Tuesday, August 22, 2017


 

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Press Release

Staging a Fake Injury Results in Criminal Charges

5/1/2017

 On April 28th, 2017, the Special Investigative Unit of RJN Investigations, Inc. was formally notified by the Los Angeles County District Attorney’s Office regarding criminal charges being filed based upon a documented referral submitted.  In this case, the claimant alleged that as a result of being hit by a forklift, he suffered multiple injuries.  The claimant stated he could not remember anything after the impact until he woke up in the hospital 1 ½ hours later.  An analysis of the employer’s security video noted that the claimant clearly and intentionally moved into a position in front of the slowly moving forklift.  The forklift operator’s view forward was obstructed by large stacks of pallets being moved and he could not have seen the claimant.  The claimant had an unobstructed view of the oncoming forklift.  Once the claimant got into position in front of the slowly moving forklift, he turned his back and at the last minute, jumped out of the way, rolling onto the ground as if injured.  During the course of the investigation, a surveillance level investigation was performed.  In that investigation, the claimant was noted to utilize a cane only upon arriving and departing from his medical appointment.  In compliance with regulations set forth by the California Department of Insurance, the case was formally referred to the Los Angeles County District Attorney’s Office and to the California Department of Insurance Fraud Division.  Upon completion of their criminal investigation, the claimant was formally charged with 1 felony count in violation of Insurance Code Section 1871.4 and one count in violation of Penal Code Section 664-118, Attempted Perjury.  A felony arrest warrant has now been issued on this case.

 

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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