Friday, December 15, 2017


 

Celebrating 30 Years (1987 - 2017)

of Superior Service to our Valued Clients

 
   
Press Release

Failing to Disclose Prior Injury Results in Criminal Charges

7/18/2017

 On July 17th, 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 a preliminary hearing based upon a documented referral submitted.  In this case, within days after receiving a disciplinary action, the claimant filed a CT claim, alleging various body parts.  As the claim progressed, the examiner learned that the claimant had been involved in a motor vehicle accident prior to his workers’ compensation claim, where he injured the same body parts.  Further investigation revealed that the claimant received a settlement as a result of the injuries suffered in this motor vehicle accident.  The claimant failed to disclose the accident, pre-existing back and neck injuries to any of the treating doctors.  Moreover, he made material misrepresentations when he denied any such accidents or injuries in his deposition taken under the penalty of perjury.  Additional investigation also discovered that the claimant was working as an Uber driver during the timeframe he was receiving TTD benefits.  In compliance with the regulations set forth by the California Department of Insurance, this case was formally referred by the RJN SIU to their Fraud Division as well as to the Los Angeles County District Attorney’s Office Workers Compensation Fraud Unit.  Upon completion of their criminal investigation, the claimant was formally charged with one felony count in violation of Insurance Code Section 1871.4(a)(1) and one felony count in violation of Penal Code Section 664-118(a).  At the claimant’s preliminary hearing, he entered a not guilty plea.  The claimant was released on $50,000.00 bail pending his next criminal hearing.

 

 

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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