(a) The company may investigate cases of suspected fraud and violations of this code relating to workers’ compensation insurance.
(b) The company may:
(1) coordinate the company’s investigations with those conducted by the division of workers’ compensation of the department to avoid duplication of efforts; and
(2) refer to the division of workers’ compensation of the department a case that is not otherwise resolved by the company so that the division may:
(A) perform any further investigation necessary under the circumstances;
(B) conduct administrative violation proceedings; and
(C) assess and collect penalties and restitution.

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Terms Used In Texas Insurance Code 2054.452

  • Fraud: Intentional deception resulting in injury to another.
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.