The adjuster’s call was exactly the kind of call that excites all defense attorneys who enjoy defeating fraud. Luckily, the call came to B&B and—with the excellent teamwork of the adjuster, carrier, SIU department, investigators, District Attorney and B&B—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?
Nope! 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 applicant continued to collect TTD, further investigation revealed he owned a carpet cleaning business. This could prove interesting!
In deposition, 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 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, we believed we had enough for a fraud referral.
It turned out the DA 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!
Blood from a turnip?
Nope! The defense received a cashier’s check from applicant for $4,000 the day he pled guilty.
Scoreboard says, “Good guys – 1, Bad Guys – 0”!
Jan D. Metheny, a Senior Partner and Managing Attorney of the Anaheim office, led the defense of this fraudulent claim. Suspect fraud? Give Mr. Metheny a call at (714) 526-9120.
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