In 2014, Natividad, while working as a Costa Mesa Police Department officer, reported a work-related injury. He falsely claimed that earlier in the day, he struck his hand against a brick wall near the CMPD jail while transporting an arrestee for booking.
Natividad claimed that the arrestee stumbled into the wall, prompting him to use his hand to prevent the arrestee from striking the wall. He was subsequently directed by CMPD to seek immediate medical attention. He listed a jail employee as a witness to the incident in his injury paperwork. The employee reviewed the jail surveillance camera footage, determined that the incident the defendant reported never occurred, and brought the video footage to his supervisor’s attention.
The City of Costa Mesa, the city’s insurance company AdminSure, and RJN Investigations, Inc a private investigation firm hired by AdminSure investigated Natividad’s workers’ compensation insurance claim. Upon completion of the SIU level investigation the RJN SIU reported the fraud to the Orange County District Attorney’s Office, who investigated this case.
Natividad was sentenced to six months in county jail for committing insurance fraud by presenting a false insurance claim and making false material statements related to the claim, after he was found guilty of one felony count each of insurance fraud and making a fraudulent statement, after a jury trial on Feb. 16, 2017. He was also ordered to pay back the city $75,000.00 in restitution .
Before trial, the prosecution filed a motion in limine to admit evidence of Natividad’s 2009 workers’ compensation claim for a right-hand injury while booking an arrestee. The prosecutor argued that because of the similarities, evidence of the 2009 claim was admissible to prove knowledge, common plan, and absence of mistake in the 2014 claim even though the insurance provider did not contest the 2009 .
The court ruled the prosecutor would be allowed to put on evidence of the 2009 claim, including the video, to establish intent, common plan, or knowledge, but she had to inform the jury the claim was paid. The court, however, ruled the prosecutor could not argue there was fraud in the 2009 claim. Natividad appealed his conviction because of this ruling. However the court of Appeal affirmed the conviction in the unpublished case of People v Natividad.
The Court agreed the trial court erred by admitting other acts evidence. There are similarities between the 2009 and 2014 claims were Natividad injured his right hand in the jail while booking an arrestee. But they differ in one important respect.
In 2009, the insurance company processed and settled his claim while in 2014 the insurance company denied his claim. The admission of Natividad’s prior legitimate 2009 workers compensation claim had little probative value. At most it indicated he knew how to file a claim.
It’s prejudicial value, on the other hand, was significant. Even valid claims of workplace injuries are viewed with suspicion. Here, the 2009 claim unfairly suggested a pattern despite the fact there was no indication there was anything improper about the that claim. A negative stigma attaches generally to workers compensation claims, and subsequent claims give rise to even greater doubts and misgivings. Repeat claimants can easily be perceived as not wanting to work and as using such an injury as an excuse to get out of work
But he was not prejudiced by this error. The trial court’s admission of evidence of the 2009 claim was harmless pursuant to People v. Watson (1956) 46 Cal.2d 818, 836. . "It was not reasonably probable that had the trial court excluded evidence of the 2009 claim the result of the proceeding would have been different."
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 3,000 examiners and the documented referrals by this unit have resulted in over 195 convictions for workers’ compensation insurance fraud in California.