 |
|
Project Manager Indicted for Workers’ Comp Fraud September 28, 2006 - Texas Mutual Insurance Company reported today that a Travis County grand jury indicted Higgie Highsmith of San Antonio on workers’ compensation fraud-related charges. Highsmith allegedly collected $7,112 in workers’ comp benefits he was not entitled to. Highsmith reported a job-related injury while working for Lakequest Enterprises, headquartered in San Antonio. 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 Highsmith was working as a project manager with another employer while he collected benefits. State law requires injured workers to contact their workers’ comp insurance carrier when they return to work. The Highsmith investigation is part of Texas Mutual Insurance Company’s “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. CompGroup AGC Earns Largest September 15, 2006 - Texas Mutual Insurance Company announced a $2,672,136 dividend to the CompGroup AGC purchasing group today. The announcement marked the largest single group dividend payout in Texas Mutual Insurance Company’s history. The Texas Department of Insurance (TDI) allows employers in similar industries to reduce their workers’ comp premiums by purchasing their coverage as a group. The CompGroup AGC is a TDI-approved purchasing group that is open to most general and specialty contractors. The group’s premium volume and loss ratio were factors in determining its dividend. “Safety is ingrained in everything we do,” said Julie Schatz of Roberts & Crow Inc., the CompGroup AGC administrator. “By controlling our group’s loss ratio, we’ve helped our members earn on average more than 10 percent of their premium back in dividends. We think that speaks volumes about our members’ commitment to safety.” For more information about the CompGroup AGC, contact Julie Schatz of Roberts & Crow Inc. by email at jkschatz@airmail.net or by phone at (800) 406-9614. For more information about other Texas Mutual® purchasing groups, click here. Texas Mutual Insurance Company is the state’s leading writer of purchasing groups. The company notes that past dividends are not a guarantee of future dividends, and TDI must approve all dividends. Texas Mutual Pays $773K Dividend September 15, 2006 - Texas Mutual Insurance Company announced a group dividend of $773,720 to the Lone Star Auto Dealers Association (LSA) purchasing group today. LSA has earned over $1.2 million in group dividends since 2002. Group dividends are separate from the approximately $100 million in individual dividends that Texas Mutual Insurance Company awarded to nearly 34,000 qualifying policyholders in July. Some LSA members may receive a share of both dividends. Texas Mutual Insurance Company evaluates each purchasing group’s premium volume and loss ratio to determine which groups qualify for dividends. Last year, the company paid over $6.7 million in group dividends. So far in 2006, it has paid approximately $6.9 million. The Wicker-Parker Insurance Agency of Abilene established the group, which is open to new car, truck, RV, boat and motorcycle dealerships in Texas. Any licensed Texas insurance agent can place a qualifying client into the group, with approval from the underwriter. For more information about the Lone Star Auto Dealers Association purchasing group, go to www.lonestarautodealers.com, or contact Brad Wicker or Judy Parker at wicker-parker@nts-online.net or (325) 437-0677. For more information on other purchasing groups, click here. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividend plans. Texas Mutual Expands Network Service Areas August 21, 2006 - Texas Mutual Insurance Company announced today that the Texas Department of Insurance has approved the expansion of its Texas Star NetworkSM option. With the expansion, the network is now available to approximately 85 percent of the company’s policyholders. Texas Mutual will begin to offer the workers’ compensation health care network option to policyholders in the additional areas in the next few weeks. “This workers’ compensation health care network is an exciting new benefit of Texas Mutual® coverage,” said Lisa Corless, senior vice president of claim and information services at Texas Mutual Insurance Company. “We want to make it available to as many of our policyholders as possible.” Texas Mutual Insurance Company partnered with Concentra to launch the workers’ compensation health care network option this spring. The network’s goal is to improve the quality of care for injured workers and control medical costs. Policyholders who are eligible for and choose this option have access to occupational health care providers and case management services that help injured workers get well and back on the job. Most also receive a 12 percent annual network premium discount. Texas Mutual Insurance Company is the state’s leading provider of workers’ compensation insurance. To learn more about the Texas Star NetworkSM option, click here. Texas Mutual Fills Key August 11, 2006 - Texas Mutual Insurance Company has promoted Cecily Gallagher to senior vice president of underwriting and actuarial services and Mitch Walsh to vice president of underwriting systems. The company is Texas’ leading workers’ compensation insurance provider and insurer of last resort. Gallagher will oversee the company’s corporate and regional underwriting, loss prevention and marketing efforts as well as its actuarial function. She joined Texas Mutual Insurance Company as vice president - actuary in 1998 and was promoted to senior vice president of actuarial and business systems planning in 2005. She has played a major role in developing the company’s pricing strategy and managing its reserving responsibilities. Walsh will facilitate underwriting process standardization, automation and training. He formerly served as a senior manager in the company’s information technology division. His responsibilities included directing business systems automation projects for the underwriting/loss prevention and premium audit/premium recovery divisions. For more information about Texas Mutual Insurance Company, click here. Oil Rig Worker Indicted for Workers’ Comp Fraud August 9, 2006 - Texas Mutual Insurance Company reported today that the Brown County grand jury indicted Chris McCall on workers’ compensation fraud-related charges. McCall allegedly collected $8,283 in workers’ compensation benefits he was not entitled to. McCall reported a job-related injury while working for United Energex Inc., headquartered in Cisco, Texas. His doctor placed him in off-work status, and Texas Mutual Insurance Company began paying him workers’ compensation benefits. Meanwhile, Texas Mutual Insurance Company uncovered evidence that McCall was working as a full-time sales associate with another employer while he collected benefits. State law requires injured workers to contact their workers’ compensation insurance carrier when they return to work. The McCall 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. Alliance KMC Pleads No Contest August 8, 2006 - Texas Mutual Insurance Company reported today that Alliance KMC Inc. pleaded no contest to workers’ compensation fraud-related charges. The Travis County 331st District Court ordered the health care provider to pay $300,000 in restitution to Texas Mutual Insurance Company and pay a $2,500 fine. Texas Mutual alleged that Alliance KMC Inc. defrauded Texas Mutual by upcoding physical therapy services. Upcoding occurs when a provider bills for a higher-level service than was actually provided. The Alliance KMC 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. Texas Mutual Announces August 7, 2006 - Texas Mutual Insurance Company announced its newest workers’ compensation purchasing group today: Texas Association of Manufacturers (TAM). The group provides qualifying members with a competitive option for workers’ comp coverage. The Texas Department of Insurance allows employers in similar businesses to reduce their workers’ comp premiums by purchasing their coverage as a group. Texas Mutual Insurance Company applies the same premium discount to each TAM group member, regardless of its individual premium size. Members can adopt a safety plan developed specifically for their industry, and they are eligible to participate in the Texas Mutual® individual and group dividend programs.* TAM is open to most manufacturing classification codes. Any licensed Texas insurance agent can place qualifying clients into the group, with the underwriter’s approval. For more information about Texas Mutual® purchasing groups, click here. *Past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Lone Star Energy Earns Texas Mutual Dividend August 4, 2006 - Texas Mutual Insurance Company announced a group dividend to the Lone Star Energy (LSE) purchasing group today totaling $46,397. Group dividends are separate from the approximately $100 million in individual dividends that Texas Mutual Insurance Company paid qualifying policyholders this year. Some LSE members may receive dividends under both programs. Texas Mutual Insurance Company evaluates each purchasing group’s premium volume and loss ratio in determining which groups qualify for dividends. Last year, the company paid over $6.7 million in group dividends. So far in 2006, it has paid approximately $3.3 million. Any licensed Texas agent can place a qualifying client into the LSE purchasing group, with the underwriter’s approval. For more information on LSE, contact the group’s administrator, Curtis Heptner of CertEssentials, LLC, at curtis@certessentials.com, (940) 397-2771 or (940) 642-2548. For more information about other Texas Mutual® purchasing groups, click here. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Texas Mutual Pays $100 Million July 25, 2006 - Texas Mutual Insurance Company began distributing about $100 million in individual dividends today. Approximately 34,000 policyholders will receive a share of the dividend payout, the largest in company history. “We’re not talking pocket change,” said Kenneth McCown, vice president of Miken Specialties, ltd., a long-time Texas Mutual® policyholder. “These dividends really help offset the cost of our premiums. We’ll put ours right back into safety programs and other areas of our business to build for the future.” Customer loyalty and loss ratio are key factors in determining which policyholders qualify for individual dividends. Policyholders that earn an individual dividend automatically qualify for special and anniversary dividends. The special dividend is the result of Texas Mutual’s exceptional financial results in 2005. The anniversary dividend is in celebration of the company’s 15 years of service to Texas businesses. With these dividends, Texas Mutual Insurance Company has distributed more than $320 million to qualifying policyholders over the past eight years. While the company cannot guarantee future dividends, it is dedicated to sharing its success with policyholders when financial conditions permit. Texas Mutual Insurance Company is the leading writer of workers’ compensation insurance in Texas and the state’s insurer of last resort. State law prohibits policyholders enrolled in the company’s insurer of last resort program from receiving dividends. For more information about Texas Mutual Insurance Company, click here. Texas Mutual Expands Lone Star July 20, 2006 - Texas Mutual Insurance Company has expanded its Lone Star Auto Dealers (LSA) workers’ compensation purchasing group. The group is now open to franchised motorcycle, RV and boat dealerships as well as franchised auto and truck dealerships. Texas law allows employers in similar industries to reduce their workers’ comp premiums by purchasing their coverage as a group. Texas Mutual Insurance Company underwrites the LSA group, and the Wicker-Parker Insurance Agency administers it. LSA is an open group, which means any agent can submit a qualifying client for membership. The classification codes for group membership are 8391 and 8748. Group members get a premium discount based on the group’s premium volume, have access to an industry-specific safety plan, and may participate in the Texas Mutual® individual and group dividend programs. Eligible members can also earn an annual network premium discount by participating in the Texas Star NetworkSM, a workers’ comp health care network option offered by Texas Mutual Insurance Company. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. For more information on LSA and other Texas Mutual®, click here. TSA Earns First Dividend from Texas Mutual July 19, 2006 - Texas Mutual Insurance Company announced a $20,255 dividend to the Texas Sign Association (TSA) Comp Group, Inc. today. The workers’ comp purchasing group, formed in November 2004, earned a dividend in its first year of eligibility. Texas Mutual® purchasing groups are eligible for their first dividend 18 months after their inception date. A group’s premium volume and loss ratio are key components in determining whether it qualifies for a dividend. The greater a group’s volume and the lower its overall loss ratio, the higher its potential dividend percentage. TSA Comp Group members get a premium discount based on the premium volume of the entire group, regardless of their individual premium size. They also have access to a dedicated loss prevention consultant and a safety plan developed specifically for their industry. The group is open to on-premises sign product manufacturers, sign supply distributors and associated sign service providers. Any agent can place a qualifying client in the group, with the underwriter’s approval. For more information about TSA Comp Group and other Texas Mutual® purchasing groups, click here. Purchasing group dividends are separate from the approximately $100 million in individual dividends Texas Mutual Insurance Company will distribute among about 73 percent of its policyholders this summer. Some TSA Comp Group members may qualify for both types of dividends. The company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Texas Mutual Pays $1.7M Dividend to TxOGA Group July 17, 2006 - Texas Mutual Insurance Company announced a $1,789,062 dividend to the Texas Oil and Gas Association (TxOGA) workers’ compensation purchasing group today. TxOGA has received over $3.5 million in Texas Mutual® group dividends since 2001. Purchasing group dividends are separate from the approximately $100 million of individual dividends Texas Mutual Insurance Company will distribute among about 34,000 qualifying policyholders this summer. Some TxOGA group members may earn both types of dividends. “The potential for dividends is one of the attractive things about this program, but it’s certainly not the only one,” said Jim Sierra, master agent for the group. “This group is a great opportunity for TxOGA members to save money on their premiums and improve safety in their workplaces.” TxOGA group members get a premium discount based on the premium volume of the entire group, regardless of their individual premium size. Texas Mutual also provides a dedicated loss prevention consultant and a safety plan developed specifically for the oil and gas industry. Any agent can place a qualifying client in the group, with the underwriter’s approval. For more information about TxOGA and other Texas Mutual® purchasing groups, click here. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Court Orders Business Owner July 12, 2006 - Texas Mutual Insurance Company reported today that Danny Katave of Richardson, Texas pleaded no contest to workers’ compensation fraud-related charges. The Travis County 331st District Court ordered Katave to repay $250,000 to Texas Mutual Insurance Company and pay a $4,000 fine. The court also sentenced Katave to two years’ deferred adjudication. Workers’ comp premium is based in part on payroll. The Texas Mutual® investigation revealed that Katave misrepresented the status of employees as independent subcontractors. Because independent subcontractors are not included in the payroll portion of the premium calculation, the scam allowed Katave to pay a lower premium than he actually owed. The Katave 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. ESO Focuses on Safety, Earns Dividend July 10, 2006 - Texas Mutual Insurance Company announced a $74,311 dividend to the Emergency Services Organization (ESO) workers’ compensation purchasing group today. ESO has received over $334,000 in Texas Mutual® group dividends since 2002. State law allows employers in similar businesses to reduce their workers’ comp premiums by purchasing their coverage as a group. The ESO purchasing group is open to emergency firetruck and ambulance services. Texas Mutual Insurance Company underwrites the group, and Texas/Regnier & Associates administers it. “This is a fairly high-risk industry, and these employers have done a great job of stressing safety to their employees,” said Jack Ogden, senior marketing specialist at Texas Mutual Insurance Company. “With Texas/Regnier & Associates’ guidance, I’m confident this group will continue to grow, improve its safety record and potentially earn more group dividends.” The group’s premium volume and loss ratio are key components in determining whether it qualifies for a dividend. The greater the group’s volume and the lower its overall group loss ratio, the higher its potential dividend percentage. Texas Mutual Insurance Company provides ESO members with a dedicated loss prevention consultant and a safety plan developed for their industry. Group members also get a premium discount based on the group’s premium volume, regardless of their individual premium size. Any agent can place a qualifying client into the group, with the underwriter’s approval. For more information about ESO and other Texas Mutual® purchasing groups, click here. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Texas Mutual Pays $220K Dividend to July 5, 2006 - Texas Mutual Insurance Company announced a $220,430 dividend for the Social Services Agencies of Texas (SSA) purchasing group today. The group dividend is separate from the approximately $100 million in individual dividends that Texas Mutual Insurance Company will pay qualifying policyholders in 2006. Some SSA purchasing group members may receive dividends under both programs. Texas law allows employers in similar industries to save money on their workers’ comp premiums by purchasing their coverage as a group. SSA group members earn a premium discount based on the premium volume of the entire group, and they retain their own experience modifier. They also have access to a Texas Mutual® safety plan developed specifically for their industry. SSA is open to non-profit social services agencies. Any agent can place qualifying clients into the group, with the underwriter’s approval. For more information on Texas Mutual® purchasing groups, click here. Texas Mutual Insurance Company notes that past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends. Texas Mutual Scores $875K Premium Fraud Indictment July 3, 2006 - Texas Mutual Insurance Company reported today that a Travis County grand jury indicted C & D Business Services, Inc., C & D Services, Inc., Donna Iversen, Carol Wiesman and Timothy Carney on workers’ compensation fraud-related charges. The companies and individuals allegedly defrauded Texas Mutual Insurance Company of over $875,000 in premium. C & D Business Services, Inc. and C & D Services, Inc. are temporary employment agencies with offices in the Dallas/Forth Worth area. The indictments allege that between April 11, 2003 and March 31, 2006, the defendants concealed business relationships and payroll records from Texas Mutual Insurance Company. Because workers’ comp premium is based in part on payroll, the scheme allowed the companies to pay less premium than they actually owed. In a related case, a Travis County grand jury indicted Harold Wayne Dennis on perjury charges. Dennis allegedly presented false testimony on matters relating to the investigation of C & D Business Services, Inc., Wiesman and Iversen. The 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. Texas Mutual® is a registered service mark of |
.gif){kind=logo} |
| HOME | CONTACT US | PRIVACY POLICY |