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HomeMy WebLinkAbout99-100RESOLUTION AUTIIORIIING DISTRICT A"l'7'ORNEY "I'O UNDERTAKE GRANT' AWARD AGREEMEN"' WHEREAS, the Butte County Board of Supervisors desires to undertake a certain program designated "Automobile -California Insurance Code Section 1872.8, Califarnia Code of Regulations Subchapter 9, Article 4, Section 2698.b~ 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 inchiding any extensions or amendments thereof. BL IT FUR"I'HER RESOLVED that grant funds received hereunder shall not be used to supplant expenditures controlled by this body. 1 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 27 day of July, 1999, by the follo~~ing vote: AYES: Supervisors Beeler, Houma, Jasiassen, Davis, and Chair Dolan NOES: None NO"I' VO`T'ING: None ABSI-;N"I~: None ~~ ~~~ f~~• , C ;~ .; -- JANE D .LAN, Chair Butte County Board of Supervisors ATTEST: .TORN BLACKI_.OCK, Chief Administrative Officer and Clerk of the Board of Supervisors DEPARTMENT OF INSURANCE GRANT APPLICATION TRANSMITTAL Office of the District Attorney, County of Butte, hereby makes application for funds under the automobile fraud program pursuant to Section 1872.8 of the Insurance Code. Contact: Ed Sz_endrey Address: 25 County Center Drive Oroville, CA. 95965 Telephone: (530) 538-7460 (1}Program Title Automobile Insurance Fraud Prosecution Program (2) Grant Period 7/U99 - 6/30/00 (3) Grant Amount $89,459 (4) Program Manager Michael L. Ramsey District Attorney 25 County Center Drive Oroville, CA. 95965 (5) Financial Officer Constance Carter-Angove District Attorney Administrative Officer 25 County Center Drive Oroville, CA. 95965 (6) -istricttlttorney's Signature Name: Mich L. ams Title: District Attorney County: Butte Address : 25 County Center Drive Oroville, CA. 95965 Phone: (530) 538-7411 Date: June 15, 1999 Butte ~'ounty District Attorney APPLICATION FOR A PROGRAM FOR THE INVESTIGATION AND PROSECUTION OF AUTOMOBILE INSURANCE FRAUD Fiscal Year 1999-00 TABLE OF CONTENTS I. SECTION ONE 1. Grant Transmittal 2. Board of Supervisors Resolution 3. Program Contact Information II. BUDGET ELEMENTS A. Personnel (Salary and Benefits) B. Operating Expenses C. Equipment III. BUTTE COUNTY PLAN A. Qualifications B. Problem Statement C. Program Strategy D. Objectives E. Organizational Chart IV. JOINT INVESTIGATIVE PLAN PROGRAM CONTACT FORM I. 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 (~roville, CA. 95965 Telephone Number: (530) 538-7735 Fax Number: (530) 538-7471 2. Provide the name, title, address and telephone number of the Chair of the County Board of Supervisors. Name: Jane Dolan "I~itle: Chairm~ul, Butte County Board of` Supervisors Address: 25 County Center Drive Oroville, CA. 95965 'T'elephone 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-Angovc Title: District Attorney Chief Administrative Oflicer ;address: ?> County Center Drive Oroville, CA. 95965 Telephone Number: (530) 538-7207 Fax Number: (530) 538-7071 ~. Provide the name, title, address and telephone number for the person responsible for t:he data collectionlreporting for the applicant agency. Name: Donna Dulyea Title: District Attorney Investigator II Address: 25 County Center Drive Caroville, CA. 95965 Telephone Number: (530) 538-2046 Fax Number: (530 538-'70'7I II ~LTDGErI' ELEIVIENTS DEPARTMENT OF INSURANCE AUTOMOBILE INSURANCE FRAUD FY 99!00 BUDGET CATEGORY AND LINE- ITEM DETAIL R. Personnel Services -Salaries/Employee Benefits COST Deputy District Attorney 111/IV (.25FTE) Program Attorney. Oversees Program -Salary 16,510 Devotes 25% of time to this program during -Benefits 3,817 last half of fiscal year. Deputy District Attorney III/IV {.25 FTE) Program Attorney. Devotes 92.5°I° of time -Salary 14,261 to program during last half of fiscal year. -Benefits 2,683 District Attorney Investigator II (.40 FTE} Program Investigator. Devotes -Salary 18,054 40 % of time to this program. -Benefits 7,107 District Attorney Investigator II (.10 FTE) Program Investigator. Devotes -Salary 4,514 90°l of Time to this program. -Benefits 1,777 Legal Secretary {.10 FTE) Clerical support for program. -Salary 3,284 Devotes 90% of time to this program. -Benefits 719 Ghief Deputy District Attorney (.03 FTE) Supervisor of Program. Devotes 3% of time -Salary 2,312 to oversight of program. -Benefits 509 District Attorney Administrator (.02 FTE) Devotes 2% of time to Program -Salary 1,289 grant management. -Benfits 276 TOTAL -Personnel Services 77,112 DEPARTMENT OF INSURANCE AUTOMOBILE INSURANCE FRAUD B. Operating Expenses Communication Expense COST 1,217 Transportation,Travel, and Training 1,600 Travel for meetings, case investigation, and program related training for investigator. Office Expense General office supplies. 770 Transportation -Motor Vehicle I 3,000 $500 per month is allocated for the use of vehicle assigned to project investigator. (500 X 12 = 6, 000 X 50% = 3000) (Audit Annual expense for Program Audit 1, 500 dministrative Overhead 4,260 5 % of total direct costs. Cost allocation plan in accordance with Federal OMS Circular A-87 is on file with the State Controllers Office. (TOTAL -Operating Expenses ~ $12,347 ~ DEPARTMENT OF INSURANCE AUTOMOBILE INSURANCE FRAUD BUDGET CATEGORY AND LINE-ITEM DETAIL C. EQUIPMENT COST None TOTAL - Equipment 0 PROJECT TOTAL $89,459 III BUTTE COUI~TT~ PLANT A.. Qualifications COUNTY PLAN AUTOMOBILE INSURANCE FRAUD QUALIFICATIONS The Butte County District Attorney's Office has been a participant in the Department of Insurance, Automobile Insurance Fraud Program for the last year. During the period of 1998J1999, the department developed its first year program, in that, we were able to actively plan and implement strategies to investigate and prosecute automobile insurance fraud. We intend to continue to build on this foundation for 1999/2000 with new ideas and programs. This office is committed to its responsibility to address the general issues of insurance fraud. We recognize with 185,000 vehicles registered in Butte County, and a tremendously high number of unregistered vehicles operating illegally in Butte County, we need the resource funded by this grant to address the issue in a positive, professional manner. The District Attorney realizes the mind-set of this office has to be to aggressively address the issue of insurance fraud an a continuing basis. E~1GV41.V~ use o~ ~. e funding and services provided by the Department of Insurance has allowed this office to bring cases to disposition. This office clearly recognizes that with the resources of the Department of Insurance, combined with the current resources of this department, we can maximize an aggressive continuation in the fight against automobile insurance fraud. Needed to address the issues of insurance fraud are. adequate resources for prosecution, follow-up investigation, outreach, clerical support and program coordination. Experienced staff in the form of Deputy District Attorney Kevin Maloney, Deputy District Attorney Frank Horowitz, Senior Investigator Guy Georgianna, I?westigator Donna Dulyea, Investigator Jos Van Hout, and the Major Crimes Unit secretary would be made available for insurance fraud cases. Whenever possible, we utilize graduate students from nearby Chico State to assist. Funding available through this grant alone, would nat be sufficient to hire a full time investigator in addition to the prosecutorial and clerical demands of an effective program. However, with the approval of this grant and the funding available through the Workman's Compensation Insurance Fraud Program, sufficient resources would be in place to hire an investi- gator. The overall plan is to provide 50o FTE of a Deputy District Attorney's time ir. the form of 25o Deputy District Attorney Kevin Maloney's time and 250 of Deputy District Attorney Frank Horowitz' time. The structure of the Butte County Consolidated Courts necessitates dividing the case load between two attorneys. 100 of Senior Investigator Guy Georgianna's time, 400 of Investigator Donna Dulyea's time, 10% of Investigator Jos Van Hout's time, and loo of the Major Crimes Unit secretary's time. 1 Funding available through this grant combined with funding available through the Worker's Compensation Insurance Fraud Program, would go a long way in helping the Butte County Office of the District Attorney address insurance fraud issues. QUALIFICATIONS CONTINUED From July 1, 1998 to June 30, 1999 _5_ investigations were initiated and involved an average of _1_ identified suspects per investigation. From July 1, 1998 to June 30, 1999 _1_ warrantsjindictments were issued, involving an average of _1_ suspects andjor defendants. From July 1, 1998 to June 30, 1999 _C_ arrests wera made. From July 1, 1998 to June 30, 1999 _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, 1.998 to June 30, 1999 defendants were ordered to pay $ 0 in fines and penalty assessments. Of this amount $ 0 was collected from 0 defendants. From July 1, 1998 to June 30, 1999 _0_ defendants were ordered to pay restitution in the amount of $ 0 in fines and penalty assessments. Of this amount $ 0 was collected from 0 defendants, benefitting 0 victims. _ 2 III BUTTE BOUNTY PLAN B. Problem Statement AUTOMOBILE 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 52,746 (93,000 is claimed by the city for the Chico greater urban area); followed by the Township of Paradise 26,357 (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 22,000). There are 185,000 vehicles registered in Butte County. Major employers include the University of California at Chico, various municipal, county, state and federal agencies. Rice almond, and walnut farming, along with lumber are the major industries of the area. The county has above average unemployment and an above average welfare population. It fv11vWS that, cos aii economically depressed area, fraud is a major concern. The advent of Indian Gaming has also had a negative impact. Two casinos have opened in the Oroville area. A smal_1 increase in bad check, theft embezzlement and fraud has been attributed to those suffering gambling losses. We have just completed our first year under a Department of Insurance Autamobi.le Grant. We have implemented new ideas and strategies to build a strong foundation on which the Department of Tnsurance and the Butte County District Attorney's Office can expand over the years. By adopting a strategy of blanket advertising, personal contacts, participating in Department of insurance presentations and assisting other police agencies with insurance related investiga- tions, we are slowly but consistently building a strong base for referrals and self initiated investigations. The Butte County District Attorney's Office, in an effort to more effectively investigate and prosecute fraud violations, is currently establishing a Computer Internet Outreach Program to potential victims. This service is estimated to be on line by August 1999. Using latest technology, a web site is being designed to allow potential victims to log onto the web site and contact our office. The web site will allow users to specifically determine what type of fraud they believe has victimized them. A detailed outline of elements and a description of specific crimes will also be available. The web site will also have a confidential area to allow users to report suspicious activities or report potential 1 suspects. Types of fraud, which can be reported are Worker's Compensation Fraud, Auto Insurance Fraud, and General Consumer Fraud. In addition to the web site, a rr^raud Line has been installed. When this standard telephone line is operational, it will allow callers to call i_n and report potential fraud, similar to the web site . Callers can identify, by selecting the appropriate mail box number, specific types of fraud by which they may have been victimized. This will allow victims, without computer access, to report potential fraud. As on the web site, a confidential mail box number will also be available for reports of fraud and potential suspects. Types of fraud, which can be reported are Worker's Compensation Fraud, Auto Insurance Fraud and General Consumer Fraud. In order to better equip the Butte County District Attorney's Office in the administration of the Department of Insurance Grants, :4Te have actively recruited qualified presecutcrs, wit? extensiv.. experience in Department of Insurance investigations and prosecu- tions. Deputy District Attorney Kevin Maloney, was such a hiring. While he anr_e managed Mendocino County's Department of Insurance Grants, he is now our primary fraud prosecutor. Department of Insurance records show there were 49 cases of Automobile Insurance Fraud in Butte County during years 1995/97. This clearly is a substantial caseload. A caseload that cannot be borne by the Department of Insurance alone. It is clear the District Attorney needs to aggressively participate in the solution of the problem. With the available funding, this office makes a commitment of one half investigator, supported by a back up investigator, and the necessary prosecutorial, administrative and clerical support to aggressively address these suspected fraud cases. Butte County remains committed to providing resources and manpower to that end. 2 III BUTTE C®UNTY PLAN C. Program Strategy AUTOMOBILE INSURANCE FRAUD COUNTY PLAN PROGRAM STRATEGY The Butte County District Attorney Automobile Insurance Fraud Investigation and Prosecution Program strategy is based on staffing, resource development, communications and pro-active programs. Staffing: Placing the most qualified persons in key positions. Prosecution of Automobile Insurance Fraud cases will be the responsibility of two Deputy District Attorneys. The division of the case load is necessitated by the structure of the Butte County Consolidated Courts. Because of this, all case loads in the Butte County District Attorney's Office are divided alphabetically. Deputy D1Stri Ct Attprnr~y KE.vi n Maloney i8 a graduate of the San Francisco School of Law. He spent his first year of law practice as a criminal defense attorney in Glen County. For the past fourteen years Kevin was employed as a Deputy District Attorney for the County of Mendocino, where his primary responsibilities included: the prosecution of worker's compensation, automobile and welfare fraud cases. Kevin was also responsible for Department of Insurance Grant management for Mendocino County. Kevin joined the Butte County District Attorney's Office in March 1999. Deputy District Attorney Frank Horowitz graduated from UCLA with Bachelor and Juris Doctorate degrees. Frank spent five years with the Los Angeles Pu'olic Defender's Office and then spent the next eighteen years with the Los Angeles City Attorney's Office. In 1997 Frank came to work for Butte County District Attorney' s Office ands currently assigned to economic crimes. Investigation of Automobile Insurance Fraud Cases will be the responsibility of Investigator Donna Dulyea. Ms. Dulyea has been a District Attorney Investigator with the San Diego District Attorney's for twenty-two years. Prior to that, she was a Police Officer for the City of San Diego. Since 1992 Ms. Dulyea has been a supervising investigator. Her assignments include major crimes, fraud and environmer_tal crimes. She was the California District Attorney Investigators Association Investigator of the Year for 1991. Investigator Dulyea accepted a position with the Butte County District Attorney's Office in 1998. Investigator Jos Van Hout was appointed as Investigator for the Butte County District Attorney in 1996. Previously he worked for the Butte County Sheriff's Department for 6 years. Investigator Van Hout has 13 years specialized experience in the field of computers, computer design and extensive knowledge of business management. He has been assigned to both Department of Insurance 1 Grants fog- 1998 f 1999 . Senior Investigator Guy Georgianna will supervise Investigators Dulyea and Van Hout and be responsible to see that all requirements of the program are carried out. Mr. Georgianna has been with the Major Crimes Unit of the Butte County District Attorney's Office since 1991. He has over twenty-five years experience in law enforcement having worked for the San Bernardino County Sheriff's Department and the U. S. Drug Enforcement Administration. Mr. Georgianna specializes in Asset Forfeiture, Economic Crime and Major Fraud Investigations. Clerical responsibilities for the program belong to Gloria Lind. Ms. Lind is the secretary for the Major Crimes Unit. She is a Supervising Legal Secretary. Ms. Lind has been employed with Butte County as a Legal Secretary for eighteen years. Resource Development: The development of resources far the Butte County District Attorney, Automobile Insurance Fraud Prosecution Program has been underway since the 199£3/1999 grant period. Investigators Georgia- nna and Van Hout, and Deputy District Attorney Kevin Maloney have participated in two training sessions presented by Department of Insurance Investigator Larry Sewell at the local CHP Office. ~r~'e have continued to access managers of successful insurance grant programs, established in other counties. Our policy has been to take advantage of every possible resource and point of contact. Investigator Dulyea is the pivotal key to the successful adminis- tration of our Automobile Insurance fraud Protection Program. It is her responsibility to maintain open lines of communication between the Department of Insurance, Deputy District Attorneys, various insurance carriers and this office. Investigator Dulyea w11_ utilize ail resources available to effectively manage the automobile Insurance Fraud case load. As the newest member of the Investigations Team, Investigator Dulyea will be instructed to make routine contacts and visits with the Sacramento Office of the Department of Insurance, Fraud Division, and whenever possible will accompanied by Investigators Georgianna and Van Hout to Department of Insurance sponsored training. Investigator Jos Van Hout has developed a computerized case tracking system, which is being utilized to track insurance fraud cases. Investigator Dulyea will be responsible for reporting new cases and case dispositions to the Department of Insurance. Investigator Van Hout will assume the role as back up investigator as well as the x~rimary responsibility of tracking cases. 2 As part of the Butte County District Attorney's Office strategy, a mail education program has been initiated throughout Butte County. 131 letters, introducing the new insurance fraud investigation unit, have been mailed. Businesses contacted were key insurance related businesses within Butte County. This mailing was conducted during April, May and June of 1999. Even with minimal response, cases obtained from this procedure, in addition to cases from local police agencies, will greatly increase numbers of overall investigations for year 1999J2000. To familiarize Investigator Dulyea with these resources, and to prepare her to be the facilitator of this program, this office will make her available to spend two to four days with the Shasta County District Attorney Insurance Fraud Unit: to attend all carrier sponsored training events; and all specialized training provided by the Department of Insurance. Communications: From our view of the overall program, communications is the key element to not 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 communications between investigator, the attorney and the Department of Insurance. We will insure these guidelines are met. Please refer to the attached Joint Investigation Plan. All cases will be reviewed by Deputy District Attorneys Kevin Maloney or Frank Horowitz, and the follow up investigation will be coordinated between Mr. Maloney, Mr. Horowitz, Investigator Dulyea and the Department of Insurance. 3 BUTTE COUNTY DISTRICT ATTORNEY INSURANCE FRAUD PROGRAM YEARLY HIGHLIGHTS FY 98j99 » »> During April 1999 a mailer went out to more than 130 letters went out to major corporations and insurance related businesses within Butte County. See attached copy. » »> Butte County District Attorney hosts a bi-monthly area wide investigator's meeting, averaging more than 40 state, federal and local investigators. Current training to include Butte County's Insurance Fraud Program is presented and each investigator discusses current cases and caiz make requests for assistance. » »> Creation of an Internet Web Site for public education and instruction regarding insurance and major fraud. » »> Establishment of a telephone fraud line, enabling the public to report suspected insurance and major fraud. » »> We are currently scheduling public speaking engagements addressing insurance fraud issues and education. Two presentations have been scheduled within the next 30 days. » »> Provided agents to work in undercover capacities for other State agencies conducting insurance fraud investigations. » »> Currently assisting Tehama County District Attorney's Office in the preparation of Department of Insurance grants. » »> Butte County District Attorney's Office has maintained an aggressive prosecution program for other forms of insurance fraud, not covered within the confines of the grant, such as staged burglaries, arson for profit and medical insurance fraud. 4 » »> At least three of our current cases involve multiple agencies and jurisdictions, requiring coordination and cross training to achieve common goals. » »> The hiring of Deputy District Attorney Kevin Maloney, formerly Mendocino County District Attorney's Office, as our lead prosecutor of insurance fraud. » »> Dave assisted DOI Investigator Larry Sewell with insurance fraud presentations at our local CHP office. » »> Significant auto fraud cases include a local auto body shop adding hours to repairs bills, defrauding all insurance companies with which they conduct business. Another case regt:ired the use of informants and prete:nt pho~~c calls ~.ca obtain necessary evidence and leads. 5 III BUTTE CQUNTY PLAN D. Objectives COUNTY PLAN FY 1999/2000 OBJECTIVES 1. Twelve new investigations will be initiated during FY 1999j2000. 2. Seven new prosecutions will be initiated during FY 1999j2000~ Our current mailing program and web site, may actually increase the numbers in category 1. and 2. dramatically, but more conservative numbers at this juncture would be appropriate. 3. Five investigations will be carried aver from the previous grant period. 4. One prosecution will be carried aver from the previous grant period. 1 III BUTTE COITNT~ PLAl`~T E. Organizational Chart BUTTE COUNTY AUTOMOBILE INSURANCE FRAUD ORGANIZATIONAL CHART MICHAEL L. RAMSEY ©ISTRICT ATTORNEY ED SZENDREY CHIEF INVESTIGATOR FRANSISCO ZARATE~ CHIEF DEPUTY DISTRICT ATTORNEY MAJOR CRIMES UNIT GUY GEORGIANNA SENIOR INVESTIGATOR DONNA DULYEA FRAUD INVESTIGATOR JOS VAN HOOT FRAUD INVESTIGATOR KEVIN MALONEY DEPUTY DISTRICT ATTORNEY III FRANK HOROWITZ DEPUTY DISTRICT ATTORNEY III IV JOII'~T INVESTIGATIVE PL~iN JOINT IlYVESTIGATIVE PLAN Memorandum of Understanding I . Introduction (a) The "parties" to 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 ofreferrals/cases, 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 far an effective joint plan to address the problem of insurance fraud in each jurisdictional territory. 2. Statement of Goals (a) To promote a close working relationship between the DAs insurance fraud unit and the Fraud Division, based on dedication to the common goal of fighting insurance fraud, commitment to 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 in a timely manner, using professional standard and 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 Present law requires that an insurer who knows or reasonably believes that an act of insurance fraud has been committed, report this information to the Department of Insurance -Fraud Division and the local district attorney (Insurance Code section I $77.3). (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. Both 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 that all referrals are being appropriately addressed. When a case is assigned far investigation, the assigning 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 (fJ below. The information shall include the suspect's name, carrier or administrator and the claim. (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 an 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 to discuss the situation and avoid any duplication of investigative efforts. (e) If the Fraud Division elects to pursue an investigation of an SFC ar case referral package sent by an insurer, the D.A.'s insurance fraud unit will suspend any further action on the case, pending the outcome of the Fraud Division's investigation, and will notify the insurer of this fact in writing. {f) If the Fraud Division elects not to pursue an investigation of an SFC or case referral sent by an insurer, because of excessive caseloads, resource limitations, or any other reason, or chooses to defer any matter referred, the D.A.'s insurance fraud unit will review the referral far 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. 2 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. (b) Joint investigations, may be undertaken in cases where the parties determine it is beneficial to combine resources to achieve the mast efficient and 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 Iaw enforcement/governmental agencies (CHP; EDD; etc.), informants and other responsible sources of information. Outreach programs are encouraged to promote this aspect of the plan. (d) It is the intent of this joint investigation plan to avoid duplication of imrestigative 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 instu~ance fraud unit's designee to review the working relationship between both agencies. {e) The deputy district attorney of the D.A.'s insurance fraud unit, or histher designee, will be available to meet with tl~e Fraud Division investigator at any time during 'she investigation of a case when so requested by the investigator to discuss any aspect of the case. (f~ It is the intent of the parties that by maintaining regular communication and adhering to agreed upon plans and procedures, the completed investigation will result in the filing of criminal charges and a successful prosecution. At the same time, however, it is understood that not every case that is investigated will result in prosecution. This can happen when the evidence does not develop as expected, material witnesses are no Longer available, the case lacks jury appeal, the reasonable likelihood of conviction is minimal, or other unforeseen circumstances develop. The pasties will take all possible steps to avoid such situations, as it is not desirable to expend investigative resources on cases that are not 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 S (c}. 3 5. Undercover Operations {a) Both parties recognize the importance of undercover investigations in those cases where it is felt this technique is a viable means (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 efficiency and integrity of the investigation. It is understood that undercover operations can be very labor intensive and time consuming, and don't always produce the desired results. {b) Either party may decide to conduct an undercover operation in a particular case using its awn personnel and resources. In a situation where the Fraud Division conducts its own independent undercover investigation in Butte County, the D.A.'s insurance fraud unit will be available to provide any advice or other assistance requested. (c} In a case where there will be a "joint° undercover investigation, there will be a memorandum of understanding (M.O.U.) prepared prior to the start of the investigation, which outlines and specifies the goals and the objectives of 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 nat only ari 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 that each case is unique, and that certain action may need to be taken in one case that would not be taken in another. {b} when submitting a case for prosecution, the investigator should present as complete a package as possible, including a detailed report, which outlines the offenses alleged to have been committed, the details of the investigation, and the evidence available to prove the charges, including identification of available witnesses and supporting documentation. In cases involving alleged false statements of misrepresentations, there must also be identified evidence to show materiality of the alleged false statement or misrepresentation to the claim. (c) To promote efficiency in this azea, Fraud Division investigators aze encouraged to contact the Butte County D.A. early in the investigation of a case to share ideas and develop strategies that will lead to a prosecutable case. (d} The D.A. will ensure that all formal case presentations made by the Fraud Division will be reviewed within ten 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 4 the additional investigation as soon as reasonably possible and 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 complaint filings shall be done in a timely fashion but no longer than thirty 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 far the rejection and provide the letter to the case investigator within ten working days following the rejection. 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 training of both parties in the area of insurance fraud. (b) The parties will participate in joint informal training sessions as necessary on 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, or 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 communication by those personnel 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 dispute, concentrating on the best interests of the overall insurance fraud program. Edward ]. Sz rey ___ Chief Investigator Butte County District Attorney ~' i ~ " 9 __ Date f ~ G~,7~ y-- ~?° l~ K thryn .Scholz Chief Investigator, Fraud Division California Department of Insurance ~ 1~s~~~ Date