Tuesday, August 22, 2017


 

Celebrating 30 Years (1987 - 2017)

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Press Release

Fraud Division’s Criminal Investigation Leads to Felony Charges Being Filed

6/7/2017

 On June 7th, 2017, the Special Investigative Unit of RJN Investigations, Inc. was formally notified by the Los Angeles County District Attorney’s Office regarding the outcome of the preliminary hearing based upon a documented referral. 

 

In this particular case, the claimant was alleging to have sustained a continuous trauma claim from August 15th, 2009 thru June 6th, 2016, as a result of daily activities and conditions at work.  The claimant alleged to be suffering from pain and multiple body parts which included his back, neck, wrists, hands and arms.  A subsequent surveillance level investigation performed over multiple days found the claimant to be engaged in significant outside activity which included building a brick wall around the front of his house, showing no signs of hesitation or restrictions.  At the claimant’s deposition taken after the subrosa video evidence was obtained, the claimant denied performing any of the types of activities that were captured on subrosa videotape.  As such, in compliance with the regulations set forth by the California Department of Insurance, the case was formally filed by the RJN SIU to their Fraud Division as well as to the Los Angeles County District Attorney’s Office.  A detailed criminal investigation conducted by the Fraud Division resulted in the filing of one felony count in violation of Insurance Code Section 1871.4(a)(2) and one felony count in violation of Penal Code Section 664-118.  At the preliminary hearing on this date the claimant entered a not guilty plea.  He is now free on bail with a hearing set 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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