Houston Man Indicted for Workers’ Comp Fraud

July 21, 2004

Texas Mutual Insurance Company reported that Travis County’s 147th District Court grand jury indicted Henry Prince of Houston for workers’ compensation fraud-related charges.

The insurer said Prince allegedly used a “double-dipping” scam to illegally receive approximately $3,400 in temporary income benefits (TIBs). State law allows some injured workers to receive TIBs when their on-the-job injuries prevent them from returning to work. The law also requires each worker to notify the workers’ compensation insurance carrier when he or she begins working again.

Double-dipping scams involve allegedly injured workers who claim that they are unable to work—so they can continue to receive TIBs—when in fact they are working, usually for a new employer. In effect, they get paid twice: once for working at a new job and again for being too hurt to work.

If left unchecked, double-dipping scams can lead to a higher workers’ comp insurance premium for the first employer when the company renews its coverage. The scams may also encourage other employees to fake injuries to collect benefits, which ultimately contributes to higher workers’ compensation costs for everyone.

With every TIBs check it issues, Texas Mutual Insurance Company includes a statement reminding the worker to contact the adjuster if he or she returns to full-time or part-time work. Additionally, Texas Mutual adjusters often contact workers directly to determine their work status.

The Prince 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.

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