Summary: Mr. Fraud pled guilty to felony fraud. In addition to three years probation, he was ordered to pay restitution. And the defense received a cashier's check from applicant for $4,000 the day he pled guilty.
The adjuster's call was exactly the kind of call that excites all defense attorneys who enjoy defeating fraud. With the excellent teamwork of the adjuster, carrier, Special Investigations Unit department, investigators, District Attorney and our office, another "bad guy" got his comeuppance.
An accepted claim filed by a long-term employee, the matter was initially suspicious solely because of the timing. The claim was filed shortly prior to the employer, a car dealership, going out of business. As such, the adjuster kept her eyes and ears open for any other evidence of foul play ... and that awareness soon proved invaluable. Research uncovered more red flags, including reports the applicant was a long-time motorcycle racer. Investigations confirmed he was continuing to race and we caught our first major break with film at the track.
Time for popcorn and celebration?
No — as we viewed the film for the first time, we learned — to our collective dismay — the sub rosa failed to actually show applicant's face.
Had we been checkmated?
No - our luck held ...
As the applicant continued to collect Total Temporary Disability, further investigation revealed he owned a carpet cleaning business. This could prove interesting.
In deposition, the applicant insisted his motorcycle racing came to an end with his alleged industrial injury — a big lie.
When asked about his business, he claimed that although he still maintained the business name, he was no longer doing business.
That turned out to be a bigger lie.
Video surveillance showed the applicant both driving a van with a sign for his carpet cleaning business and visiting residences with a clipboard doing estimates.
The lies had been fully documented with a long line of detailed questions in deposition and, as such, our office believed we had enough for a fraud referral. It turned out the District Attorney agreed. Criminal charges were filed on December 21, 2010, including eight felony counts.
Merry Christmas, "Mr. Fraud!"
In short order, "Mr. Fraud" pled guilty to felony fraud. In addition to three years probation, he was ordered to pay restitution. And the defense received a cashier's check from applicant for $4,000 the day he pled guilty.
Jan Metheny is managing attorney of the Fullerton office of Bradford & Barthel, LLP. His previous work in criminal law, court appearances, and Trials has proven invaluable for case development including all stages of discovery, witness interviewing, conducting depositions, and presenting the Workers’ Compensation cases at Trial in a clear and coherent manner.
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