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HomeMy WebLinkAbout00-121r t.~_. r. ! t.. ~ ~,~ TY `~ ~~ ~'E, S''fATE.OF; ~GALIFORNIA Resolution No. 00-121 RESOLUTION AUTHORIZING DISTRICT ATTORNEY "I'O SUBMIT AUTOMOBILE INSURANCE FRAUD GRANT APPLICATION WHEREAS, the Butte County Board of Supervisors desires to undertake a certain program designated as the Automobile Insurance Fraud Program as authorized under California Insurance Code Section 1872.8, California Code of Regulations Subchapter 9, Article 4, Section 2698.65 administered by the California Department of Insurance. NOW, THEREFORE, BE IT RESOLVED that the District Attorney of the Butte County District Attorney's Office is authorized, on its behalf to submit the attached proposal to the California Department of Insurance and is authorized to execute on behalf of the Board of Supervisors the Grant Award Agreement upon award including any extensions or amendments thereof. BE IT FURTf-IER RESOLVED that grant funds received hereunder shall not be used to supplant expenditures controlled by this body. I hereby certify that the foregoing is a true copy of the resolution adopted by the Butte County Board of Supervisors in a meeting thereof held on the 26th day of September, 2000, by the following vote: AYES: Supervisors Beeler, Houx, Josiassen, Davis, and Chair Dolan NOES: None NOT VOTING: None ABSENT: None JANE DOLAN, Chair Butte County Board of Supervisors ATTEST: JOHN BLACKLOCK, Chief Administrative Officer and Clerk of the Board of Supervisors . ~ ; p 1 f- > ,,~ .. .. Butte County District Attorney Automobile Insurance Fraud Program Projected Plan and Budget Fiscal Year 2000/2007 ~`~ _ ~ ~~ ~d~ ®~ An continued partnership with the Butte County District Attorney APPLICATION FOR A PROGRAM FOR THE INVESTIGATION AND PROSECUTION OF AUTOMOBILE INSURANCE FRAUD Fiscal Year 2000/U1 TABLE OF CONTENTS I. TECHNICAL ELEMENTS A. Grant Transmittal B. Board of Supervisors Resolution C. Program Contact Information II. BUDGET ELEMENTS A. Personnel (Salary and Benefits) B. Operating Expenses C. Equipment D. Carryover Funds III. BUTTE COUNTY PLAN A. Qualifications 199912000 Highlights B. Problem Statement C. Program Strategy D. Staff Qualifications E. Organizational Chart IV. JOINT INVESTIGATIVE PLAN A. DEPARTMENT OF INSURANCE GRANT APPLICATION TRANSMITTAL Office of the District Attorney, County of Butte, hereby makes application for funds under the Automobile Insurance Fraud Program pursuant to Section 1872.8 of the Insurance Code. Contact: Ed Szendrey, Chief Investigator Address: 25 County Center Drive Oroville, CA 95965 Telephone: (530} 538-7460 (1) Program Title (2) Grant Period Automobile 7/1100 - 6/30/01 Insurance Fraud Prosecution Program (3) Grant Amount $105,433 (4) Program Manager Michael L. Ramsey District Attorney 25 County Center Drive Oroville, California 95965 (5) Financial ©,f~cer Constance Carter-Angove District Attorney Chief Administrator 25 County Center Drive Oroville, CA 95965 (6) District Attorney's Signature ame: M' hae .Rams Title: District Attorney County: Butte Address: 25 Caunty Center Drive Oroville, CA 95965 Phone: (530) 538-7411 Date: August 30, 2000 ~. ~~f~~~~j~~ ~~~'~R~I~~~~ ~~YJ~®~J~~~V~ This resolution will be heard and adopted by the Butte County Board of Supervisors At its regularly scheduled meeting, September 26, 2000. RESOLUTION AUTHORIZING DISTRICT ATTORNEY TO SUBMIT AUTOMOBILE INSURANCE FRAUD GRANT APPLICATION WHEREAS, the Butte County Board of Supervisors desires to undertake a certain program designated as the Automobile Insurance Fraud Program as authorized under California Insurance Code Section 1872.8, California Cade of Regulations Subchapter 9, Article 4, Section 2698.65 administered by the California Department of Insurance. NOW, THEREFORE, BE IT RESOLVED that the District Attorney of the Butte County District Attorney's Office is authorized, on its behalf to submit the attached proposal to the California Department of Insurance and is authorized to execute on behalf of the Board of Supervisors the Grant Award Agreement upon award including any extensions or amendments thereof. BI IT FURTHER RESOLVED that grant funds received hereunder shall nat be used to supplant expenditures controlled by this body. I hereby certify that the foregoing is a true copy of the resolution adopted by the Butte County Board of Supervisors in a meeting thereof held on the 26th day of September, 2000, by the following vote: AYES: NOF,S: NO'f VOTING: ABSENT: JANE DOLAN, Chair Butte County Board of Supervisors ATTEST: JOHN BLACKLOCK, Chief Administrative Officer and Clerk of the Board of Supervisors By C. PROGRAM CONTACT FORM Provide the name, title, address and telephone number for the person having day- to-day responsibility for the program. Name: Guy Georgianna Title: Senior District Attorney Investigator Address: 25 County Center Drive Oroville, CA 95965 "retephone Number: (530} 538-7735 Fax Number; (530) 538-7071 2. Provide the name, title, address and telephone number of the Chair of the County Board of Supervisors. Name: Jane Dolan Title: Chairman, Butte County Board of Supervisors Address: 25 County Center Drive Oroville, CA 95965 Telephone Number: (530) 538-7643 Fax Number: (530) 538-7120 3. Provide the name, title, address and telephone number for the District Attorney's Financial Officer. Name: Constance Carter-Angove Title: District Attorney Chief Administrator Address: 25 County Center Drive Oroville, CA 95965 Telephone Number: (530) 538-7207 Fax Number: (530) 538-7071 4. Provide the name, title, address and telephone number for the person responsible for the data collectionlreporting for the applicant agency. Name: Bernie Lightner Title: District Attorney Investigator II Address: 25 County Center Drive Oroville, CA 95965 Telephone Number: (530) 538-7080 Fax Number: (530) 538-7071 II I~UI)G~ET ELEMEIeTT~ A DEPARTMENT OF INSURANCE AUTOMOBI<_E INSURANCE FRAUD FY 2000 / 2001 BUDGET CATEGORY AND LINE-ITEM DETAIL A. Personnel Services -Salaries / Em to ee Benefits COST Deputy District Attorney III / IV (.25 FTE} Program Attorney. Oversees Program Salary 17,375 Devotes 25% of time to this program Benefits 4,015 Deputy District Attorney III / IV (.25 FTE) Program Attorney. Devotes 25°l0 of time Salary 14,781 to program Benefits 3,722 Senior DA Investigator (.10 FTE) Senior DA Investigator. Devotes 10% of time to Salary 5,419 oversight of program and Grant Management Benefits 1,998 New - District Attorney Investigator II (.50 FTE} Program Investigator. Devotes 50% of Salary 24,615 time to this program. Benefits 9,340 Expanded - Legal Secretary (.20 FTE) Clerical support for program. Salary 4,788 Devotes 20% of time to this program. Benefits 1,531 Ghief Deputy District Attorney (.02 FTE} Supervisor of Program. salary 1,703 Devotes 2% of time to oversight of program. Benefits 358 Chief Investigator (.02 FTE} Chief Investigator. Devotes 2% of time to Salary 1,421 program Grant Management Benefits 462 TOTAL -Personnel Services $91,525 8130!00 8:44 AM B DEPARTMENT OF INSURANCE AUTOMOBILE INSURANCE FRAUD FY 2000 / 2001 BUDGET CATEGORY AND LINE-ITEM DETAIL B. O eratin Ex enses COS Communication Expense 1,217 Transportation,Travel, and Training 2,400 Travel for meetings, case investigation, and program related training for investigators & prosecutors. Office Expense 770 Genera! office supplies. Transportation -Motor Vehicle 3,000 $500 per month is allocated for the use of vehicle assigned to project investigator. (500 X 7 2 = 6, 000X50 % =3, 000) Audit 1,500 Annual expense for Program Audit Indirect Costs /Administrative Overhead 5,021 5% of fotal direct costs. Cosf allocation plan in accordance with Federal OMB Circular A-87 is on file with the State Controller's Office. ©isirict Atfomey Administration County Auditor Administration General Insurance Office Maintenance Utilities TOTAL - O eratin Ex enses X13,908 8/30/00 8:30 AM C DEPARTMENT OF INSURANCE AUTOMOBILE INSURANCE FRAUD FY 2000 / 2001 BUDGET CATEGORY AND LINE-ITEM DETAIL COS C. E ui ment Equipment Expenses 0 TOTAL - E ui ment 0 TOTAL GRANT AWARD TOTAL -Personnel Services $ 91,525 TOTAL -Operating Expenses $ 13,908 TOTAL -Equipment $ $ 105,433 8/30/00 8:30 AM ~. ~A~.~~ - (~~ER F~JNI3S /1 _ f"_ LAND O'r NATURAL WEALTH AND 3EAU~'~ - :> _ - MICHAEL L. RAMSEY District Attorney EDWARD J. SZENDREY FRANCISCO R ZARATE Chief Investigator Chief Deputy District Attorney June 30, 2000 hung T. Le, Program Coordinator State of California Department of Insurance, Fraud Division 9342 `T'ech Center Drive, Suite 500 Sacramento, CA 95826 Dear i~~Ir. L.c, This office respectfully requests to carry over $1,000 in funds provided for in the I'Y 1999/2000 Autatnobilc Insurance Fraud grant. The Coifnty <luditor advises there is a $1,000 savings in audit expenditures. Thank you for your consideration of this matter. Very truly yours, MICI-IAEL. L. RAMSEY District Attorney Ed Szendr Chief Investigator 25 County Center Drive Oroville, California 95965-3385 ~ 655 Oleander Avenue Chico, California 95926-3924 Tel: (530) 538-7411 Fax: (530) 538-7071 4 Tel: (530) 891-2712 Fax: (530) 891-2715 III B~LTTrTE ~C)~TNT~ P'I~AN A. Qualifications BUTTE COUNTY AUTO INSURANCE FRAUD COUNTY PLAN QUALIFICATIONS In 1998/1999 Butte County recognized its responsibility to address the general issues of Automobile Insurance Fraud with mare than 190,000 Vehicles registered within our borders. This issue needed to be addressed in a positive and professional manner. Because of this, the Butte County District Attorney's Office applied for and received fiznds from the State Department of Insurance in fiscal year 1998/1999 and 1999/2000, This office recognized that with the resources of the Department of Insurance combined with the resources of this office u~e could aggressively participate in the fight against automobile insurance fraud. Based on current funding the Butte County District Attorney Automobile Insurance Fraud Program is staffed by Deputy District Attorney Kevin Maloney (2~°fo FTE), Deputy District Attorney Michael Candella (25% F`TE), and Legal Secretary Marcie Hummel {10°,% FTE}. (For staff qualifications see Section III D.) In March of 1999 Deputy District Attorney Kevin Maloney, formerly of Mendocino County, was hired by Butte County and assigned to the Insurance Fraud Program. Deputy District Attorney Mike Candela teamed with Kevin Maloney in August of 1999 to address the civil and criminal prosecution of Insurance Fraud. Building on this foundation, funding from the Department of Insurance for fiscal year 1999/2000 a11o~~~ed this office to commit veteran Investigator Bernie Lightner, half-time , to the Workers' Compensation Insurance Fraud and Automobile Insurance Fraud programs. Senior Deputy District Attorney Kevin Maloney provides in-house instruction and guidance for Deputy District Attorney Candela and Investigator Li<~htner. 'Through this team building process, these three members, plus support personnel meet regularly to discuss cases, plan investigation strategies, explore training issues and establish outreach. Funding from the 1999/2000 Automobile Insurance Fraud Grant was not sufficient to adequately provide for investigative support for the prosecution team. However, some grant funding helped support the efforts of District Attorney Investigator Bernie Li~~htner and helped support outreach programs done in conjunction with the Workers' Compensation Insurance Fraud Grant. Non-grant funded investigative resources were also pro~rided by the District Attorney's Investigation Bureau, Major Crimes Unit. It was not until nearly mid fiscal year that we were able to assign Investigator Lightner to eYClusively concentrate on our Insurance Fraud program. In this short period of time ire ha<<e observed how effective a competent investigator can be to the development of a viable program. The blend of outreach ,inter-agency relations, program coordination and ease investigation, to f1111y realize the potential of the program, is an art form that requires skilled individuals who can focus on the program. Since his appointment Investigator Lightner has used his membership in the Northern California Fraud Investigator's Association to make known Butte County's desire to establish an effective Insurance Fraud program. He has met with the Department of Insurance staff to iron out problems, establish lines of communication and learn how to effectively interact with the DOI. I-Ie has reached out to the insurance industry and has developed some significant relations from within that community. Investigator Lightner has established a close working relationship with both State Farm and California Automobile Association S.I.U.'s and is actively investigating follow-up matters requested by their offices. All in all Investigator Lightner has been a very busy man wearing many hats. It is apparent for this office to fully meet the opportunities and demands of a viable unit for this next year, Investigator Lightner's position needs to be augmented with the addition of another part time investigator. To make this a viable program this office has committed resources above and beyond that provided for by the grant. Senior Investigator Guy Georgianna has committed the resources ,of the Major Crimes Unit to instue the success of the Insurance Fraud programs. Investigator Georgianna and his staff have given numerous hours, above and beyond the resources of the grant , in outreach, investigation and the coordination of joint efforts with the Department of~ Insurance. The computer skills of District Attorney Investigator Jos Van Hout have been used to develop a case tracking system and oversee the development of a District Attorney Fraud ~~'eb Site. This office also takes advantage of a quarterly area-wide Investigators's Meeting to network with local, state and federal law enforcement agencies. ~~~e have been and will continue to feature our Insurance Fraud programs at these meetings. This past year we have made strides to improve our community outreach. Our promised ~~eb Site is now a reality. Our toll free Fraud Hot Line is up and operational. w'e are developing a Fraud Watch news column to be published monthly in the local newspapers. ti~'e anticipate an outreach program to promote its use by our citizens. In May we highlighted our Insurance Fraud program in the District Attorney's booth at the Silver Dollar Fair in Chico, the main population center of our county. Fair attendance was about 60,040 persons. From that exposure, we are already getting calls on our Fraud Hot Line giving us tips on possible Insurance Fraud activities. We also staffed another such information booth this year at the Butte County Fair in Gridley. In fiscal year 1999/2400 it became apparent from the increase in reported insurance fraud cases that we needed to expand our resources to more effectively handle the evolving case load. It is our belief that with an increase in our Department of Insurance ~~orkers' Compensation funding and an additional funding award from the Auto Fraud Insurance Grant ~~~e can and »~ill be able to make additions to our staffing level in a way which will provide us with a vehicle to efficiently and effectively handle our increased case referrals- tisJhile it has taken a concentrated effort on behalf of the-District Attorney staff to build a foundation for an effective Insurance Fraud Unit, we must attribute a significant portion of our growing success to a strong partnership with the Department of Insurance Fraud Division. In order to address the issues of insurance fraud it is necessary to have adequate resources for outreach, investigation, prosecution, clerical support and coordination. Funding available through this grant would allow for the half-time (50% F I E) Investigator and added clerical support that is essential for a viable Automobile Insurance Fraud Program. BUTTE COUNTY DISTRICT ATTORNEY INSURANCE FRAUD PROD RANI IIIGIILIGII"TS FY 199)/2000 • The Butte County District Attorney's Office filed felony Auto lnsurance Fraud charges against an applicant whose case tivas taken to jury trial. The applicant agreed to a $10,000 settlement with her carrier for an auto insurance claim. She was sent rivo $10,000 checks in error and cashed them both. She refused to return the additional $10,000. The case went to trial and the jury found her guilty of insurance fraud. She is currently awaiting sentencing. • The Butte C.'ount}~ District Attorney's Office filed felony Insurance hraud charges against the owner of an automobile towing company for filing a false insurance claim. The action steins from an accident involving one of his company's tow truck. The owner falsely claimed himself as the driver during the time of the accident because his driver vas not properly licensed. IIc also lied about how and where the accident occurred in order to avoid responsibility for major daYnagc to :~ county owned traffic-light standard. The owner of the towing company was held to answer the felony Insurance Fraud charges and ultimately pled guilty. Ile was fined X575 and paid restitution of $13,00?. • Tite Butte Counh~ District Attorney's Office prosecuted X38 autt~ theft cases i~~ Calendal' yCar 1999. At least thlt'teetl OI tht)sC had 1l1S~it'at3CC` Clalnls l3~cil. 'The Butte County District Attorney's Office receiycd 78 vehicle vandalis~u c~i.ses ial eale~idar year 1999. At least five resulted in insurance claims. Q The Butte County District Attorney hosts a bimonthly area-wide investigatoY-'s meeting, averaging more than 40 state, federal and local investigators. Current training to include Butte County District Attorney's Office Insurance hraud I'rograln is laresented and each investigator discusses current cases and can make requests for assistance. • The Butte County District Attorney's Office has ctpanded its Internet ~Veb-site to include a web page devoted to ~Vorkcrs' Compensation and Auto Insurance Fraud information far the public. The site includes an on line fraud reporting form which a user can fill out and transmit back over an Internet secured Line, or if they prefer, the site lists our 24-hour toll-free Hotline number. • The Butte County District Attorney's Office Insurance h+'raud Linn installed a 2~ hour, toll-free hotline for reporting ~Vorl.crs' C:ompcusation and Auto Insurance Fraud. The system accepts ,ill calls from ~yithin our S30 area code. The numhcr is I-866-DA FRAUD. • The Butte County District Attorney's (Jftice constructed a public information booth tivhich was set up and staffed with our employees for five full days at our County Silver Dollar Fairgrounds in Chico. The booth contained posters, flyers, handouts and provided information on our Workers' Compensation and Auto Insurance Fraud Program. Our booth had exposure to more than 60,000 people in attendance. Many merchants and professionals from the insurance industry took handout materials and gave positive feedback. • 'T'his past year the Butte County District Attorney's Office saw a need to improve the way we were distributing our insurance fraud in~~estigations. As a result, our office hired an experienced investigator to work Workers' Compensation and Auto Insurance Fraud cases exclusively. This has resulted in a much improved relationship with the State of California Department of Insurance and the insurance industrv as a whol£. ~' °' ~ .AEA- L Rq ~ ~`r~^ M~GK .1..,.-....,M's~, „_ ~'~ InSU~~I~~ ,~~°C~ ANNOUNCING A NEW SERVICE FOR THE INVESTIGATION AND PROSECUTION OF Auto Insurance Fraud The District Attorney's Office has been awarded a Grant by the California State Department of Insurance to investigate and prosecute suspected fraud in Auto Insur- ance Claims. The District Attorney has the ability to handle these cases independ- ently or in concert with the Department of Insurance Investigations Division. Types of Auto Insurance cases we investigate include: FP.LSE CLAIMS: where a person falsely claims a loss that IZever occurred. This rl~ay include such claims as theft or IoSS of personal property which the claimant has secreted or disposed of for profit. ~~Jhere a person falsely Y~~eports his or her vehicle as stolen when in fact it was aban- doned by the insured after having been involved in an accident while driving under the influence of alcohol or drugs. Where ~~ person falsely claims the details of an automobile accident in order to cover up another crime such as a hit and ruts. Where a person stages a false automobile accident in order to receive payment for damages or faked injury. INFLAhED LOSS CLAIMS: where a person exaggerates the dollar loss or the type and number of items lost or damaged to an automobile in order to receive an additional settlement. Where a person exaggerates pain and suffering or his or her inability to work due to an automobile accident in order to receive additional settlement money. rl'O REPORT SUSPECTED INSURANCE FRAUD CALL THE DISTRICT ATTORNEY'S FRAUD HOTLINE TOLL FREE 24 HOURS A DAY AT Butte County District Attorney - .trance Proud ~oz n rr p ® ~u ~ ~ ;liiiiii~i~t1 ~~~,K ~~~'46 y ~ // ~+ )~ .f, " FF++~~ ,,.. _.... Page 1 of 3 Insurance Fraud Unit Insurance Fraud ;~ FeHe~rnderketln® FOR THE INVESTIGATION AND PROSECUTION Internet Fraud OF Contact IJs Co nflden tlfl I ly ~ Fraud Unit U~~IAkers Cc~l~~pensatiOn ~=raF~~d Horne Page At.«~:C~ I~~SU~°+c~CtC;:£': ~r~R.t'S~ The District Attorney's Office is funded by the California State Department of Insurance to investigate and prosecute suspected fraud in both Workers' Compensation and Auto Insurance Claims. Both of these types of crimes are felonies and are punishable by state prison. The District Attorney may investigate these cases independently or with the assistance of the Department of Insurance Investigations Division. ~ :_. _i.4 ~n~,..4... ~ C:a_r.~~'%{,:'€i`_x.'.`i>.~r; ?.i ~~:ai .xt+?,... ~~`;=~E,t_; Gci:~ ?~"a APPLICANT FRAUD: typically occurs when a person lies about being injured or when a person gets injured off the job but claims the injury occurred at work. This type of fraud also occurs when a person exaggerates the seriousness of an injury in order to receive a higher dollar benefit or extend the benefit for a longer period of time. PREMIUM FRAUD: typically occurs when an employer falsely claims a lower number of employees ar changes their work classification in order to reduce the amount of their premiums for workers' compensation insurance coverage. PRACTITIONER FRAUD: typically occurs when a Medical Doctor or Chiropractor bills an insurance company for treatments not actually received by the patient ar extends the number of treatments beyond what is necessary in order to collect additional insurance money. PROVIDER FRAUD: typically occurs when the insurance company misleads prospective clients, collects premiums httpJ/now2000.com/fraud/insurance.html 8/30100 Butte County District Attorney - urance Fraud Page 2 of 3 for insurance coverage not provided, inflates premiums, or fraudulently fails to pay an appropriate claim. Types of Automobile insurance fraud cases we investigate include: FALSE CLAIMS: typically occurs when a person falsely claims a loss that never occurred. This may include such claims as theft or loss of personal property which the claimant has secreted or disposed of for profit. e Where a person falsely reports his or her vehicle as stolen when in fact, they abandoned it after having been involved in an accident while driving under the influence of drugs or alcohol. . Where a person falsely claims the details of an accident in order to cover up another crime such as hit and run. . Where a person stages a false automobile accident in order to receive payment for damages ar faked injury. INFLATED LOSS CLAIMS: where a person exaggerates the dollar loss or the type and number of items lost or damages to an automobile in order to receive an additional settlement. o Where a person exaggerates pain and suffering or his or her inability to work due to an automobile accident in order to receive additional settlement money. Please contact us if you have been a victim of either of these types of crimes or if you have information regarding these types of fraud, which have been committed in Butte County. Your report will be kept confidential, and will be safely transmitted through a secure server. Upon receipt, our office will investigate, and when possible, prosecute these crimes to the fullest extent of the law. OR CALL US ON OUR DISTRICT ATTORNEY FRAUD HOT LINE TOLL FREE 1 866 DA F RAIJ D Top of Page Insurance Fraud ~ Telemarketing Fraud ~ Internet Fraud Contact Us Confidentially Fraud Unit Home Page http://now2000.camlfraud/insurance.html 8,/30100 Contact the Butte County Distric ttorney Fraud Unit -Secure Form 1L~ "Tlp ~ ca t ~ -e ' ~'. ~!~~~ j~ ~r'Iv.==- ~ -~= ~" :~--~ ~~Lrl ~?~.,_ ~~ ~ ~~ ~. _I ~.r Page 1 of 2 'J Insurance, Freud TBlernerketing Freud '.+~ Internet Freud ~1 contact Us Confldentlelly Fraud Unit Horne E~age Secure Form for Contacting the Fraud Unit of the Butte County District Attorney's Office If you have been defrauded, or if you think someone is conducting fraud, please complete the following form and describe the circumstances. Information you supply will be transmitted securely over the Internet, and we will treat it with complete confidentiality upon receipt. Thank you for your input. Name Address Company (if applicable) City ~~ State ~u Zip ~r-~ Prone E-Mail Have you been defrauded? r Yes ~ No Do you think someone is conducting a fraud? ~ Yes ~' No If yes, what type of fraud is being conducted? ~ Telemarketing f Internet I Insurance I-Investment Scam f Prize Promotion or Sweepstakes Offer I- Travel Scam (- Lottery ~ False Charity (- Credit Repair/Debt Consolidation I- Employment Scam I Office Supplies I- Recovery Rooms f Rip and Tear ~ Telephone Billing r Business Opportunities ~ Home Repair httpsa/secure.now2000.comlfraud,'contact.htrnl 8~30!0~ ~ I ' , ,, f I I I ` I i I ! I j I' i I I I ~ I1 ' cv ~ I I i ' 'II^ 1I I II I S ~ ~ ~ ~ I ~ I I I ; I i I I rn " I !! ~' I I I' I ~ I I I I I.~ I I I I I I ! I i ( ~, ~ ~ I ~ ~ ~ I I I I 'Q ~, ~ I I( I ~i I I I i I i i, I ~ ~ ~; I ~ I ! 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"' C.p, I u ~' N~ I ~' c ~ 3~ ~ N ~ i I ~ i ~' I ~ ~ I O~. F-' 3~° O L~ i A. ~ ~ ~ _ i I~,LL °'~ °~ E' ~ °'~ IN'o'~ ~ ~ to i N ~ M i I 'n ' ~ Iy I I NI m~ °', ~. ~ =~ o ~ NI , c ~c o ~> l~ ~ I 10 ~ ~ IOIOi N,r QI ~i~i U ~ ~ E I W a , ~ , ( ~C' ~U E o; «:! o z lU v ' irn' c . x• ai; E i o ` cv Q, a o m o o ~ w ;a U ~ c ~l z n ~ ; o z ~ ~ ~ , c o U. ~ Z ~ i t I i t f ~ i . LL ¢j "l -I w 1 I ~ I ~I I C I I I I i ~ I ~ I I 'I Ir I I r . I - .... _.. , I I i i i I i ', i i ; 1 I I ~ I li ~ i I,, ' I~ i I ~I II i ~ i I a~' i I ~a~! IN c ai . ' I~; I i °' I ~ c m ' o U SCI co c to c ~ ~i~' ' I I, 3,~i~ i.. m, of 5'~ O! ~ ~ ~ ~ C '. (0 7~~- ~ ~, ~~ N~~I~ m N Q~~ U 'Q U I ! i J ~. O~ ~i O; ~ i IU` I itU mo! ~~~JI M N; I ~ p! ~CiN W I tI ^I ~ cn: ~;-I ~ t9,J, orb ~'ro d' t'U . ~ ~l c''~~ p ~ , . Y a _. ~ ~.~'~ V, N O C cc' ~ ~ t7 , D1it~' ~~Y'. w ml Nio I (9~T: a_ ~ '~ m ~: ~' 'E~C~ ~ CI . ~ ~' - , N C Ta; tV. N,(9'N lll O ay ~'~- (9 O t9 QS Wm~~~J W~SCfl• ~ ~, ~., ^~I ~N~7.O j~N lL LLId m. ~ i I 'iI I ~ ~ ~ i l l I l '~, ~ ~; i , I i I ~ i i i 1 i ! N I I I I ~ ~NI I~ ~, ' I ~ ~ I I ~ ~~ l ~ ! I ~ l i I I I a! I Imo; ~ ~ ~ v, ~ i > tU ~~~ I N; O ~ ~ rn _ ~ I tf3 i O ' ' ~ ~ ~ i ~ ~ ~ ' ~ I ~ Q} ~ '~ ~ ~ O C.•O' I v ~ I ~ i I C I i U~in i O' ~, I I~ ~ I O o ~ ,~ IO , I .,, J ~, ~ o ri ,., ~IO • ~ I~ I°. I ` i~; . I I ?j° l r N. ~ I I c ' O' ~'~ O~''D CI•~,O N O N N O ~'~ ~W'~ d i i a ~6R h ~~ O. ~ d N N to • i ~ Ql~ i ~_ dl ~ ,~ I ~ ~ ~,. ~ E E cr co ~,.c I L E ~I ~ i ~ i O O rU ci a''_ C O ~Ni i'Q', to E cA.. vll Q~Q~Q Q l ~ C'~ S i ~' Q ~ LI~ LL.'. T h ...~ ZIZ Z Z.... ZIP CO.~,.~ MitO'....- lu. ` , ~ Z',.Z......M~N,,,"^`III,~ QUALIFICATIONS (cony d. } If the District Attorney has received a grant from CDI prior to this application, list only those achievements made possible by the use of grant funds. Also complete the Summary of closed and pending prosecutions for FY 1999- 2000. A page listing program achievements realized with the use of other funds may be included in the Appendix. 2. In FY 98-99 5 investigations were initiated and involved an average of 1 identified suspect per investigation. From July 1, 1999 to May 15, 2000 (or June 30, 2000), 4 investigations were initiated and involved an average of 1 identified suspect per investigation. 3. In FY 98-99 0 warrantsJindictments were issued, involving an average of 0 suspects andlor defendants. From July 1, 1999 to May 15, 2000 (or June 30, 2000}, 2 warrants/indictments were issued, involving an average of 1 suspect and/or defendant. 4. In FY 98-99 0 arrests were made. From July 1, 1999 to Niay 15, 2000 (or June 30, 2000), 2 arrests were made. 5. In FY 98-99 0 convictions were obtained involving 0 defendants. Of these convictions, 0 were obtained by trial verdict, 0 were obtained by plea or settlement. From July 1, 1999 to May 15, 2000 (or June 30, 2000), 3 convictions were obtained involving 3 defendants. Of these convictions, 1 was obtained by trial verdict, 2 were obtained by plea or settlement. 6. From July 1, 1999 to May 15, 2000 (or June 30, 2000}, 1 defendant was ordered to pay $795.00 in fines and penalty assessments. Of this amount $795 was collected from 1 defendant. 7. From July 1, 1999 to May 15, 2000 (or June 30, 2000) , 1 defendant was ordered to pay restitution in the amount of $13,200 in fines and penalty assessments. Of this amount $13,200 was collected from 1 defendant benefiting 1 victim. III BUTTE C CIUNTY PLAN B. Problem Statement BUTTE COUNTY AUT01fIOBILE INSURANCE FRAUD COUNTY PLAN PROBLEM STATEMENT Butte County is a semi-rural county with a population of 201,596 people. The largest city is Chico with a population of 52,~4b (93,000 is claimed by the city for the Chico greater urban area); followed by the Township of Paradise 26,57 (with a claimed area of influence of 40,000); Oroville 12,603 (45,000 is claimed for the greater Oroville area); then Gridley 4,912 (with a claimed area of influence of ??,000 people). Major employers include the California State University at Chico, various municipal, county, state and federal governments. Rice, almond, and walnut farming, along with lumber are the major industries of the area. The county has above average unemployment anal an above average welfare population. It follows that, as a economically depressed area, fraud is a major concern. The Scape and IYlagnitude of Automobile Insurance Fraud in Butte Caunrir The Butte County District Attorney's Office has acti~•ely participated in the California Automobile Insurance Fraud Program for two years. 1~1uch of the efforts of Butte County's Automobile Insurance Fraud Progam during this time have been focused on identifying the scope of the problem in this area. While the magnitude of the problem is significant we feel we are just scratching the surface. With the assistance of the Department of Insurance training and information sessions were set up the local California Highway Patrol Offices. Cases referred to the District Attorney tivere reviewed and potential automobile insurance fraud cases were identified. Among them eighty-eight cases of vehicle theft and seventy-eight cases of vandalism to vehicles were identified for calendar year 1999. Of the vehicle theft cases 13 were identified as having had an insurance claim filed. Of the vandalism cases 5 were identified as having had an insurance claim filed. Present internal mechanisms are not geared to adequately identify all such cases. This office is working with California Department of Insurance Fraud Division on the 40 automobile fraud cases identified by DOI in Butte County in the Fiscal Year 1999-00. This clearly is a substantial caseload. A caseload that camlot be borne by the Department of Insurance alone. It is clear the District Attorney needs to aggressively participate in the solution to the problem. - `~Thile the large dollar cases are significant, it appears the greatest volume of cases are those involving theft and vandalism. To further our grasp on the automobile insurance fraud problem, strong working relationships with Farmers Insurance Group, State Farm Insurance Company, and the California State Automobile Association have been established. Obtainable Performance Objectives that will SiQnificantiv Impact Automobile Insurance Fraud in Butte Counri~ Investigations: Based on the last six months of investigation, outreach and intelligence gatherin~7. we are discovering there are broad avenues for potential automobile fraud in Butte County that are relatively untouched. The addition of a half-time (~0°lo FTE) investigator is a step toward meeting the problem. This investigator will not only investigate individual cases but will actively network with local agencies, the Department of Insurance, and insurance carriers. He or she will also actively participate in the various outreach programs. Case Development: The additional investigative and clerical support will address the issue of identifying automobile theft and vandalism cases and establish internal tracking mechanisms of these cases. Through this effort attorneys can be trained to pursue restitution in cases not previously targeted. The establishment of program elements for recoupment of restitution for the victims as well as for investigations and prosecutions u~-ill be sought as logical goals following successful prosecution: Further case development will come through outreach programs, networking, and our working relationship with the Department of Insurance. Outreach and Public Education: w'e belieti~-e through news coverage, the fullest public relations and education benefits will be realized.~This office experiences a very good relationship with all the local media outlets, including ABC, NBC, and CBS as well as all our local newspapers and radio stations. These public media resources will be fully utilized to not only publish cases but to educate the public on automobile fraud issues. The Butte County District Attorney Fraud Hotline (1-866-DA FRAUD) is operational. `With advertising through newspapers, television PSA's and outreach at local fairs, we anticipate receiving greater use of the Hotline by the public. This year, the outreach at the Silver Dollar Fair and the Butte County Fair will be our most comprehensive thus far. Information on the fraud website and 24 hour Fraud Hotline, flyers and automobile insurance fraud handouts will be made available to every attendee. We expect to maximize our public education efforts to effectively reach all segments of the community effected by automobile insurance fraud. The value of outreach and education cannot be under estimated. Experience and investigative interview with suspects makes it apparent that not all insurance fraud violators are hare core sophisticated criminals. Since the majority of insurance fraud offenses detected are of a smaller caliber we are learning that many offenders are mere opportunists taking advantage of a perceived high volume of claims and a lack of true enforcement. With effective outreach and education it is our belief many local potential offenders will either abstain, knowing we have an effective enforcement program, or at least choose a more insurance fraud friendly county to carry out their fraudulent schemes. Nettivorking: This office will ei~lance the Automobile Insurance Fraud program tluough continued networking with the California Department of Insurance Fraud Division, the Northern California Fraud Investigator's Association (NCFIA), insurance providers, and local investigative agencies. Lon; Terris Goals With (1) a firm commitment to investigation and prosecution of insurance fraud by the District Attorney: (2) the establishment of a strong investigation and prosecution team; (3) the beginnings of a workable public outreach and education program; (4) established networking with investigative associations, the insurance industry, as well as the Department of Insurance, a solid foundation has been built. Building upon each of these elements will strengthen and expand the existing program. Due to the expected expansion of the Automobile Insurance Fraud caseload, within three years we anticipate the need to add another half-time attorney, another half- time investigator, and bring the secretary position up to a half-time status. Like any other significant product, we need name recognition. By the end of the three year period, the citizens of Butte County w=ill be able to identify the District Attorney's Office as a name linked to automobile insurance fraud education and prosecution. Violators will know that criminal conduct will not go undetected and prosecution and accountability will be the norm in Butte County for participation in automobile insurance fraud. To be recognized as a leading authority in automobile insurance fraud investigation and prosecution is a key long term objective. One of the greatest compliments is to see a program copied and emulated. From a committed partnership with the Department of Insurance, we fully expect to share the results of our investigations and prosecutions and to see them utilized in future training presentations. We expect our personnel to be instrumental in its dissemination . Butte County District Attorney's Office has developed state and nationally recognized programs such as Drug Endangered Children, Asset Forfeiture, and Child Abuse Response Team. `Ve will apply our knowledge, enthusiasm and talent to make our Automobile Insurance Fraud Progam reach the same level of recognized success. III BUTTE COUNTS PLAN C. Program Strategy BUTTE COUNTY AUTOMOBILE INSURANCE FRAUD COUNTY PLAN PROGR~tiI STRATEGY In summary, our goals for fiscal year 2000-2001 are to • Increase our outreach and education program in an effort to reduce the actual incidents of automobile insurance fraud in our county by getting the word out of the potential consequences that hind of conduct will generate, to the majority of the population base. • Have adequate staffing to deal ~`•ith the expected increase in the numbers of investigations and prosecutions over those of fiscal year 1999/2000 which should be a result of our enhanced public outreach and education program. • Identify existing automobile fraud cases in District Attorney caseload and develop enhanced restitution policies and procedures. • Expand public exposure to the Insurance Fraud Program through the fallowing mediums: WEB site, Fraud Hotline, radio, television, newspapers, local fairs, and community meetings. Produce a Public Ser-~~ice Announcement (PSA} featuring the D.A. Fraud Hotline for airing on local television stations. Develop a monthly "Fraud ~'Vatch" column in local newspapers. • Continue to explore identifying fraud through nerivorking with Department of Insurance Fraud Division, local law enforcement agencies, insurance carriers, and the Northern California Fraud Investigator's Association. As an example local police agency "for insurance purpose only" reports will be reviewed for potential fraud. --------------- 0 ----------------- We propose to accomplish this using existing staff and resources with the addition of a half time, (SO% FTE), investigator and increasing the clerical support from a Legal Secretary (10%FTE) to a Legal Secretary (20 % ~'TE) Narrative We have discovered key staff members, effective use and development of resources, and good inter-agency relations are imperative to a successful and viable program. Staffing: Ptzttin~ the most gzzczlified persons in the key positions. Currently staffing our Automobile Insurance Fraud program are Deputy District Attorneys Kevin Maloney and Mike Candella (each at 2~% FTE) who have proven strong prosecutorial backgrounds. They have been assisted by District Attorney Investigator Bernie Lightner who brings nearly thirty years of experience to the program. Though now working outside the grant, Investigator Jos Van Hout has developed a computerized case tracking system and aweb-site for this County's program. Senior Investigator Guy Georgianna, who supervises Investigators Lightner and Van Hout, is responsible to see all requirements of the program are carried out. He is also responsible for providing other departmental resources where needed. Gloria Lind, an experienced Legal Secretary who had been be assigned to handle the clerical responsibilities (10°'o FTE), will be replaced by Legal Secretary Iti~larci Hummel. Ms. Hummel is the personal Legal Secretary for both DDA Maloney and DD~1 Candela. Utilizing Ms. Hummel in this position will stream line grant activity as Iti1s. Hummel already has a daily working relationship with the two program attorne~~s and is familiar with their respective work. V The additional half-time (50%FTE) investigator and increase of clerical support (10% to 20%FTE) will allow for more focused investigation of Automobile Insurance Fraud Cases. Use and Development of Resources: Through the continued development of public edaccatio~z, industry networkijr„ and case development, fiscal year ?000/2001 should be our strongest year yet. Public Education Outreach and education are key to building public confidence in our ability to protect the citizens from those who drive up insurance costs by stealing. Public outreach and education are also essential to develop the needed communication between the citizens and government to identify the fraud that is taking place. To that end the Butte County District Attorney established the Fraud Hotline and Fraud Web Page. This year we took advantage of the District Attorney's participation in the local Community Fairs and highlighted our Insurance Fraud Unit using banners, handouts from the Department of Insurance, and flyers advertising the Fraud Hotline. During this coming fiscal year the Butte County District Attorney will produce a Public Service Announcement (PSA) to advertise the Fraud Hotline on local television stations. Also currently being developed is a Fraud Watch newspaper column to be published monthly in the local newspapers. The use of the PSA, exposure at the Fairs, and news releases will add to the public's knowledge of the existence of the Fraud Hotline and ~Ueb Page. The District Attorney is also committed to public education through news releases of arrests and prosecutions and of significant fraud concerns. Public education is also accomplished by the District Attorney and staff members in presentations made before community groups. It is believed the resulting public education from these efforts will have a significant impact in the form of a reduction in automobile insurance fraud in our county- and a reduction in losses paid by the insurance companies due to fraud, which in turn should translate into reduced premiums for our citizens. Networkiszg The development of working relationships within the Insurance Fraud industry as well as related investigative agencies is key to the development of cases and efficient case management. It is anticipated that with the resources to actively outreach to our local law enforcement angencies, including rive local California Highway Patrol offices, we can provide a channel for increased automobile insurance fraud referrals and ultimately the successful prosecution of these cases. Since his appointment to the Insurance Fraud Unit, Investigator Lightner has used his membership in the Northern California Fraud Investigators Association to make known Butte County's desire to establish an effective Insurance Fraud program. The District Attorney will also sponsor the new investigator's membership in NCFIA. Case Development Given the personnel resources to identify and actively pursue automobile insurance fraud cases will result in enhanced prosecution and restitution efforts. In addition to networking with the Department of Insurance Fraud Division and local law enforcement agencies, automobile theft and vandalism cases will be examined an a continuing basis to identify fraud, fraud trends, and ways to improve restitution efforts. Local police agency "for insurance purposes only" reports will be reviewed for potential fraud. Inter-agency ReCations The success of any viable Insurance Fraud program relies on a load working relationship with the Department of Insurance Fraud Division. ~Ue have made the cultivation of this relationship a priority for our Insurance Fraud Unit. From our view of the overall program, communications is a key element to nat only insure adequate investigation and prosecution, but is essential to avoid duplication of effort and coordinate joint ventures with the Department of Insurance. In our Joint Investigation Plan specific guidelines have been established regarding communication between the investigator, the attorney, and the Department of Insurance. We will insure these guidelines are met. In Conclusion ~~'e are confident we have the ability to deliver what we've promised. and must attribute a significant portion of our growing success to a strong partnership with the Department of Insurance's Fraud Division. ~Ve thank the Commission for the confidence they have shown in our ability to achieve our common goals. ~Ve thank the Department of Insurance Fraud Bureau for the confidence they have shown us by their willingness to be truly full partners in the insurance fraud efforts of our county. III BITTTE COUNTS PLAN D. Staff Qualifications BUTTE COUNTY DISTRICT ATTORNEY AUTO INSURANCE FRAUD PROGRAM STAFF DEPUTY DISTRICT ATTORNEY: DDA Kevin Maloney, formerly with Mendocino County District Attorney's Office, extensive knowledge of Insurance Fraud investigation and prosecution. Kevin will be overseeing most all prosecutions. Kevin is a graduate of the San Francisco School of Law. His first year of law practice was spent as a defense Attorney in Glenn County, followed by fourteen years as a prosecutor at Mendocino County District Attorney's Office, and was that office's Insurance Grant Administrator and prosecutor. Member California District Attorney Association, Insurance Fraud Committee. Mr. Maloney has been an instructor at CDAAIDOI fraud seminars. DDA Mike Candela graduated from the University of San Francisco School of Law in 19$7. Prior to his graduation he was a law clerk for the California Supreme Court. After graduation he worked as a Research Attorney for the San Francisco Superior Court. He also worked as a Deputy District Attorney for Mann County and worked in private practice before coming to Butte County in 1997. Mr. Candela is a co-author of a second and third editions of the CEB, California Criminal Law, Procedure and Practice. DDA Michael Candela will share actual prosecutions with DDA Maloney. SENIOR INVESTIGATOR: Senior Investigator, Guy Georgianna, supervises the Major Crimes Unit of the Butte County District Attorney, Investigation Division. Mr. Georgianna is responsible for the supervision of the program investigators and responsible for the management of the program grants and grant reporting process. 10°l0 of Mr. Georgianna's time is devoted to the program. He has held this position since December 1997. Guy graduated from the University of Redlands with a Business Degree and has more than twenty-five years experience in both state and federal law enforcement. PROGRAM INVESTIGATORS: Bernie Lightner, Investigator II, is the Insurance Fraud Program Investigator. Investigator Lightner has been a law enforcement officer for over thirty years. Investigator Lightner worked nine years as a patrol officer and 10 years as a detective for the San Carlos, California Police Department. After moving to the North State, he continued his law enforcement career as a DA Investigator for the Butte County District Attorney's Office, assigned as the agency's Homicide Investigator for seven years. Lightner brings thirty years of experience and thousands of hours of training to this position. Investigator Jos Van Hout currently works outside the funding provided in the grant. Prior to entering law enforcement Mr. Van Hout spent 13 years specializing in computers and electronics. This background has proven valuable combined with his ten years in law enforcement. He continues to maintain the computer tracking system he developed far the Insurance Fraud system. At this time he is overseeing the development of the Fraud Web Page. Investigator Van Hout continues to assist in the investigation of Insurance Fraud Cases. SUPPORT STAFF: Marcie Hummel, Legal Secretary, provides clerical support for the Insurance Fraud program. Secretary Hummel has over twenty years experience as a Legal Secretary and Office Manager. She only recently came to the District Attorney's Office and is a welcome addition. 2 III BUTTE COUNT'S PLAN E. Organizational Chart BUTTE COUNTY AUTOMOBILE INSURANCE FRAUD ORGANIZATIONAL CHART CHIEF INVESTIGATOR MAJOR CRIMES UNIT SENIOR INVESTIGATOR DISTRICTv ATTORNEY MARCIE HUMMEL ~~ Legal Secretary ~ 1 CHIEF DEPUTY DISTRICT ATTORNEY KEVIN MALONEY DEPUTY DISTRICT ATTORNEY DEPUTY DISTRICT ATTORNEY FRAUD INVESTIGATOR IV JQINT INVESTIGATIVE PLAN JOINT INVESTIGATIVE PLAN Memorandum cf Understanding Automobile Insurance Fraud 1. Introduction (a) The "parties" tc this joint plan are the California Department of Insurance - Fraud Division, and the Butte County District Attorney`s Insurance Fraud Unit. {b) The parties of this joint investigative plan recognize that the C.D.I. - Fraud Division was established to investigate allegations of insurance fraud throughout the State of California, and is the primary investigative agency in this field. However, while the headquarters for the Fraud Division in Central Northern California is based in Sacramento, its investigative responsibilities encompass twenty-five central and northern counties. Due to this considerable geographical territory, the number of referralslcases, and the finite number of investigators available, the Fraud Division cannot reasonably be expected to devote its efforts in any one county. Thus the important need for an effective joint plan to address the problem of insurance fraud in each jurisdictional territory. 2. Statement of Gcals (a) To promote a clcse working relationship between the DA's insurance fraud unit a^:d the Fraud Division, based on dedication to the common goal of fightir:g insurance fraud, commitment tc the highest professional and ethical standards, and mutual respect as law enforcement officers devoted to the pursuit of justice and the protection of the citizens of Butte County and the State of California. (b) To investigate ir. a timely manner, u sing professional standard anal procedures, and prosecute when appropriate, as many identifiable cases of suspected insurance fraud as we can. (c) To achieve the best possible anti-insurance fraud program we can produce, through the efficient and effective use of the limited resources provided, and the promotion of awareness in this community that the serious problem of insurance fraud is being addressed in a meaningful way by law enforcement. 3. Receipt and Assignment of Cases (a) When a suspected fraudulent claim (SFC} or a case referral package is received from insurer, it will be entered into a database, available for future reference. Bath parties will maintain a case tracking system to monitor all SFC`s and case referral packages received. (b) Both parties will communicate on a regular, scheduled basis to discuss SFC`s and case referral packages received, with the objectives being to avoid duplication of investigative efforts, and to insure t!~:at all referrals are being appropriately addressed. When a case is assigned for ir.vestigatior., the assigr.i::g party will notify the other within ten working days. A monthly report regarding intake of SFC's and assigned cases will be generated by both parties and mailed to one another by the fifth working day of each month. .; c) If the SFC or case referral package is sent only to the Fraud Division, the Fraud Division will address the matter, exercising its best discretion on how to proceed, with appropriate notice to the D.A.'s insurance fraud unit of the action taken. If the SFC or case referral package is sent only to the D.A.'s insurance fraud unit, it will notify the Fraud Division and determine what action, if any, the Fraud Division desires to take, as indicated in paragraphs (d}, (e}, and (f) below. T'r,e information shall include the suspect's name, carrier or administrator and the claim number. (d) As the primary investigative agency in the field of insurance fraud, the Fraud Division will have ~~first claim" to any SFC or case referral package sent by an insurer for investigation. There can be a:: exception to this provision if the referring insurer specifically requests that the investigation be done by the D.A.'s office. The Fraud Division will be notified immediately tc discuss the situation ar.d avoid any duplication of investigative efforts. (e)wf the Fraud Division elects to pursue an investigation of an SFC er case referral package sent by an insurer, the D.A.`s insurance fraud unit will suspend any further action en the case, pending the outcome of the Fraud Division's investigation, ar.d will notify the insurer of this fact in writing. (f) If the Fraud Division elects n.ot to pursue an investigation of an SFC or case referral sent by an insurer, because of excessive caseloads, resource limitations, or ar.y ether reason, or chooses to defer any matter. referred, the D.A.'s insurance fraud unit will review the referral for investigation. The referring insurer will be notified of this fact in writing and a copy of the writing will be submitted to the appropriate D.A.'s insurance fraud unit. (g} If the D.A.'s insurance fraud unit receives a referral that would be more appropriately handled in another county`s jurisdiction, the original receiving D.A.'s office will forward the referral to the appropriate county and notify the Fraud Division. 4. Investigations (a} Pursuant to the above provision', and to maximize the expenditure of resources, it is understood and agreed that either party will provide assistance to the other upon request in any investigation. where such assistance is needed. This could include serving search warrants, interviewing witnesses, making arrests, etc. 2 (b} Joint investigations, may be urndertaken in cases where the parties determine it is beneficial to combine resources to achieve the most efficient ar.d effective results. This will be determined on a case-by-case basis. {c} It is expected that cases will be developed from referrals by insurers, other law enforcemer.tlgovernmental agencies (CHP; EDD; etc.), informants and other responsible sources of information. Outreac:~ programs are encouraged to promote this aspect of the plan. (d} It is the intent of this joint investigation plan to avoid duplication of investigative efforts by maintaining regular communication to discuss caseloads and share information concerning current investigations. The Fraud Division regional supervisors will meet at a minimum of twice a year with the D.A.'s ir.surar.ce fraud unit's designee to review the working relationship between beth agencies. (e; The Deputy District Attorney of the D.A.'s insurance fraud unit, or his/her designee, will be available to meet with the Fraud Div~~sion investigator at ar.y time during the investigation of a case when. so requested by t:~e investigator to discuss any aspect of the case. (f> It is the intent of the parties that by maintaining regular communication. ar.d adher~ng to agreed upon plans and procedures, t:~e completed investigation will result in the filing of criminal charges anal a successful prosecution:. At the same time, however, it is understood that r.ot every case t'r.at is investigated will result in prosecution. This can happen when the evidence does :•:ot develop as expected, material witnesses are no longer available, the case lacks jury appeal, the reasonable likelihood of conviction is minimal, er other unforeseen circumstances develop. The parties will take all possible steps to avoid such situations, as it is not desirable to expend investigative resources on cases that are r.ot prosecuted in court. (g Any investigative costs associated with a Fraud Division investigation prior to the complaint being filed, the Fraud Division will incur the cost. Any costs associated with the investigation after the complaint is filed the District Attorney's Office will incur the cost. Responsibility for costs incurred during a "joint" undercover operation will be determined by the Memorandum of Understanding - see section 5(c). 5. Undercover Operations (a) Bcth parties recognize the importance of undercover investigations in those cases where it is felt this technique is a viable mear:s (often the only means) of developing evidence to prove a suspected insurance fraud. However, the parties also agree that undercover operations need to be highly organized and carefully monitored by supervisor level personnel to insure the efficie;:cy ar.d integrity of the investigation. It is understood that undercover operations can be very labor intensive ar.d time consuming, and don't always produce the desired results. 3 (b) Either party may decide to particular case usir,q its situation. where the Fraud undercover investigation in notify the D.A.'s office. be available tc provide any conduct an undercover operation in a own personnel and resources. In a Division conducts its own independent Butte County, the Fraud Division will The D.A.'s insurance fraud unit will advice or other assistance requested. (cl In a case where there will be a "joint" undercover investigation., there will be a memorandum of understanding (M.O.U.) prepared prior to t'r.e start of the investigation, which outlines and specifies the goals and the objectives cf the investigation, as well as the duties and responsibilities, including personnel and financial responsibilities, of each of the parties in the investigation. 6. Case Filing Requirements (a) The investigation of suspected insurance fraud cases should focus not only on the development of probable cause to make an arrest, but also on the obtaining of sufficient evidence to prove the charge beyond a reasonable doubt in a criminal court. It is understood t'nat each case is unique, and that certain action may need to be taker. in er.e case that would not be taken ir. another. (b) when submitting a case for prosecution, tine investigator should present as complete a package as possib_e, including a detailed report, whic~: outlines the offenses alleged to have beer. committed, t:;e details of the investigation, and the evidence available to prove the c^:arges, including identification. of availab.e witnesses ar.d supporting documentation. In cases involving al~.eged false statements of misrepresentations, there must also be iden*ified evidence to show materiayity cf the alleged false statement or misrepresentation to the claim. (c) To promote efficiency ir. t'.nis area, Fraud Division investigators are encouraged to contact the Butte County D. P.. early in the investigation of a case to share ideas and develop strategies that will lead to a prosecutable case. (d) Tt-ne D. A. will ensure that all formal case presentations made by the Fraud Division will be reviewed within thirty working days of the presentation or delivery. If additional investigation is believed to be needed by the reviewing D.A., he/she will notify the case investigator immediately. The case investigator will complete the additional investigation as soon as reasonably possible ar.d provide the D.A. with status updates at a minimum of every fifteen working days until the investigation is completed. The D.A. will further ensure that decisions on completed investigations, and any complaint filings shall be done in a timely fashion. but no longer than sixty days from the date of receipt. If a formal case is rejected for prosecution, the D.A. will prepare a letter in writing stating the reasons for the rejection. and provide the letter to the case investigator within ten working days following the rejection. 4 7. Training (a) Both parties have been, and will continue to be, active participants in the annual CDAA/CDI insurance fraud training seminar. This will provide a significant portion of the ongoing tra.~ning of both parties in the area of insurance fraud. (b) The parties will participate in joint informal training sessions as necessary or. issues important to the investigation and prosecution of insurance fraud cases. (c) The parties will assist each other, when requested, in training sessions for insurance carriers and administrators, ar issues important to the detecting, investigation, and prosecution of insurance fraud cases. Both parties will notify each other when there is a request for training by an insurance carrier and administrator. 8. Problem Resolution (a) It is the intent of this joint plan that any problems or differences that may arise between the parties be resolved quickly through early, direct, and open cammuniaation by those persanr.e~ directly involved in the dispute. If necessary, the Chief Investigator of the Fraud Division. and the prosecutor in charge of the D.A.`s insurance fraud program may be called upon to resolve any d'_spute, concentrating cr. the best i.^.terests of t::^.e overall insurance fraud nraaram. Edward J. Szendr y ate Chief Ir.vestiga;.or Butte County District Attorney Kathryn L. Scholz Date Chief Investigator, Fraud Division. California Department of Insurance