Farm Laborer Felony Charges Filed

Tulare County, Calif., February 13, 2018 — This claim involves a 53-year-old male Farm Laborer who was first hired by the insured on April 14, 2014. In the late morning of May 13, 2016, the Farm Laborer sustained significant injuries to his face, including contusions, lacerations and a nasal fracture. He was transported by ambulance to the hospital where he was admitted and remained for six days before his release.

Argus First, Inc. was called to investigate the case and found there were some variations and inconsistencies in the exact description that the Farm Laborer told the insured and all initial medical providers. He said that his injuries were sustained as a result of tripping and falling while walking in the orchard at work. In direct contrast, interviews with other workers and witnesses revealed that the Farm Laborer had been drinking the morning of the injury incident and was antagonizing another worker, which resulted in a physical altercation with the other worker.

The claim was denied on June 9, 2016. To date, the Farm Laborer has not litigated or contested the denial. Although no benefits were provided, the treating hospital filed a lien against the carrier for approximately $45K and, additionally, there are investigation costs and legal costs as a direct result of the misrepresentations made by the Farm Laborer.

Argus First’s SIU prepared and submitted a full Documented Referral Package to Tulare County District Attorney’s Office on November 21, 2016. Criminal charges were filed on February 13, 2018 and an arrest warrant is pending. The final restitution figure is pending conviction and is estimated to be approximately $4700. More significantly, the charges will provide a valid defense to contest paying the $45K hospital lien.