Texas Mutual Says Thanks, But No Thanks, to State Oversight

Texas’ leading workers’ comp insurer says we don’t need courts and juries watching over them. Yeah, right.

As a result of his back problems, he says he can't do any of the work he's trained for, can't lift anything heavy. His dream was to become a Houston firefighter after he moved to the area. But because he was still recovering from the surgery, he lost the opportunity to take a civil service exam before his 36th birthday, he says, and now he's too old to qualify to work for them. It's hard to understand how he could physically do the job either.

He goes over to his wife's store—she runs a small pet grooming and boarding facility—and helps out at the front desk.

"I've been on one of the biggest tower fires in the state of Texas. I've been on one of the biggest chlorine derailments in the United States," he says, mixing pride and pain. "I've done all these high-profile things. Here come the firefighters. They're here to save the day, riding in on a white horse.

Lance Morris, here with wife Karen, keeps winning battles against workers' comp company Texas Mutual Insurance, but he's yet to win his war.
Margaret Downing
Lance Morris, here with wife Karen, keeps winning battles against workers' comp company Texas Mutual Insurance, but he's yet to win his war.
Karen and Lance Morris meet with lawyer Jeff Raizner, whose firm isrepresenting Lance, a former Justin volunteer firefighter, over a claim that Texas Mutual acted in bad faith in denying coverage for Morris' back injury.
Margaret Downing
Karen and Lance Morris meet with lawyer Jeff Raizner, whose firm isrepresenting Lance, a former Justin volunteer firefighter, over a claim that Texas Mutual acted in bad faith in denying coverage for Morris' back injury.

"Now I count the beans and do customer service."

Doyle continues to allege that if it's a significant case involving a lot of money, Texas Mutual escalates its denials. "They'll deny on this reason. They'll deny on that reason. They'll deny each and every prescription. It's an exhaustion-of-remedies deal. You are going to be exhausted before you ever think about filing a lawsuit against these guys.

"The most severe injuries, they basically give you a lifetime of denials instead of a lifetime of benefits until you go away."

Attorney Rogers takes a somewhat more temperate approach. He says that on the whole, Texas Mutual does OK—some of the claims adjusters are very good, and most of the people there do a good job.

But things do go wrong, and Texas Mutual won't admit it, Rogers says. "When they don't do OK, they ought to recognize it and mediate the case out." Other insurance companies probably have more bad-faith claims filed against them because they are more likely to settle—there's a better chance of fighting them and winning.

Texas Mutual, on the other hand, fights whenever it thinks it is right, however otherwise expedient it might be to just let it go, Rogers says.

"They make you go to court on each and every claim. People have to be very serious and have to have a very good case before they ever file a lawsuit against Texas Mutual. If you file one, you're into a great big battle.

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