Tex. Ins. Code Section 2054.451
Identification and Investigation Program for Fraud and Other Violations

(a)

The company shall develop and implement a program to identify and investigate acts of fraud and violations of this code relating to workers’ compensation insurance by applicants, policyholders, claimants, agents, insurers, health care providers, or other persons.

(b)

The company shall cooperate with the division of workers’ compensation of the department to compile and maintain information necessary to detect practices or patterns of conduct that violate this code relating to workers’ compensation insurance or that violate Subtitle A, Title 5, Labor Code.

Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 2, eff. April 1, 2007.

Amended by:

Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.054(a), eff. September 1, 2007.

Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.054(a), eff. September 1, 2007.

Source: Section 2054.451 — Identification and Investigation Program for Fraud and Other Violations, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.2054.htm#2054.451 (accessed Jun. 5, 2024).

2054.001
Definitions 2054.002
Reference to Texas Workers’ Compensation Insurance Fund 2054.003
Operation as Domestic Mutual Insurance Company 2054.004
Insurance Company Under Texas Workers’ Compensation Act 2054.005
Applicability of Code 2054.006
Authority of Commissioner and Department 2054.007
Open Meetings Law and Open Records Law Not Applicable 2054.008
Investigation Files 2054.009
Conflicts with Certain Insurance Laws 2054.051
Board of Directors 2054.052
Qualifications 2054.053
Presiding Officer 2054.054
Terms 2054.055
Vacancies 2054.056
Grounds for Removal 2054.057
Procedures for Removal 2054.058
Committees and Subcommittees 2054.059
Meetings 2054.060
Quorum 2054.061
Compensation 2054.101
General Powers of Board 2054.102
General Duties of Board Relating to Workers’ Compensation Insurance 2054.103
Appointment of President 2054.104
Appointment of Internal Auditor 2054.105
Personal Liability of Board Members, Officers, and Employees 2054.106
Principal Office 2054.107
Certain Relationships with Other Insurers Prohibited 2054.108
Program and Facility Accessibility 2054.151
Purposes of Company 2054.152
Payment of Taxes, Fees, and Other Charges 2054.153
Membership in Texas Property and Casualty Insurance Guaranty Association 2054.154
Company Assets 2054.155
Required Reserves 2054.156
Ratio of Certain Premiums to Surplus 2054.157
Dissolution Prohibited 2054.201
Examination by Department 2054.202
Providing Information to Legislature 2054.203
Annual Accounting of Money Received and Disbursed 2054.204
Annual Statements 2054.205
Publication and Filing of Audited Report 2054.206
Additional Reports 2054.207
Periodic Reports to Board 2054.251
Ratemaking Authority 2054.252
Amounts of Rates 2054.253
Multitiered Premium Systems 2054.254
Cash Dividends 2054.255
Appointment of Agent Not Required 2054.256
Work Product Information 2054.257
Payment of Commission to Agent 2054.301
Application for Coverage 2054.302
Policy Forms 2054.303
Denial of Coverage Based on Credit Risk 2054.304
Cancellation and Nonrenewal 2054.351
Insurer of Last Resort 2054.352
Required Declination of Certain Risks 2054.353
Required Insurance of Certain Commonly Owned or Controlled Entities 2054.354
Development and Publication of Certain Information 2054.401
Appeal of Certain Actions and Decisions 2054.402
Review of Board Decision by Commissioner 2054.403
Appeal of Commissioner’s Decision 2054.451
Identification and Investigation Program for Fraud and Other Violations 2054.452
Investigations 2054.453
Restitution Payable to Company 2054.454
Deposit and Use of Penalties Collected by Division 2054.455
Funding Agreements for Criminal Prosecutions 2054.456
Immunity for Certain Actions 2054.501
Definition 2054.502
Requirements for Prevention of Injuries 2054.503
Grounds for Cancellation or Denial of Coverage 2054.504
Safety Consultation for Certain Insureds 2054.505
Safety Consultation Procedures 2054.506
Safety Consultant Report 2054.507
Accident Prevention Plan 2054.508
Accident Investigations 2054.509
Follow-up Inspection 2054.510
Cancellation of Coverage by Company 2054.511
Continuing Compliance with Subchapter 2054.512
Fees for Services 2054.513
Enforcement of Subchapter 2054.551
Public Interest Information 2054.552
Complaints 2054.553
Complaint Record 2054.601
Definition 2054.602
Health Benefit Coverage Offered by Subsidiary Authorized 2054.603
Considerations and Guiding Principles for Developing Health Benefit Coverage Offerings 2054.604
Rules 2054.605
Exemption from Other Insurance Laws 2054.606
Subsidiary Not Engaged in Business of Insurance 2054.607
Risk Transfer or Coverage

Accessed:
Jun. 5, 2024

§ 2054.451’s source at texas.gov

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Location: https://texas.public.law/statutes/tex._ins._code_section_2054.451

Original Source: Section 2054.451 — Identification and Investigation Program for Fraud and Other Violations, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.2054.htm#2054.451 (last accessed Jun. 5, 2024).