Sunday, October 22, 2017


 

Celebrating 30 Years (1987 - 2017)

of Superior Service to our Valued Clients

 
   
Press Release

Claimant Pays $36,059.07 in Restitution to Her Employer as Part of Plea

8/7/2017

 On July 31st, 2017, the Special Investigative Unit of RJN Investigations, Inc. was formally notified by the Los Angeles County District Attorney’s Office regarding the successful prosecution in the case of People of California vs. S. Desselle.  In this case, the claimant alleged to have suffered a work related injury while working at a children’s center.  Based upon subjective complaints, she subsequently began to receive TTD benefits.  As the claim progressed, information came into the claim file indicating that the claimant may be working at a second job while collecting benefits.  The case was assigned to the RJN SIU for investigation.  Upon completion of that investigation, it was determined that the claimant had indeed secured secondary employment, working at a school district while at the same time, collecting TTD benefits.  The claimant never reported the secondary income to the examiner or her employer as required by law.  In compliance with the regulations set forth by the California Department of Insurance, the case was then submitted in a documented referral by the RJN SIU to that of the California Department of Insurance Fraud Division and Los Angeles County District Attorney’s Office.  The claimant was subsequently charged with violation of Insurance Code Section 1871.4 as well as violation of Penal Code Section 550(b)(3).  After attending only two hearings, the claimant agreed to enter into a plea bargain agreement that would entail her bringing in a cashier’s check to sentencing in the amount of $36,059.07 as restitution to the employer.  At the sentencing, aside from the restitution payment, the claimant was ordered to complete 200 hours of community service within six months and the felony charges on her record would be reduced to a misdemeanor. 

 

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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