Insurance fraud has increased in California over the last few years. There are many kinds of insurance fraud, including auto insurance fraud, fire insurance fraud, property insurance fraud, and homeowners’ insurance fraud. If you have been arrested for an insurance fraud case or are under investigation for an insurance fraud case, you will want the help of a California criminal defense attorney. The team of knowledgeable California financial crime lawyers at My Rights Law is here for you. Contact us completing our secure web or call (888) 702-8882 for a free case consultation.
When a person files a claim for insurance benefits, the insurance company will investigate the claim. If an insurance company thinks the claim was fraudulent, it will report it to law enforcement as attempted fraud. This report could lead to criminal penalties under the California Insurance Code. Any claim can result in criminal charges if the insurance company thinks it was made fraudulently. My Rights Law has a proven history of defending people cited for insurance fraud. If you’ve been charged with insurance fraud, contact us today to go over the details and discuss your legal options.
Definition Of Insurance Fraud
Insurance fraud under California law is any action that seeks to receive compensation from an insurance company on untrue grounds. For instance, filing a workers’ compensation claim while not being injured could be committing insurance fraud. Likewise, a claim that exaggerates injuries from a car crash can also be deemed insurance fraud.
For insurance fraud to occur in California, two elements are necessary:
An individual must have the intent to defraud the insurance company and do it knowingly;
A person must act on that intent by filing a fraudulent claim.
Both aspects must be present and established for a defendant to be convicted of insurance fraud. No actual loss must happen – so a claim can be rejected or under investigation when insurance fraud charges are filed against a person.
California Insurance Code Section 1871 defines insurance fraud as providing untrue info to their insurance company or to another individual’s insurance company, resulting in money or services being provided to which they are not authorized.
Instances of insurance fraud could include:
Claiming that property was damaged in an accident when it wasn’t damaged
Faking an accident to receive money
Overstating the damage to property
Wrongly stating that a car was stolen to collect money
Burning property to obtain insurance money
Lying about a personal physical injury to get cash
Medical insurance fraud
Life insurance fraud
Workers’ compensation insurance fraud
Fire insurance fraud
Property insurance fraud
Healthcare insurance fraud
More insurance fraud areas are covered as follows:
California Insurance Code Section 1872.8 defines auto insurance fraud
Motor Vehicle Theft and Motor Vehicle Insurance Fraud Reporting 1874.2(a)
Medical Insurance fraud is defined by Penal Code Section S 550(a)(5)
Insurance fraud can be filed as a felony or a misdemeanor. Elements that law enforcement uses to resolve the level of crime to charge may include the extent of the false info and the amount of the economic loss.
California Penal Code Sections 548 – 551 – Auto Insurance Fraud
Car insurance fraud under California Penal Code Section 548 means you knowingly made an untrue statement involving an auto with the specific intent to get an insurance payment. Under California law, you commit automobile insurance fraud when you:
Make an erroneous claim to an insurance company about an incident involving your cars, such as damage sustained in an accident or theft.
Intentionally damage or abandon your car to collect insurance funds.
Submit numerous insurance claims for the same accident
Knowingly participate or start a car collision to collect insurance funds.
Submit a written or oral statement to an insurance carrier to get auto insurance that you reside in California, but you reside in another state.
There are many standard ways people commit car insurance fraud. For example, someone abandons their care and then tells the insurance company it was stolen. Another example is when someone wrongly informs their insurance company they were involved in a crash, but there was no collision. Another instance involves cases where someone was involved in a crash that only caused minor damage, but they claim major damage and spent much more money on repairs. Finally, one more example is when someone intentionally slams on their breaks to cause an accident to receive an insurance payment.
California laws deal primarily with presenting false car insurance claims with a specific intent to defraud an insurance company. It’s essential to mention that it’s not legally required that the targeted insurance company suffer financial loss. Just the attempt is enough to face charges. The legal punishments for a conviction of car insurance fraud include jail time, weighty fines, restitution, and probation. The prosecutor will file an auto insurance fraud case as a felony offense in most cases. Legal defenses generally include you had no intent to defraud the insurance company, or there is not enough evidence to convict you. If you face allegations of car insurance fraud, call a criminal defense lawyer at our law firm to go over your case.
California Penal Code Section 550 – Health Insurance Fraud
Healthcare fraud typically involves making untrue statements or deceptive acts with the specific intent to get payment from a healthcare provider or a government agency. Healthcare fraud usually involves private insurance companies and includes Medicare and Medicaid, where it’s the government that is defrauded. In California, the most standard examples of healthcare fraud include cases where you:
Billed an insurance company for services not conducted
Overcharged an insurance company for services conducted
Submit several insurance claims for the same thing
A conviction for violating California Penal Code Section 550, a felony offense, includes up to 5 years in state prison and a fine of up to $50,000, or double the amount of the fraud, whichever is more. Nevertheless, some healthcare fraud cases are wobblers, meaning the state can file the case as either a misdemeanor or felony crime.
Our criminal defense attorneys can use a wide range of potential legal defenses to defend you against accusations of healthcare fraud. For example, our lawyers might argue that the injury or loss that the prosecutor is claiming is fraudulent is legitimate. We might be able to establish this utilizing medical records or the testimony of a medical professional. Contact us today to learn more information.
Workers’ compensation fraud is outlined in California Insurance Code 1871.4 and Penal Code Sections 549-550. Workers’ compensation is a kind of insurance that pays a worker for an injury or a disability that occurred at work. This means workers’ compensation fraud can be perpetrated when you receive payment or attempt to receive payment for which you were not entitled. The most common examples of workers’ compensation are committed when you:
Knowingly make untrue statements with the goal of receiving workers’ compensation benefits
Prompt others to make untrue statements about a worker’s compensation claim
File a claim for treatment of an injury when you were not treated
Submit numerous claims for the same harm
Claim you were hurt at work, but the injury was not work-related
Lie about the extent of your actual injury
Workers’ compensation fraud is a “wobbler,” meaning you could be charged with a misdemeanor or felony crime based on your charges and criminal history circumstances. If convicted for a misdemeanor violation of workers’ compensation fraud, the punishments include up to one year in jail, a fine of up to $150,000, or two times the amount of fraud, and restitution.
Typical Legal Defenses For Insurance Fraud
Our experienced insurance fraud defense attorneys can use many different legal defenses to help you dodge a conviction. The most common defenses include the following:
Lack of Knowledge:For the state to get a conviction for insurance fraud, they must be able to establish you knew what you were claiming was not true. If our lawyers can cast some reasonable doubt that you didn’t realize your claims were false, you can likely sidestep a conviction. For instance, if you claimed on insurance paperwork because another person told you the claim was true, we could argue you did not knowingly make a false claim.
Lack of Intent:Likewise, the prosecutor has to prove you intentionally submitted a false claim to be found guilty of insurance fraud. In some cases, our attorneys might be able to argue it was an accident or an honest mistake. In most fraud-related cases, intent is the absolute key element of the crime. If we can doubt your actual intent, you stand a good chance of avoiding a conviction.
Experienced California Insurance Fraud Lawyer
Insurance fraud is a grave charge, and you may wish to have an experienced defense to guard yourself if you’ve been accused. A conviction could mean serious time behind bars, thousands of dollars in fines, and a damaged reputation. Our firm, My Rights Law has the knowledge you need to get a reduced sentence or walk away free of any charges. Contact us by calling (888) 702-8882 or leave a message on our secure web form today for free case consultation.
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