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Construction worker has an accident while working

There are basically four ways an individual can be prosecuted for committing workers compensation fraud: 1) faking a work injury; 2) secretly working while collecting workers’ compensation benefits; 3) collecting benefits from multiple employers; and, 4) fraud rings. Today’s fraudster from Midland, Texas chose number two to steal more than $6,000 from the Texas Department of Insurance Division of Workers’ Compensation.

The Travis County man claimed that he had suffered an on-the-job injury while working as an appliance repairman for a Midland-based company. (He said that the injury prevented him from working – yeah, right. You know where this is going.)  

 Texas Mutual approved the claim and began paying out income benefits to the supposedly injured appliance repairman. But, it wasn’t long before the insurance company found out that the appliance repairman was working as a self-employed appliance repairman. (He probably wanted to branch out on his own, but didn’t want the risk of going it all alone. So, he thought he’d take advantage of his employer.)

The appliance repairman was convicted of workers compensation fraud and was sentenced to a misdemeanor. He got one day in jail and paid $6,049 back to the insurance company that awarded him workers’ compensation benefits. (Most likely the only injury this man incurred was to his pride. Get back to work buddy!)

 Today’s “Fraud of the Day” is based on an article, “Texas Man Convicted of $6K Workers’ Compensation Fraud,” posted on InsuranceJournal.com on October 8, 2019.

Texas Mutual Insurance Co. reported that a Travis County district court has sentenced Joe D. Lozano, Sr. of Midland, Texas, on workers’ compensation fraud-related charges.

Lozano reported a job-related injury while working as an appliance repairman for A & A Appliance in Midland and claimed he was unable to work because of his injury. Texas Mutual began paying income benefits to him, but then discovered Lozano was working as a self-employed appliance repairman.

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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.