On September 20th, 2021, the Special Investigative Unit of RJN Investigations, Inc. was notified regarding the successful prosecution in the case of People of California v P. Brooker. In this particular case, the claimant was employed as an invasive cardiovascular technician who allegedly suffered a back injury while transferring a patient. Due to complaints of ongoing and worsening pain, the claimant eventually stopped working and remained off work. Given the amount of time the claimant was off work, the examiner assigned surveillance on the case to the RJN SIU. During the surveillance level investigation, substantial video evidence was obtained depicting the claimant engaged in physically demanding yard work, which directly contradicted his prior complaints reported to the industrial physician. Furthermore, in his subsequent deposition, the claimant made multiple material misrepresentations regarding his physical abilities, denying that he was engaged in any such activities captured on the subrosa video evidence. In compliance with the regulations set forth by the California Department of Insurance, the RJN SIU formally referred this case to both the CDI Fraud Division as well as the Sacramento County District Attorney’s Office. Upon completion of a criminal investigation by the CDI Fraud Division, the claimant was formally charged with one felony count in violation of Insurance Code Section 1871.4(a)(1), one felony count in violation of Insurance Code Section 1871.4(a)(2) and one felony count in violation of Penal Code Section 550(a)(1). As part of the plea, the claimant pled no contest to Insurance Code Section 1871.4(a)(1) and the other two counts were dismissed. He was sentenced to one year probation and ordered to pay the employer $12,137.00 in restitution.
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 $925,236.00 in court ordered restitution on behalf of our valued clients.
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