Monday, November 20, 2017


 

Celebrating 30 Years (1987 - 2017)

of Superior Service to our Valued Clients

 
   
Press Release

WCAB Judge Issues “Take Nothing” Order and Claimant Gets Charged With Insurance Fraud

9/6/2017

 On September 5th, 2017 the Special Investigative Unit of RJN Investigations, Inc. was formally notified by the Los Angeles County District Attorney’s Office regarding the filing of felony charges for workers’ compensation insurance fraud based upon submission of a documented referral.  This case involved a full time pest control exterminator who reportedly sustained a strain/sprain to his neck in February, 2014.  Medical treatment benefits were initially provided.  Subsequent evidence secured during an AOE/COE level investigation discovered that the incident never occurred.  A surveillance level investigation had established that the claimant had opened his own pest control business and was working without any restrictions.  In June, 2015, the claimant provided testimony in a WCAB trial revealing that he had not been truthful during his former deposition testimony.  On June 13th, 2016, the WCAB judge subsequently issued a “take nothing” based upon the evidence reviewed.  The case was then formally referred by the RJN SIU to the California Department of Insurance Fraud Division and to the Los Angeles County District Attorney’s Office.  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 664-118(a).  The claimant attended his preliminary criminal hearing on August 31st, 2017 and entered a not guilty plea.

 

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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