TCIF HEARS FRAUD EXPERTS:

Elliott Flood, vice president of special investigations for Texas Mutual Insurance Company, recently addressed the Texas Committee on Insurance Fraud (TCIF) on the topic of workers’ compensation fraud. He was one of several speakers who discussed various types of insurance fraud at the Committee’s inaugural meeting. He noted that one of the biggest stumbling blocks to enforcement is that some district attorneys are reluctant to prosecute insurance fraud. This is especially true when the case involves health care provider fraud or premium fraud, the two most costly types of fraud in the workers’ comp system, he said. District attorneys often lack “the technical knowledge to handle white-collar crimes,” commented Flood. “Unlike so-called regular crimes, prosecuting insurance fraud, especially premium fraud or health care provider fraud, may require intensive record reviews and an in-depth understanding of [Texas Workers’ Compensation] Commission fee guidelines and rules. We need prosecutors who are dedicated to fighting insurance fraud.” Texas Reps. Jack Stick and Larry Taylor also attended the meeting. Both said they supported TCIF’s efforts. Taylor said a big part of TCIF’s mission will be educating the public and his fellow legislators on the high cost of insurance fraud. TCIF Chairman Craig Sparks said insurance fraud costs an estimated $120 billion per year, nationally. Other TCIF speakers included Insurance Commissioner José Mon-temayor, Dennis Pompa of the Texas Department of Insurance, Dave Hennings of the National Health Care Anti-Fraud Association, Beverly Boone of the Automobile Insurance Agents of Texas, Thomas Dixon of the National Insurance Crime Bureau, Howard Goldblatt of the Coalition Against Insurance Fraud, Jay Thompson of the Association of Fire & Casualty Companies of Texas, and Mark Hanna of the Insurance Council of Texas. TCIF will meet again on April 21 at the Texas Department of Insurance in Austin.