Double-Dipping Dilemma

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Construction worker has an accident while working

When will unscrupulous people figure out that they can’t double-dip on workers’ compensation claims? (Most likely, never.)

A double-dipping lesson came too late for a man from Kingwood, Texas, who was recently convicted of workers’ compensation fraud. (Hindsight is 20-20 they say.)

The Texan received a four-year deferred sentence (meaning, he’s going to jail if he messes up again) and must repay $7,200 in restitution to Texas Mutual Insurance Co.

The man reported a job-related injury while working as a driver for Direct International Wine and Spirits in Houston. He claimed he was unable to work because of the injury. (Those wine and liquor bottles can be pretty heavy.)

Texas Mutual began paying income benefits to him, but then discovered Flores was working as a clerical worker for another company (better known as ‘double-dipping’).

Texas law requires claimants to contact their workers’ comp carrier when they return to work. Left unchecked, double dipping and other workers’ compensation fraud can lead to higher premiums for all Texas employers.

Today’s Fraud of the Day comes from the article, “Man Convicted of Workers’ Comp Fraud Must Repay $7.2K to Texas Mutual,” published in insurancejournal.com on Sept. 18, 2019.

Texas Mutual Insurance Co. reported that a Travis County district court sentenced Ramon S. Flores of Kingwood on workers’ compensation fraud-related charges.

Flores reported a job-related injury while working as a driver for Direct International Wine and Spirits in Houston and claimed he was unable to work because of the injury. Texas Mutual began paying income benefits to him, but then discovered Flores was working as a clerical worker for another company.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.