Texas Gov. Targets Fraud in Executive Order

July 14, 2004

  • July 14, 2004 at 1:18 am
    Wade Austin says:
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    I will belive it when I see it. The government is just to big & lazy to stop fraud. It is just to easy to pay it than fight it. I have seen this too many times over the 24 yrs. in the insurance business.

  • July 14, 2004 at 3:03 am
    Jay Davis says:
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    It is a step in the right direction though. It is better than doing nothing. If you always “do what you did”, you will always “get what you got.”

  • July 23, 2004 at 7:18 am
    zoeygirl says:
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    What about the cost to injured workers and the fruad that insurance companys commit daily. I have seen insurance companys ripping off the tax payers and bussiness by charging outlandish prices and then not paying the injured worker, dening care and treatment and paying off doctors. Thus making sure that injured worker remains injured and the insurance gets richer by taking money and in bad faith not paying any claims. These days it is very difficult to fake an injury as a nurse I feel I have an educated knowledge. CT’s, MRI, ect it is possible to see if someone is faking it. Most injured employees are denied until a copurt orders the WC carrier to pay. Which cost more money than if they ran the test and fixed the problem. What all this boils down to is the same laws apply to insurance companys. They are the ones putting injured workers out of work and into the walfere system. Costing more TAX PAYERS money, but that is the whole idea. That way the insurance company wins by not paying, (TAX PAYER) you do it for them! So to the congressman who insurance companys pay lots of mony to you for your onesided vote. Ripping off taxpayers and bussiness. Lets save money by not having insurance. Doesn’t pay on claims anyway. So why should bussiness have to provide it and why should TAX PAYERS have to pay for it?

  • July 28, 2004 at 2:20 am
    Jay Davis says:
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    While I understand Zoey’s concern, there is plenty of blame to go around for a system that is in need of serious reform.

    I will concede that in some instances Carriers have been to blame for poor decisions regarding injuries. However, looking at the number of fraudulent claims filed in all types of cover this is a significant exposure for insurers. Everyone pays when someone commits fraud. Consumers ultimately pay the cost when insurers pay fraudulent claims or when they investigate claims that appear fraudulent.

    To address some of your most specific allegations…

    When you say “most injured employees are denied until a court orders them to pay”, what basis do you have for making this assertion. I don’t believe that “most” injured employees are denied. I do believe from my experience that many workers compensation claims are not truly workers comp claims. Many are injuries that may be aggrevated by work but were not “work” related.

    #2 Insurers do not put injured employees out of work. Workers Compensation Physician’s do. The injured worker cannot return to work until allowed to do so by the physician.

    #3 I believe you need to research the issue much more than your statements indicate you have. You will find that there are numerous issues that impact the ultimate cost to carriers, employers and injured employees.

    Try sites like insurancefraud.org, rand.org, atra.org or iii.org for further information and statistical data for your research.

    Regards,

    Jay



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