The Special Investigative Unit of RJN Investigations, Inc. was notified that the Riverside County District Attorney’s Office has filed felony insurance fraud charges based upon a documented referral submitted by RJN SIU to their office. In this particular case, the county employee had a significant past medical history that was carefully documented by the proactive claim’s examiner via significant research and issuance of subpoenas. By analyzing those past medical records in comparison to the statements made by the claimant in her current claim to the treating doctors it was found that she was not being forthcoming as to her true medical history. Under further questioning in her deposition, additional material misrepresentations were identified. Upon compiling all the evidence during the SIU level investigation, the case was then formally submitted to both the Riverside County District Attorney and California Department of Insurance Fraud Division. Upon completion of the criminal investigation performed by the Riverside District Attorney’s office, the claimant was arrested, notified of the charges filed against her and arraigned. The next scheduled criminal hearing is set to occur on February 5th, 2026.
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 255 convictions for workers’ compensation insurance fraud in California. In just the last four years, we have secured $2,172,027.00 in court ordered restitution on behalf of our valued clients.
Leave a comment!