No workers’ compensation fraud

A Texas fireman injured his back in 2000 after lifting an accident victim. He received workers’ compensation and was treated by a doctor. Three years later, he re-injured his back and had to undergo surgery for a herniated disk. The insurance carrier, Texas Mutual Insurance Company (TMIC), had initially paid the claim, but then started inquiring about his original back injury in 2000. TMIC wondered whether the fireman had a pre-existing condition and was questioning whether it should have paid for medical care at all.

During the investigation, the TMIC allegedly failed to provide the fireman’s doctor with pertinent medical records and filed a claim against the fireman for fraud – which was never proven. The fireman sued TMIC for bad faith. A Texas jury found in his favor and awarded him nearly $750,000 for the mental anguish that he went through, the damage to his credit reputation and for TMIC’s intentional violation of the Texas Insurance Code.

What are bad faith insurance practices?

All insurance companies have a duty to treat their policyholders in good faith and deal with them fairly. However, some insurance companies would rather not pay claims at all or pay as little as possible in order to increase their profits. It’s a common theme throughout the insurance industry as a whole. However, when insurance companies do not treat their policyholders fairly, those policyholders can fight back by contacting their state’s Insurance Department and an attorney with experience in bad faith insurance litigation. Unfortunately, bad faith insurance practices aren’t limited to workers’ compensation issues; they can occur in any insurance setting including disability, long term care, health care, homeowners and many more.

To contact an attorney whose practice focuses in this area of the law, please click here. Consultations are free, without obligation and are strictly confidential.