Texas Mutual Claimant Sentenced In Double-Dipping Case


Austin, TX (CompNewsNetwork) -Texas Mutual Insurance Company reported today that Felix Prado of Falfurrias, Texas pleaded guilty to workers' compensation fraud-related charges. A Travis County district court sentenced Prado to 30 days in the Travis County jail and ordered him to repay $2,791 to Texas Mutual.

Prado reported a job-related injury while working as a laborer for XXtreme Pipe Services in Houston. He claimed he was unable to work as a result of the injury, and Texas Mutual Insurance Company began paying him income benefits.

Meanwhile, Texas Mutual uncovered evidence that Prado was working as a laborer for a Porter, Texas company while receiving disability income benefits.

Investigators call this type of scam double-dipping because the claimant collects benefits for being too injured to work when he or she is gainfully employed. Texas law requires claimants to contact their workers' comp carrier when they return to work. Left unchecked, double-dipping and other workers' comp fraud can lead to higher premiums for all Texas employers.
About Texas Mutual Insurance Company

Austin-based Texas Mutual Insurance Company is the state's leading provider of workers' compensation insurance, with approximately 25 percent of the market. Since 1991, the company has provided a stable, competitively priced source of workers' comp insurance for all Texas employers. Texas Mutual has zero tolerance for fraud. In 2007, the company saved $4.2 million through its claimant fraud investigations.

It recovered another $1.1 million from employers who tried to illegally lower their premium, and it prevented $1.3 million in health care provider fraud.

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