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This insured company presented themselves to their insurer as a pool cleaning and repair company to keep their premiums low, but was suspected of actually building pools. Investigation by our SIU confirmed the employer was actively doing construction work, including decking and swimming pool construction, although they claimed all pool building was done by subcontractors…. Read More

While preparing for a lien consolidation with a well-known medical group recently indicted by Los Angeles County, SIU was approached by the provider’s attorney to discuss settlement options. SIU aggressively pursued pressuring the vendor into coming to the global settlement table. As the result of aggressive settlement discussions and negotiations, the vendor agreed to a global… Read More

An insured driver was allegedly rear-ended by another car. Both the insured driver and his passenger sought PIP benefits under the insured policy. An investigation revealed valid insurance in force for the at-fault vehicle, negating the PIP claim; plus no medical charges were ever presented. Additionally, ISI found the passenger provided fake ID to police… Read More

While lifting a heavy cabinet, the claimant heard his knee pop. An orthopedic doctor placed him in off-work status. Surveillance found him playing beach volleyball, with good range of motion and gait. He was also filmed purchasing construction supplies and offloading them at a home where he was building a deck. When interviewed by our… Read More

An “injured” worker on disability was found to be working again, this time as a janitor for an office building. Five hours of surveillance video showed him exceeding his modified duty restrictions while working for his new employer. In a deposition, his testimony was contradicted by the surveillance video. When his primary treating physician and… Read More

Criminal charges have been filed against the providers involved in the Landmark Medical scheme where kickbacks were paid to numerous providers for prescribing and dispensing compound creams with highly inflated prices. Our investigations resulted in Landmark filing a lien consolidation against our client, a claims administrator. With evidence demonstrating that Landmark had manipulated the NDC… Read More