View this article online: https://www.claimsjournal.com/news/southcentral/2003/02/14/26288.htm
Armando M. Villesca Sr. of Fort Stockton, Texas, pleaded guilty to charges of workers’ compensation insurance fraud. A Travis County District Court judge ordered Villesca to submit to three years of community supervision, perform 180 hours of community service, pay a $2,000 fine, and repay $2,965.30 in benefits he fraudulently obtained from Texas Mutual Insurance Company.
Villesca allegedly injured his right knee while working as a delivery driver for the Fort Stockton branch of Abtex Beverage Corp.. Villesca claimed that he was unable to return to work because his injury prevented him from climbing in and out of his delivery truck. Texas Mutual Insurance Co. began paying temporary income benefits (TIBs) to Villesca.
Texas Mutual received information that Villesca was working as a contractor repairing homes and businesses while collecting TIBs for his alleged injury. Under state law, an injured worker who collects benefits must notify the insurance carrier if he or she returns to work in any capacity.
Texas Mutual investigator Tommy Jones obtained statements, canceled checks, and other documents that proved Villesca was working while reportedly collecting TIBs. In order to prove fraud, however, Texas Mutual had to show that Villesca knowingly collected benefits he was not entitled to.
Jones called Villesca and recorded a conversation in which the man reportedly denied working. Texas Mutual presented the evidence to Assistant District Attorney James Young, who prosecuted the case.