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, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.