary award based on the company’s exceptional financial results in 2005. The anniversary dividend is in celebration of the company’s 15 years of service to Texas businesses. “Texas Mutual Insurance Company has forged strong relationships with Texas employers, which have allowed the company to enjoy remarkable long-term success,” said Texas Mutual® Chairman Martin Young Jr. “These dividends are part of our long-term commitment to help Texas businesses build for the future. The $50 million anniversary dividend is a unique recognition of our 15 years of service and a special thank you to our policyholders who have contributed to that success.” Texas Mutual® policyholders with policies in force on June 15, 2006 may qualify for the dividend plan, which still requires Texas Department of Insurance approval. State law prohibits policyholders enrolled in the company’s insurer of last resort program from receiving dividends. Chairman Young also noted that individual dividends are separate from the company’s purchasing group dividend programs. The company paid over $6 million in dividends to its purchasing groups last year. Over the past eight years, Texas Mutual Insurance Company has declared over $320 million in dividends to qualifying policyholders. State law prohibits insurance companies from guaranteeing annual dividends; however, Mr. Young said, “Our philosophy is to share the company’s financial success with our good customers.” Grand Jury Indicts Two for Workers’ Comp Fraud May 23, 2006 - Texas Mutual Insurance Company reports that, in unrelated cases, the Travis County grand jury indicted Carlos Torres and Shantel Babineaux on workers’ compensation fraud-related charges. Both workers were allegedly double-dipping, a term investigators use for claimants who collect workers’ comp income benefits by saying they are unable to work while they are actively employed. Torres and Babineaux reported job-related injuries while working for Riteway Service Company, headquartered in San Antonio; and Interfaith Ministries of Greater Houston, respectively. Their doctors placed them in off-work status, and Texas Mutual Insurance Company began paying them workers’ comp benefits. Meanwhile, Texas Mutual Insurance Company uncovered evidence that Torres was working as an air conditioning technician and Babineaux was working as a day care employee while they collected workers’ comp benefits. State law requires injured workers to contact their workers’ comp insurance carrier when they return to work. The indictments allege that Torres collected $6,518 and Babineaux collected $2,745 in benefits they were not entitled to. The Torres and Babineaux investigations are part of the Texas Mutual® “zero tolerance for fraud” policy. Texas Mutual Insurance Company 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 criminal conduct. Texas Mutual Unveils Interactive Safety Tools May 19, 2006 - Texas Mutual Insurance Company announced that it has added interactive tools to its safety resource center at www.texasmutual.com. The new tools help policyholders uncover and correct the root causes of their most common and severe workplace accidents. They also provide written safety programs designed around policyholders’ operations. “The reality is that most of our policyholders, especially small-business owners, don’t have the luxury of a full-time safety coordinator,” said Larry Wagner, vice president of underwriting at Texas Mutual Insurance Company. “These new tools provide a convenient, user-friendly way for employers to take charge of their safety programs, reduce workplace accidents and, ultimately, help control their claim costs.” To use the new tools, Texas Mutual® policyholders should go to the safety resource center and enter their username and password. Policyholders who are not registered to use Texas Mutual® online services should complete the free online application. Texas Mutual Insurance Company is the state’s leading provider of workers’ comp insurance. For more information, visit www.texasmutual.com. Warehouse Worker Indicted for Workers' Comp Fraud May 17, 2006 - Texas Mutual Insurance Company reports that the Travis County grand jury indicted Jose Rubio on workers’ compensation fraud-related charges. Rubio allegedly collected $4,320 in workers’ compensation benefits he was not entitled to. Rubio reported a job-related injury while working for Fluids Management, headquartered in Sour Lake, Texas. His doctor placed him in off-work status, and Texas Mutual Insurance Company began paying him workers’ comp benefits. Meanwhile, Texas Mutual Insurance Company uncovered evidence that Rubio was working as a dispatcher for another employer while he collected benefits. State law requires injured workers to contact their workers’ comp insurance carrier when they return to work. The Rubio investigation is part of the Texas Mutual® “zero tolerance for fraud” policy. Texas Mutual Insurance Company 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 criminal conduct. Two Delivery Drivers Indicted for Workers' Comp Fraud May 16, 2006 - Texas Mutual Insurance Company reports that, in unrelated cases, Texas grand juries indicted two former delivery drivers on workers’ compensation fraud-related charges. Both men were allegedly double-dipping, a term investigators use for claimants who collect workers’ comp income benefits by saying they are unable to work while they are actively employed. Matthew Goeke of Fred, Texas and Cecil Romero Bryant of DeSoto, Texas reported job-related injuries while working as delivery drivers for Silver Eagle Distributors and Ashley Furniture, respectively. Their doctors placed them in off-work status, and Texas Mutual Insurance Company began paying them workers’ comp benefits. Meanwhile, Texas Mutual Insurance Company uncovered evidence that Goeke was working as an investment representative and Bryant was working as a mechanic. State law requires injured workers to contact their workers’ comp insurance carrier when they return to work. Texas Mutual Insurance Company presented Goeke’s case to the Travis County grand jury and Bryant’s case to the Dallas County grand jury. The indictments allege that Goeke collected $14,039 and Bryant collected $11,814 in benefits they were not entitled to. The Goeke and Bryant investigations are part of the Texas Mutual® “zero tolerance for fraud” policy. Texas Mutual Insurance Company 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 criminal conduct. Second Professional Football Player May 15, 2006 - Texas Mutual Insurance Company reports that the Dallas County grand jury indicted Kerry Linnear on workers’ compensation fraud-related charges. Linnear allegedly collected $2,627 in workers’ comp benefits he was not entitled to. Linnear reported a job-related injury while playing professional arena football in the Intense Football League, headquartered in Corpus Christi, Texas. His doctor placed him in off-work status, and Texas Mutual Insurance Company began paying him workers’ comp benefits. Meanwhile, Texas Mutual Insurance Company uncovered evidence that Linnear was working while collecting benefits. State law requires injured workers to contact their workers’ comp insurance carrier when they return to work. This is the second Texas Mutual® fraud investigation involving a professional arena football player. On April 12, 2006, the company reported that the Lubbock County grand jury indicted Shaheed Richardson on fraud-related charges. Click here for more information. The Linnear and Richardson investigations are part of the Texas Mutual® “zero tolerance for fraud” policy. Texas Mutual Insurance Company 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 criminal conduct. Texas Mutual Appoints Larry Wagner VP of Underwriting May 4, 2006 - Texas Mutual Insurance Company appointed Larry Wagner as its new vice president of underwriting. Wagner will serve as the company’s chief underwriting officer and oversee its loss prevention efforts. Wagner has 30 years of underwriting experience with a focus on workers' compensation and commercial property/casualty insurance. His resume includes five years as vice president of underwriting for General Fire & Casualty Company. He has also developed strategic plans for carriers such as SAFECO Insurance Companies, Royal Insurance Company and Kemper National Insurance Companies. “Over 45,000 employers count on Texas Mutual Insurance Company for competitive pricing and effective safety services,” said Texas Mutual® President Russ Oliver. “Larry’s extensive experience will help us continue to deliver top-tier service that our customers deserve.” Texas Mutual Insurance Company is the state’s leading workers’ comp insurance provider, with offices in Austin, Houston, Dallas and Lubbock. Professional Football Player April 12, 2006 - Texas Mutual Insurance Company reported today that the Lubbock County grand jury indicted Shaheed Richardson on workers’ compensation fraud-related charges. Richardson allegedly collected $1,534 in workers’ compensation benefits he was not entitled to receive. Richardson reported a job-related injury while playing professional arena football for the Amarillo Dusters. His doctor placed him in off-work status, and Texas Mutual Insurance Company began paying him workers’ compensation income benefits. Meanwhile, Texas Mutual Insurance Company uncovered evidence that Richardson played professional arena football in a different league while he collected benefits. State law requires injured workers to contact their workers’ compensation insurance carrier when they return to work. The Richardson investigation was part of the Texas Mutual® “zero tolerance for fraud” policy. Texas Mutual Insurance Company 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 criminal conduct. Doctor Indicted on Felony April 10, 2006 - A Travis County grand jury indicted Ihsan Shanti, M.D. of Houston, and his health care facility, Shanti Pain & Wellness Clinic, on felony workers’ compensation fraud-related charges. The indictments were the result of investigations conducted by Texas Mutual Insurance Company and the State Office of Risk Management. Shanti Pain & Wellness Clinic provides medical services to injured workers in Texas. The indictments allege that between January 2003 and March 2006, Shanti and his clinic over-billed Texas Mutual Insurance Company and the State Office of Risk Management for pain management services in excess of hours actually attended by patients. The Texas Legislature created Texas Mutual Insurance Company to ensure the availability and affordability of workers’ compensation coverage. The company is the state’s insurer of last resort for businesses that are unable to find coverage elsewhere. The State Office of Risk Management administers the State Employees Workers’ Compensation Program for state agencies and their employees. The Shanti investigation was part of the Texas Mutual® “zero tolerance for fraud” policy. Texas Mutual Insurance Company 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 criminal conduct.
Money Includes Special and Anniversary Dividends
Indicted for Workers' Comp Fraud
Indicted for Workers' Comp Fraud
Workers' Comp Fraud Charges