League City Man Sentenced on Workers’ Comp Fraud

September 21, 2011 - Texas Mutual Insurance Company reported today that a Travis County district court sentenced Thomas Mikulenka of League City, Texas on workers’ compensation fraud-related charges.

The court sentenced Mikulenka to three years’ deferred adjudication and 100 hours of community service. Mikulenka was also ordered to pay $7,221 in restitution to Texas Mutual.

Mikulenka reported a job-related injury while working as an electrician for IGC Construction, Inc. in Houston. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.

Meanwhile, Texas Mutual uncovered evidence that Mikulenka was working as a laborer while receiving 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. Left unchecked, double-dipping and other workers’ comp fraud can lead to higher premiums for all Texas employers.

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Texas Mutual Announces Safety Group for Oil and Gas Industry

September 20, 2011 - Today, Texas Mutual Insurance Company announced a new workers’ compensation safety group: Texas Alliance of Energy Producers (TAEP). The group is open to qualifying businesses in the oil and gas production industry.

Members of the TAEP safety group have access to free, industry-specific workplace safety training materials in the safety resource center at texasmutual.com. They also get a discount on their workers’ compensation premiums, and they participate in Texas Mutual’s individual and group dividend programs.

Any licensed Texas agent can submit qualifying clients for membership in the TAEP safety group. For more information about the group, including eligible class codes, visit texasmutual.com/agents/pr_taep.shtm.

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Texas Mutual Rewards CompGroup AGC with $773K Dividend

September 7, 2011 - Texas Mutual Insurance Company announced a $772,782 dividend to the CompGroup AGC today. The workers’ compensation safety group dividend was based largely on the group’s overall loss ratio.

CompGroup AGC members have shared in $15.5 million in Texas Mutual dividends since 2002.

CompGroup AGC provides a competitively priced source of workers’ compensation insurance for members of the Texas Chapters of the Associated General Contractors of America, Inc.

In addition to potential dividends, CompGroup AGC members get a discount on their workers’ compensation premiums. They also have access to industry-specific workplace safety training materials in the safety resource center at texasmutual.com.

Any licensed Texas agent can submit qualifying clients for consideration in the CompGroup AGC. For more information, including qualifying class codes, visit compgroupagc.org.

Texas Mutual notes that past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.

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Texas Mutual Introduces Safety Group for Houses of Worship

September 1, 2011 - Today, Texas Mutual Insurance Company announced a new workers’ compensation safety group: Texas Church Group. The group is open to qualifying nonprofit, faith-based organizations operating houses of worship, such as churches and synagogues.

Members of the Texas Church Group have access to free, industry-specific workplace safety training materials in the safety resource center at texasmutual.com. They also get a discount on their workers’ compensation premiums, and they participate in Texas Mutual’s individual and group dividend programs.

Any licensed Texas agent can submit qualifying clients for membership in the Texas Church Group. For more information, about the group, including eligible class codes, visit texasmutual.com/agents/pr_tcsg.shtm.

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Vidor, Texas Business Indicted on Fraud Charges

August 30, 2011 - Texas Mutual Insurance Company reported today that a Travis County grand jury indicted Johnny Elroy Revia Jr. of Vidor, Texas; Johnnie Mozelle Mundell of Beaumont, Texas and Ramco Group, LLC on workers’ compensation fraud-related charges.

Ramco Group, LLC was a contract hauling company located in Vidor. Texas Mutual alleged that between March 23, 2006, and June 24, 2007, Ramco Group, LLC intentionally misrepresented operations and payroll.

Because workers’ compensation insurance premium is based, in part, on payroll, this type of scheme results in an employer being charged a lower premium than it actually owes. By hiding payroll, an employer can gain an unfair advantage over competitors.

Note: A grand jury indictment is a formal accusation, not a conviction, of criminal conduct.

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Texas Mutual Rewards Medical Group with $874K Dividend

August 29, 2011 - Texas Mutual Insurance Company announced an $873,522 dividend to the Texas Medical Group (TMG) today. The workers’ compensation safety group dividend was based largely on TMG’s overall loss ratio.

TMG safety group members have shared in $2.6 million in Texas Mutual dividends since 2008.

In addition to potential dividends, TMG safety group members get a discount on their workers’ compensation premiums. They also have access to industry-specific workplace safety training materials in the safety resource center at texasmutual.com.

Any licensed Texas agent can submit qualifying clients for consideration in the TMG safety group. For more information, including qualifying class codes, visit texasmutual.com/agents/pr_tmg.shtm.

Texas Mutual notes that past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.

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Texas Supreme Court Decision in Texas Mutual Insurance v. Ruttiger Strengthens State’s Workers’ Comp Law

August 26, 2011 - The Supreme Court of Texas issued a decision today in Texas Mutual Insurance Company v. Timothy J. Ruttiger that strengthens a law affecting millions of Texans—the Workers’ Compensation Act.

The Court reversed the Houston Court of Appeals and rendered judgment that Mr. Ruttiger take nothing on his Insurance Code and Texas Deceptive Trade Practices Act claims.

Justice Phil Johnson wrote in strong terms that a bad faith cause of action is inconsistent with the current workers’ compensation system.

“[If the plaintiff were to prevail, the precedent would build] additional costs into the system by increasing litigation expense to employees, insurers and employers,” Justice Johnson wrote. “The way the dispute was resolved after Ruttiger initiated the dispute resolution process is the way the Act is designed to function.”

Lawsuits claiming “bad faith” on the part of all insurance carriers, Texas Mutual included, were on the increase when the Ruttiger case first came to the courts. In 2004, Texas Mutual disputed Mr. Ruttiger’s claim for an on-the-job injury because his employer reported that he was hurt at a non-work related softball game. Texas Mutual ultimately entered into a compromise agreement with Mr. Ruttiger over the claim. In 2006, a trial court found that the company’s adjuster had acted in “bad faith” by believing the employer instead of Mr. Ruttiger. The court awarded money to Mr. Ruttiger in excess of the amounts Texas Mutual had already paid him to cover his medical costs and replace his wages. He was also awarded extra money for his “mental anguish over having his claim disputed.”

The First Court of Appeals in Houston upheld the original decision, and Texas Mutual appealed to the Supreme Court.

“The Texas Supreme Court has today given careful consideration to the many speedy remedies and protections that the Legislature has granted to injured workers,” Mary Barrow Nichols, General Counsel and Senior Vice President for Texas Mutual, said. “It found that permitting an injured worker to additionally recover with a lawsuit of this kind is inconsistent with these remedies and protections. This decision is a significant victory for Texas employers.”

To see the full text of the decision, please visit www.supreme.courts.state.tx.us.

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Company Ordered to Pay $300K to Texas Mutual

August 24, 2011 - Texas Mutual Insurance Company reported today that Bar H Concrete, Inc. of Sulphur Springs pleaded guilty to workers’ compensation fraud-related charges. A Travis County district court ordered Bar H Concrete to pay $300,000 in restitution to Texas Mutual.

Bar H Concrete, owned by Charles Rick Henderson and John Herbert Heilman of Sulphur Springs, obtained workers’ compensation coverage through Texas Mutual from January 11, 2005, to January 11, 2009. During that time, Bar H Concrete concealed payroll through a related company that was not disclosed to Texas Mutual.

Because workers’ compensation insurance premium is based, in part, on payroll, this type of scheme results in an employer being charged a lower premium than it actually owes. By hiding payroll, an employer can gain an unfair advantage over competitors.

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El Paso Man Pleads Guilty to Workers’ Comp Fraud

August 10, 2011 - Texas Mutual Insurance Company reported today that a Travis County district court sentenced Sergio Garcia of El Paso, Texas on workers’ compensation fraud-related charges. The court sentenced Garcia to two years of deferred adjudication and 50 hours of community service. It also ordered Garcia to pay $1,800 in restitution to Texas Mutual.

Garcia reported a job-related injury while working as a laborer for Sun Fab Industrial Contractors Inc. of El Paso, Texas. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.

Meanwhile, Texas Mutual uncovered evidence that Garcia was working as a truck driver for a Kansas-based company while receiving 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. Left unchecked, double-dipping and other workers’ comp fraud can lead to higher premiums for all Texas employers.

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Texas Mutual Awards Nearly $1M in Safety Group Dividends

August 8, 2011 - Texas Mutual Insurance Company announced today that five safety groups underwritten by the company earned a combined $965,513 in workers’ compensation dividends.

The dividends were based largely on each group’s overall loss ratio.

Texas Apartment Association, $345,585; Social Services Agencies of Texas, $297,910; Texas Lumber and Wood Products, $148,125; Emergency Service Organization, $90,470; Texas Sign Association, $83,423.

In addition to potential dividends, safety group members have access to industry-specific workplace safety resources at texasmutual.com. They also get discounts on their workers’ compensation premiums.

For more information about safety groups, visit texasmutual.com/agents/group.shtm.

Texas Mutual notes that past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.

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Construction Group Earns $1.3M Texas Mutual Dividend

August 3, 2011 - Texas Mutual Insurance Company announced a $1,319,586 dividend to the Texas Construction Association (TCA) safety group today. The workers’ compensation dividend was based largely on the group’s overall loss ratio.

TCA members have shared in nearly $10 million in Texas Mutual dividends since 2005.

In addition to potential dividends, TCA members get a discount on their workers’ compensation premium and access to industry-specific workplace safety resources at texasmutual.com.

Any licensed Texas agent can submit qualifying clients for consideration in the TCA safety group. For more information, including qualifying class codes, visit texasmutual.com/agents/pr_tca.shtm.

Texas Mutual notes that past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.

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Texas Mutual Announces Premium Fraud Indictments

August 1, 2011 - Texas Mutual Insurance Company announced today that a Travis County grand jury indicted Premrock Commercial Drywall Ltd. Co., Timothy Castonguay of Arlington and Carlos Aguilar of Ft. Worth on workers’ compensation fraud-related charges.

Castonguay and Aguilar own and operate Premrock Commercial Drywall Ltd. Co., a Dallas- area drywall contractor. The indictments allege that the individuals intentionally misrepresented the payroll of Premrock Commercial Drywall Ltd. Co. between December 26, 2006, and May 14, 2007. The misrepresentation allowed the company to fraudulently obtain lower premiums from Texas Mutual.

Workers’ compensation insurance premium is based, in part, on payroll. An employer who intentionally underreports payroll is charged a lower premium than it actually owes. By fraudulently concealing or underreporting payroll, an employer gains an unfair advantage over competitors.

Note: A grand jury indictment is a formal accusation, not a conviction, of criminal conduct.

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Texas Mutual Distributes $155M in Policyholder Dividends

July 27, 2011 - This afternoon, Texas Mutual Insurance Company began distributing $155 million in workers’ compensation dividends.

Texas Mutual estimates that about 77 percent of its policyholders will earn a dividend based largely on their premium sizes, workplace safety records and tenures with the company.

“As a mutual insurance company, Texas Mutual is not publicly traded, and it does not answer to stockholders,” said Bob Barnes, chairman of Texas Mutual’s board of directors. “Our policyholders – the Texas entrepreneurs who put their trust in us every day - own the company. When Texas Mutual enjoys financial success, it has a solid history of sharing with those who have contributed to that success.”

By the end of this year, Texas Mutual will have paid more than $1 billion in policyholder dividends since 2000. That number includes a combined $260 million in 2008 and 2009, at the height of the recession.

Texas Mutual President Ron Wright said the company’s dividend track record is a direct reflection of policyholders’ efforts to keep employees safe and on the job.

“Texas Mutual is fortunate to have more than 50,000 owners who share its vision of a safer, more productive state,” said Wright. “Our policyholders have invested in their safety programs and supported injured workers during their recoveries. I hope this return on their investments will keep their businesses strong far into the future.”

Wright noted that Texas Mutual cannot guarantee future dividends, and all dividends require Texas Department of Insurance approval.

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Oil and Gas Group Earns $1.8M Texas Mutual Dividend

July 25, 2011 - Texas Mutual Insurance Company announced a $1.8 million dividend to the Texas Oil and Gas Association (TxOGA) safety group today. The workers’ compensation dividend was based largely on the group’s overall loss ratio.

TxOGA members have shared in $18 million in Texas Mutual dividends since 2001.

In addition to potential dividends, TxOGA members get a discount on their workers’ compensation premiums. They also have access to industry-specific workplace safety training materials in the safety resource center at texasmutual.com.

Any licensed Texas agent can submit qualifying clients for consideration in the TxOGA safety group. For more information, including qualifying class codes, visit texasmutual.com/agents/pr_txoga.shtm.

Texas Mutual notes that past dividends are not a guarantee of future dividends. The Texas Department of Insurance must approve all dividends.

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Houston Man Pleads Guilty to Workers’ Comp Fraud

July 22, 2011 - Texas Mutual Insurance Company reported today that a Travis County district court sentenced Derrick F. Crockrom of Houston on workers’ compensation fraud-related charges. Crockrom was sentenced to 15 days in jail and two years’ deferred adjudication. He was also ordered to complete 50 hours of community service.

Crockrom reported a job-related injury while working as a driver for Best Delivery Systems, Inc. of Houston. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.

Meanwhile, Texas Mutual uncovered evidence that Crockrom was working as a broker for a Houston financial company while receiving 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.

Left unchecked, double-dipping and other workers’ comp fraud can lead to higher premiums for all Texas employers.

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