On June 15th, 2021, the Special Investigative Unit of RJN Investigations, Inc., was advised regarding the criminal charges filed in response to a documented referral submitted. In this particular case, the claimant worked as a full time Deputy Juvenile Correctional Officer. He alleged that as a result of restraining a youth, he fell to the ground injuring both his right and left knees. Based on a tip, the RJN SIU conducted a social network level investigation which resulted in finding extensive postings of the claimant being involved in body building activities. Subsequent surveillance yielded substantial video evidence of the claimant working out inside of a gym on several occasions, showing no signs of hesitation or restrictions. The social media and surveillance video evidence was then provided to the Primary Treating Physician who subsequently changed his medical opinion. In compliance with the regulations set forth by the California Department of Insurance, the RJN SIU then formally referred the case to their Fraud Division as well as to the Orange County District Attorney’s Office. Upon completion of an extensive criminal investigation performed by the Orange County District Attorney’s Office, the claimant was formally charged with one count in violation of Penal Code Section 550(b)(3) and one count in violation of Insurance Code Section 1871.4(a)(1). The claimant’s arraignment is scheduled to take place on August 18th, 2021.
ABOUT R.J.N. SIU:
Formed in 1996, the RJN SIU Division was created to assist California employers, 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. In just the last three years, we have secured $ 894,120.00 in court ordered restitution on behalf of our valued clients.