Sunday, June 24, 2018


 

Celebrating Over 30 Years (1987 - 2018)

of Superior Service to our Valued Clients

 
   
Press Release

San Diego USD Bus Driver Charged With Insurance Fraud

11/6/2017

 On November 6thth, 2017, the Special Investigative Unit of RJN Investigations, Inc. was formally notified by the San Diego County District Attorney’s Office regarding the filing of  criminal charges as a result of the submission of a documented referral.  In this particular case, the San Diego County District Attorney’s Office received an anonymous tip on their Fraud Hotline regarding this claimant.  The tip indicated that the claimant, who was out on a workers’ compensation claim, was in the process of engaging in significant physical activities while moving.  A RUSH surveillance by the RJN SIU was successful in securing over 2.5 hours of video evidence depicting the claimant engaging in moving activities.  The claimant’s deposition was then secured, where she made material misrepresentations under the penalty of perjury in reference to her true physical abilities.  The video evidence was then shown to the PQME, where a change of medical opinion was rendered.  In compliance with the regulations set forth by the California Department of Insurance, the case was then referred by the RJN SIU to their Fraud Division as well as to the San Diego County District Attorney’s Office.  Upon completion of a detailed criminal investigation by the SDDA, the claimant was formally charged with 12 counts in violation of Insurance Code Section 1871.4 and Penal Code 664-118(a)   Her preliminary hearing is scheduled for next month. 

 

ABOUT R.J.N. SIU:

 

Formed in 1996, the SIU Division was created to assist California employers, small size insurance carriers and TPA firms in securing professional assistance so as to detect, investigate and prosecute insurance fraud.  To date, the unit has trained well over 2,750 examiners and the documented referrals by this unit have resulted in over 165 convictions for workers’ compensation insurance fraud in California.  

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