On April 4th, 2022, the Special Investigative Unit of RJN Investigations, Inc. learned that the San Bernardino County District Attorney’s Office had issued an arrest warrant and 2 felony charges have been filed against the claimant in this case. In this case, the claimant worked as a Housekeeper and alleged to have sustained injuries to her knee while working her normal customary duties. The claimant subsequently went on disability and was receiving TTD disability payments. During this time, the claimant reported to her doctors that she was not currently working and needed a cane for ambulation. A surveillance investigation was initiated, and video surveillance was obtained of the claimant working at a salon as a hairstylist. A statement was secured from the claimant who reported to RJN Investigators that she had not received any other sources of income and was only collecting TTD benefits biweekly at a rate of $802.00 bi-weekly which was a material misrepresentation. Upon completion of the RJN SIU level Investigation and in compliance with the California Department of Insurance the case was then formally referred to the California Department of Insurance Fraud Division as well as to the San Bernardino County District Attorney’s Office. Upon completion of the criminal investigation performed by the District Attorney, it was determined that criminal charges were justified and filed. A warrant was issued to the claimant, and she is set to be arraigned on April 8th, 2022, at which time she will enter a plea.
ABOUT R.J.N. SIU:
Formed in 1996, the RJN SIU Division was created to assist California employers, governmental agencies, 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 210 convictions for workers’ compensation insurance fraud in California. In the last 3 ½ years we have secured $ 968,645.00 in court ordered restitution on our Insurance Fraud Convictions on behalf of our valued clients.