On October 31st, 2019 the Special Investigative Unit of RJN Investigations was formally notified by the San Diego County District Attorney’s Office as to the successful prosecution in the case of People of California v. D. Rose. In this case the claimant alleged to have suffered a back injury while moving a wheelchair into a loading space on the bus. As the claimant did not appear to be improving despite the medical treatment being provided, a surveillance level investigation was authorized by the examiner. In the course of the surveillance performed by the RJN SIU several hours of video evidence was obtained depicting the claimant engaged in significant outside physical activities as a high school football coach. The claimant’s recorded statement was then obtained. During that interview the claimant made several material misrepresentations regarding his true physical abilities as well as denying a prior motor vehicle accident that he was involved in. The case was formally referred by the RJN SIU to the California Department of Insurance Fraud division as well as to the San Diego County District Attorney’s Office Workers Compensation Fraud Unit. Upon completion of the criminal investigation, the claimant was formally charged with violation of Insurance Code Section 1871.4(A)(2), 1871(A)(1) as well as Penal Code Section 550 (B) (3). After attending several hearings at the San Diego Superior Court, the claimant formally pled guilty on October 30th, 2019. As part of his probation the claimant was ordered by the Judge to pay restitution back to the school district in the amount of $20,000.00.
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.