Retail Store Associate Charged with Felony Workers Compensation Fraud

On June 2nd, 2022, the Special Investigative Unit of RJN Investigations, Inc. was notified that the Los Angeles County District Attorney’s Office has filed Felony Insurance Fraud Charges against a claimant based upon a documented referral submitted. In this case, the claimant worked as a Retail Store Associate for a non-profit organization and upon termination from the insured, threw himself to the ground alleging to have sustained injuries to his neck, right shoulder and right ankle. A surveillance investigation was initiated, and video footage was obtained of the claimant inconsistently utilizing “Kids Crutches” on the date of the deposition. However, when the deposition was concluded he was observed not using any form of artificial support while attending law school and running errands in the afternoon. Furthermore, a CSI Investigation found the claimant to be highly active attending various protesting events showing no signs of hesitation in contrast to what he testified to during his deposition. The surveillance video was subsequently released to his treating doctors, and upon review, not only did the claimant file a petition to dismiss his claim, but the doctors made comments calling into question the likelihood of the actual injuries. Upon completion of the RJN SIU level Investigation and in compliance with the California Department of Insurance, the case was then formally referred to their Fraud Division as well as to the Los Angeles County District Attorney’s Office. Upon completion of the criminal investigation performed by the Los Angeles County District Attorney’s Office, the claimant was formally charged with one felony count of insurance fraud.  His arraignment is scheduled to occur on 06/28/2022 at which time the claimant will be notified of the charge against him, and he will enter a plea.

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 3,500 examiners and the documented referrals by this unit have resulted in over 210 convictions for workers’ compensation insurance fraud in California.  In just the last 3 ½ years, we have secured $1,184,278.00 in court ordered restitution on behalf of our valued clients.


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