Supermarket Employee Pleads Guilty to Felony Insurance Fraud

On November 19th, 2020, the Special Investigative Unit of RJN Investigations, Inc. was notified as to the successful prosecution in the case of People of California v M. Sandoval. In this case, the claimant worked as a cake decorator for a major California supermarket. As a result of a slip and fall, the claimant alleged to have suffered numerous injuries. Video evidence secured by the RJN SIU Department found the claimant to be engaged in significant outside physical activities, showing no restrictions or utilization of artificial support. The claimant’s deposition was then secured in Los Angeles County and the claimant made several material misrepresentations in her testimony given under the penalty of perjury. As such and in compliance with the regulations set forth by the California Department of Insurance, the RJN SIU formally filed the case with their Fraud Division as well as with the Los Angeles County District Attorney’s Office. Upon completion of their criminal investigation, the claimant was formally charged in May of 2018 with one felony count in violation of Insurance Code Section 1871,4(a)(1) and two felony counts in violation of Penal Code Section 664-118(a). At her most recent criminal hearing she entered a plea to one felony count. She was then sentenced to three years of felony probation, three days in county jail, 200 hours of community service and ordered to pay restitution in the amount of $ 15,352.78.


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 3,750 examiners and the documented referrals by this unit have resulted in over 200 convictions for workers’ compensation insurance fraud in California.

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