Austin-based Texas Mutual Insurance Company reported that Henry Prince of Houston has pleaded guilty to workers’ compensation fraud-related charges and must pay restitution to the insurer.
The Travis County 147th District Court sentenced Prince to six months’ deferred adjudication and ordered him to pay a $200 fine and $3,400 in restitution to Texas Mutual.
According to Texas Mutual, while Prince was off work for his alleged injury, a second company asked his former employer to verify his employment. The employer contacted Texas Mutual, which opened an investigation and verified that Prince had become gainfully employed while continuing to receive temporary income benefits.
Investigators call this type of fraud a “double-dipping” scam. Double-dipping usually involves workers who collect TIBs for an alleged injury at one job, when in fact, they are working for a new employer. In effect, the scam allows them to get paid twice: once for working at the new job and again for being too hurt to work at the old job.
State law allows qualifying injured workers to receive TIBs only when their on-the-job injury prevents 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.
With every TIBs check it issues, Texas Mutual 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.
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