Tuesday, June 27, 2017


 

Celebrating 30 Years (1987 - 2017)

of Superior Service to our Valued Clients

 
You are here Services SIU
   
Worker's Compensation Special Investigative Unit Services

 

  • Registered with the California Department of Insurance Fraud Division as an approved SIU vendor since 1994
  • Our SIU staff is comprised of former investigators of the Federal Bureau of Investigations, California Department of Justice and the California Department of Insurance Fraud Division.
  • We offer in-house training so as to maintain compliance with the Department of Insurance. To date we have trained over 2500 examiners and our training program has been approved by the Department of Insurance to issue CE Credits.
  • We personally review any claims file you suspect as fraudulent. We will submit an SIU analysis and plan of action so an effective decision can be made as to the merits of the case.
  • If warranted a formal suspected fraud referral will be made. This will involve a comprehensive chronology of the events that transpired, the claims file, (or portions thereof) and all supporting evidence.
  • We personally meet with the Local District Attorney and/or Department of Insurance Fraud Division.
  • We act as the liaison for communication between the insurance company/employer and the local law enforcement agency.
  • We professionally complete the mandated annual reports for the states in which you offer insurance coverage and back these reports by our $5 million in E&O coverage.
  • Our clients can access our RJN Case Track system 24/7 and as such remain fully updated as to the status of each and every siu referral for prosecution.  Moreover, updated investigative reports, audio and video evidence can be reviewed in a seamless and time efficient manner via our secure internet connection.
  • Our SIU Medical audits lower lien costs and can give you evidence to deny/object to fraudulent or illegal medical TX/Bills. 
  • We are experienced in participating in SIU audits performed by the California Department of Insurance Fraud Division. As such, we could help implement policies and procedures within your claims office to ensure that you are in compliance before you receive notice of an intended audit
  • Our vendor management system provides senior executives 24/7 access to data such as average investigative costs per claim file, number of assignments per office or examiner, video ratio per vendor, turnaround time and rating system per report. 

In summary, our SIU Program is geared for clients who are result driven as opposed to primarily seeking a compliance position with the California Department of Insurance.

 

Results to date: 

160 California Convictions for Workers Compensation Insurance Fraud 
  38 Cases Under DOI/DA Criminal Investigation  
  

 

 

                                                                       

Continuing Education Credits are now available!

Ask us how: 1-888-323-3832

                                                   

 

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RJN Investigations, Inc. provides investigative services nationwide throughout a proven network of dedicated, highly trained employees, and specialized licensed associates.
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