On August 30th, 2024, the Special Investigative Unit of RJN Investigations, Inc. was notified of the successful prosecution of People of California v. E. Brown by the Los Angeles County District Attorney’s Office. Their office had filed six felony insurance fraud charges based upon a documented referral submitted by RJN SIU. In this case, the claimant worked as a residential counselor who sustained injuries while breaking up a fight. The claimant sustained injuries to her left shoulder, neck and low back. Investigation determined that the claimant had a history of injuries to the same body parts. When questioned, the claimant denied any prior work related, auto accidents and/or injuries to the same body parts in contrast to records that became available. She also declined to provide an accurate history to her treating doctors as well. The material misrepresentations made by the claimant impacted the claim particularly when it came to apportionment. 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 Commerce Regional Fraud Division as well as to the Los Angeles County District Attorney’s Office. Subsequently, the claimant changed her plea and accepted a plea deal which converted her felony charges into a misdemeanor upon payment of restitution in the amount of $3,708.85. (consisting of $2,523 in investigative costs, and $1,185.85 in medical).
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 245 convictions for workers’ compensation insurance fraud in California. In just the last four years, we have secured $1,816,729.00 in court ordered restitution on behalf of our valued clients.
Leave a comment!