Fighting Fraud

Some Advertise It. We Do It.

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To order 11"x17" Fraud StoppersSM posters, email the safety services support center at safety@texasmutual.com.

Workers' Compensation Fraud Hurts All Texans

The majority of workers' comp claims filed in Texas and other states stem from real instances of on-the-job injuries. Unfortunately, the people who cheat the system drive up costs for employers, consumers and insurers.

As a corporate executive once noted, if workers' comp fraud were a legitimate business in the United States, it would rank among the
Fortune 500 companies. Indeed, according to the National Insurance Crime Bureau, workers' comp fraud totals $7.2 billion a year—more than Yahoo! Inc.'s revenue in 2007. The Texas Department of Insurance notes that insurance fraud is the second most profitable crime after drug trafficking.

Some insurance carriers write off workers' comp fraud as merely one cost of doing business. Texas Mutual, on the other hand, takes workers' comp fraud seriously. We employ three teams of full-time investigators dedicated to protecting your premium dollars, and they get results.

We're in this for the long haul.

Richard Gergasko
President & CEO

Case Activity 2014 2015 2016
Claimant referrals to SID 1,708 1,649 1,698
Claimant fraud convictions 9 8 11
Claimant fraud discovered 187 176 154
Claimant fraud $ discovered $843,639 $902,637 $1,022,643
Estimated future savings from claimant fraud discovered $3,887,291 $3,645,800 $6,321,337
Health care fraud (criminal cases) 5 3 2
Indictments for health care fraud 0 0 0
Convictions for health care fraud 2 1 2
Health care fraud and abuse prevented $937,880 $1,048,031 $1,681,882
Health care fraud restitution collected (criminal) $8,856 $6,512,022 $58,537
Premium fraud discovered $5,275,007 $3,115,033 $2,484,261
Premium fraud indictments 2 1 4
Premium fraud convictions 3 3 1

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