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A Texas district court judge recently accused Texas Mutual Insurance Company of falsifying documents in a workplace injury case. The judge, seeking to teach the insurer a lesson, required Texas Mutual to post the notice on its web site.
What happened…
A Texas man was injured at work in 2003 and required surgery. Texas Mutual, Texas’s largest provider of workers’ compensation insurance, apparently paid some of the bills, but later alleged that it was not liable for any insurance benefits in the case. It sued the injured man for any past and future benefits caused by the injury.
According to Mississippi’s Sun Herald newspaper, Texas Mutual did not have sufficient evidence to prevail in the case and falsified medical records instead. It also allegedly asked a doctor to falsify documents in the case who later testified that the submitted records were false. The judge in the case was quoted as saying that Texas Mutual’s fraudulent activity was committed “knowing and intentionally” to “gain an advantage in this suit.” Texas Mutual was also required to pay the injured man $30,000 in litigation sanctions.
Irony
What’s most ironic about this case is that Texas Mutual is an outspoken advocate of that insurance companies should be immune from bad faith insurance claims – regardless of whether their conduct was intentional or not.
Texas Mutual lists all of the fraudulent activity that it discovers on its website (www.texasmutual.com). We scoured their site to see if the judge’s required notice was included, but unfortunately, could not locate it. We did run across the following quote on its website:
We [Texas Mutual] have zero tolerance for fraud; however, we can only investigate suspected fraud against Texas Mutual Insurance Company. If we cannot link a fraud tip to a Texas Mutual claim or policy, we will forward the information to the Texas Department of Insurance's fraud unit.
Insurance companies often go to great lengths to avoid paying valid claims and may act in bad faith as a result. If you’ve been denied valid insurance benefits, contact an attorney who understands insurance industry practices. To contact a qualified attorney for a free, no-obligation consultation, please click here.
