The Special Investigative Unit of RJN Investigations, Inc. was notified by the Riverside County District Attorney that their office filed criminal charges against a Fast-food Employee who alleged to have sustained injuries to her neck, low back, bilateral shoulders, bilateral elbows, and bilateral wrists. The claimant had a history of prior auto accidents and prior work-related injuries which also involved similar body parts for the claimant’s current claim. However, when questioned by the treating Doctors, the claimant denied such a history. Furthermore, when questioned at the time of the scheduled deposition, the claimant also denied a past history of auto accidents and work-related injuries which was in contrast to the records subsequently secured. Based on this outcome and evident misrepresentations, RJN SIU submitted a formal referral to both the Riverside County District Attorney’s Office as well as the California Department of Insurance Fraud Division. Upon completion of the criminal investigation, our office was notified by the Riverside County District Attorney’s office that an arrest warrant and criminal charges were filed against the claimant. Three felony counts in total were filed, one count of Penal Code 664, one count of penal code 550 and one count of Insurance Code section 1871.4, subdivision (a)(1). A future Arraignment is currently pending at this stage as the arrest warrant remains active.
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 250 convictions for workers’ compensation insurance fraud in California. In just the last 4 years, we have secured $1,989,784.00 in court ordered restitution on behalf of our valued clients.
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