Friday, December 15, 2017


 

Celebrating 30 Years (1987 - 2017)

of Superior Service to our Valued Clients

 
   
Press Release

In Home Care Provider Charged With Submitting False Invoices

4/17/2017

 On April 12, 2017 the Special Investigative Unit of RJN Investigations, Inc.  was notified by the Los Angeles County District Attorney's Office as to the filing of felony charges on an in-home care provider based upon a documented referral submitted.  In this case, the examiner noted that on the invoices submitted by the in-home care provider that she billed exactly 4 hours every single day, from   8 AM to 12 PM, seven days a week.  An initial surveillance performed by the RJN SIU found no evidence of the in-home care provider providing care to the Claimant during the time frames billed. A unmanned surveillance  van was then utilized on a 24/7 basis and substantial additional video evidence was secured reflecting the in-home care provider was not with the claimant taking care of her during the time frames she was billing the claim file.   Further investigation discovered that the in-home care provider was actually a relative of the claimant with a different last name.  A documented referral was then submitted to the California Department of Insurance Fraud Division as well as to the Los Angeles County District Attorney's Office.  Upon completion of their criminal investigation ,  the in-home care provider was formally charged with two felony counts in violation of Insurance Code Section 1871.4 and Penal Code section 118 (a)  The arraignment 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 160 convictions for workers’ compensation insurance fraud in California. 

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