The Special Investigative Unit of RJN Investigations, Inc. was recently notified by the Los Angeles County District Attorney’s Office regarding the arrest and arraignment based on a documented referral submitted. In this particular case, the examiner received a tip indicating the claimant was working for his own construction company while out on a workers’ compensation claim, collecting TTD benefits. The examiner proactively authorized surveillance and the claimant was indeed found to be performing construction related work on a private residence. The claimant’s deposition was then secured, where he made several material misrepresentations pertaining to his work history and income while collecting TTD benefits. The homeowner of the residence was then interviewed by the RJN SIU, and it was established that he paid the claimant $3,000.00 cash for the work performed. Armed with the additional evidence and in compliance with the California Department of Insurance regulations, the case was filed by the RJN SIU to their Fraud Division as well as to the Los Angeles County District Attorney’s Office. Upon completion of the criminal investigation, the claimant was formally charged with one count in violation of Insurance Code Section 1871.4(2) and one count of Penal Code Section 550(a)(1). As the claimant did not show up for his court appearance, a felony warrant was issued by the Superior Court Judge in February 2020. The claimant remained a fugitive until he was recently arrested on felony charges. At his preliminary hearing, he entered a not guilty plea, and his next criminal hearing is scheduled for July 25th, 2024.
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 240 convictions for workers’ compensation insurance fraud in California. In just the last 4 years, we have secured $1,729,120.00 in court ordered restitution/savings on behalf of our valued clients.
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