The Special Investigative Unit of RJN Investigations, Inc. was notified of the successful prosecution of People of California vs. R. Irons in Los Angeles County.
As a result of a slip and fall, the claimant alleged to have injured his low back which radiated to the left leg and experienced pins and needles in the right arm. The claimant denied prior injuries related to the low back and denied prior treatment to the low back or being treated at any medical facility for any back related injuries. Subpoenaed medical records show that the claimant first complained of back pain in January 2017, which contradicted the claimant’s testimony and statements to his industrial treating physicians. The medical records documented that the claimant complained of right lower back pain and complained of a low left back pain with shooting pain down the left leg into the groin and lateral side of the hip and leg. Additional medical records show that the claimant was treated for pain in the neck and back due to a motor vehicle accident in 2012.
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 with two felony counts in violation of Insurance Code Section 550(b)(3) and one felony count in violation of Penal Code Section 664-118(a). After being arrested and attending multiple court hearings, the claimant entered a plea agreement. The claimant pled no contest to one count of Insurance Code 550(B)(3). As part of a plea agreement, the claimant agreed to pay $10,684.17, and serve 1 year probation.
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 4,000 examiners and the documented referrals by this unit have resulted in over 225 convictions for workers’ compensation insurance fraud in California. In just the last 4 years, we have secured $1,579,743.00 in court ordered restitution on behalf of our valued clients.
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