Texas Mutual Announces 2 Workers’ Comp Fraud Convictions

Texas Mutual Insurance Co. recently announced that Marcos Ricoy of Harlingen, Texas and Enrique Colon of Deer Park, Texas, pleaded no contest to a felony charge of engaging in organized criminal activity involving workers’ compensation healthcare fraud.

The convictions are in connection to alleged fraud committed by Expert Medical Evaluators International Inc.

Texas Mutual investigated EME, an entity that determined impairment ratings and performed functional capacity evaluations on injured employees in Texas.

Texas Mutual alleged that EME used unlicensed providers to perform services and overbilled Texas Mutual. The investigation led to several indictments by a Travis County grand jury on June 28.

Ricoy will serve three years deferred adjudication, complete 120 community service hours, and paid $10,000 in restitution to Texas Mutual. Colon will serve three years deferred adjudication, participate in any court-ordered treatment or counseling, and pay $10,000 in restitution to Texas Mutual.