California Insurance Fraud


Posted almost 5 years ago. Applies to California, 6 helpful votes



What is Insurance Fraud?

Insurance Fraud is intentionally providing false information or hiding information in order to get a payment or some other benefit from an insurance company that would otherwise not be payable. In California and most other states, Insurance Fraud is a serious offense and it is generally charged as a felony. The penalties are severe and include incarceration. The majority of Insurance Fraud cases involve staged car accidents, false medical claims (e.g., Medicare or workers compensation fraud) and stolen or damaged property claims for property that was not stolen or damaged.


What does the Prosecutor need to prove for a conviction?

In California, the prosecutor must prove that the suspect intentionally and successfully completed a fraudulent act aimed at getting a benefit from an insurer. If the act and intention do not occur together, it is not Insurance Fraud. The prosecution does not need to prove that anyone was actually defrauded or harmed in order to prove a case of Insurance Fraud. If the defendant tries and fails to defraud an insurer, the crime of Insurance Fraud can still be charged.


What are the penalties?

California Insurance Fraud Law is primarily contained in California Penal Code Sections 548, 549 and 550. Prosecutors can decide whether to charge Insurance Fraud as either a misdemeanor or felony. A person convicted of Misdemeanor Insurance Fraud may have to serve up to 1 year in the county jail and/or pay fines and restitution. A person convicted of Felony Insurance Fraud can be sentenced to 2, 3 or 5 years in state prison and ordered to pay additional fines and restitution. A prior Insurance Fraud conviction generally results in more severe sentencing.


What if I am contacted by the police?

If you are contacted by an Insurance Fraud Investigator, police officer or detective regarding insurance fraud, do not speak to him/her until you have talked to a lawyer. Do not just wait to see what happens and hope that the case will go away. A successful defense will require early intervention and investigation. Most likely, the Fraud Division of the California Department of Insurance has been investigating the case for a long time - they have a serious head start. The reason that investigators/police officers/detectives contact potential suspects is because they are hoping the suspect will implicate him/herself in the Insurance Fraud scheme during an informal interview. Do not try to talk your way out of an Insurance Fraud allegation. Anything you tell them can and will be used against you if Insurance Fraud charges are brought against you.


Your criminal defense lawyer makes all the difference

A lot of resources are devoted to prosecuting Insurance Fraud cases in California. In some counties, entire offices are devoted to a particular type of Insurance Fraud. For example, in Los Angeles County, the Los Angeles Automobile Insurance Fraud Task Force Regional Office handles all of the Car Insurance Fraud cases. In other words, if you are being charged with Car Insurance Fraud in Los Angeles, chances are the person prosecuting the case is highly specialized. To level the playing field, you need a skilled and experienced criminal defense attorney.

Additional Resources

Stephen G. Rodriguez & Associates

Insurance Fraud Defense Lawyer

California Felony Defense Lawyer

California Misdemeanor Defense Lawyer

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Felony crime

A felony is a crime that is punishable by more than one year in prison. Certain especially severe felonies may be punishable by the death sentence.

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