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Claimant Fraud Arrest

February 26, 2021

This accepted claim involved a 21-year-old Turf Installer, who alleged injuries to the left knee.  While holding a roll of turf with a co-worker, it “rolled onto his knee.”


Surveillance was conducted by Argus West after minimal improvement six months post injury. During surveillance, the claimant was observed on video only utilizing crutches at medical appointments while walking and jogging normally when observed otherwise.


The Claimant was suspected of misrepresenting the true extent of his injuries, limitations, and ability to work to his primary treating physician and the panel QME.


Argus West SIU filed an FD-1 with the CA Department of Insurance.  Due to the strength of the case, Argus West SIU prepared a Criminal Referral Package to law enforcement.


In late 2021, criminal charges were filed by the Riverside County District Attorney’s Office and an arrest warrant was issued.  The claimant was later convicted, and our client was awarded restitution in the amount of $76,868.


The Claimant was sentenced to 270 days of incarceration, 24 months of probation, a $300 fine, and ordered to pay restitution.

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