In May of 2020, our office received confirmation from a Detective with the Department of Insurance Fraud Division who advised that criminal charges were formally filed against the claimant in this case. A felony arrest warrant was issued, and the claimant subsequently turned himself in where he was advised of the charges against him.
The claimant was scheduled to be arraigned in April, however, due to Covid-19 and its effect on the court system, the arraignment was postponed.
This case involves a claimant who was employed as a Janitor since 2013. The claimant alleges to have sustained injuries to his back and right shoulder as a result of his normal and customary work duties.
A surveillance investigation was initiated by the RJN SIU which found the claimant to be extremely active and showing no restrictions in his movements. When questioned under the penalty of perjury during his deposition, the claimant made multiple material misrepresentations at that time which did not match with what the claimant was seen doing on surveillance.
In compliance with the regulations set forth by the California Department of Insurance, the RJN SIU formally referred the case to their Fraud Division as well as to the Fresno County District Attorney’s Office. Upon completion of their criminal investigation, the claimant was formally charged with three felony counts which included making false or fraudulent claims, fraudulent statements and an act of Insurance Fraud.
His arraignment is currently set for May 22nd, 2020.
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 3,500 examiners and the documented referrals by this unit have resulted in over 195 convictions for workers’ compensation insurance fraud in California.