Insurance Fraud Defense Attorney Los Angeles

There are many forms of insurance fraud, depending on the type of insurance benefit being sought. Being the target of an insurance fraud investigation can be disruptive, intrusive, and expensive. It’s essential to seek counsel from skilled and experienced insurance fraud defense attorneys as soon as you learn you are being investigated. Early intervention by savvy counsel might restrict the scope of any investigation and result in a negotiated settlement rather than a long, drawn-out investigation and ensuing litigation, whether civil or criminal.

Unfortunately, if you are caught up in an insurance fraud investigation, ordinary mistakes can escalate into civil liability. Intentional fraud can result in criminal prosecutions. No matter what, you need the services of skilled and experienced insurance fraud defense attorneys to protect you, your business, and your future livelihood.

Retaining skilled and experienced counsel early in an insurance fraud investigation is necessary to preserve your options and to protect your rights as a provider or vendor. As soon as you learn that you might be the target of such an investigation, you should contact RP Criminal Defense Law to schedule a consultation to permit our Los Angeles-based insurance fraud defense attorneys to assess the strength of the government’s case and guide you through the investigation and ensuing criminal prosecution or civil suit. We are conveniently located in Encino and Ontario. RP Criminal Defense Law provides aggressive individualized representation backed by experience and a thorough understanding of all aspects of insurance fraud litigation, both civil and criminal.

Common Types of Insurance Fraud

Insurance fraud comes in many varieties, depending on the insurance policy whose benefits were sought. There is a type of insurance fraud that matches each type of policy. The fraudulent acts can be committed by the service provider, vendor, or the beneficiary of the policy. These are just some examples of what insurance fraud might look like.

Auto Insurance

Penal Code sec 548-551: making a knowingly false statement related to a motor vehicle that was made with the intent to receive an insurance payment.

  • A false claim to an insurance company regarding a motor vehicle-related incident, such as damage from an accident or theft
  • Willfully damages or abandons a motor vehicle with the intent to collect insurance for the vehicle
  • Makes multiple claims for insurance relief out of a single incident
  • Creates or helps to create an accident to collect insurance proceeds
  • Knowingly makes a false statement to an insurance company.

Health Care Insurance

Penal Code 550: making a knowingly false statement or engaging in a deceptive act to receive payment from a healthcare company or government agency.

  • Billing for a service that was never performed
  • Overcharging the insurance company or government agency for services
  • Submitting multiple claims for a single incident

Workers’ Compensation Insurance

Penal Code 549-550: knowingly making or encouraging another to make a false statement for workers’ compensation benefits to be granted or denied.

  • Claiming a workplace injury when you were not injured
  • Claiming a workplace injury when you were injured outside of work
  • Submitting a bill for treatment for an injury, if the treatment was not received

Homeowners’ Insurance

Penal Code 448-451: knowingly making a false claim for damages under a homeowner’s property, liability, flood, or fire insurance policy.

What is Insurance Fraud?

Insurance fraud occurs when someone knowingly lies to receive a benefit to which they are not entitled under an existing insurance policy. To prove criminal insurance fraud, the prosecution must show beyond a reasonable doubt that:

  • A person makes a false insurance claim or helps another person to make a false statement
  • The person knew the claim was false and fraudulent
  • The act was committed with the intent to defraud.

Insurance Fraud Penalties

Depending on the gravity of the law violation, a prosecution for insurance fraud can be brought as a misdemeanor or felony. A misdemeanor conviction might result in up to a year in jail and a fine of $10,000. A felony conviction might result in 2, 3, or 5 years in prison and a $50,000 fine or double the amount of the fraud. If the fraud involves health care benefits in the amount of less than $950, the offense will be charged as a misdemeanor with a possible 6-month jail sentence and a $1,000 fine.

Restitution must always be ordered in the resolution of an insurance fraud case. That means that in addition to any fines, you must repay the loss to the insurance company.

Legal Defense for Insurance Fraud Charges

It’s always best to retain skilled and experienced insurance fraud defense counsel as soon as you learn that you might be the target of an investigation. All defenses raised are dependent upon the unique facts of your case. However, the most common defenses are:

  • Mistake
  • No intent to defraud
  • The statute of limitations has expired.

Insurance Fraud Lawyer Serving Los Angeles & San Bernadino

Facing an investigation or prosecution for insurance fraud can be disruptive and threatening. You deserve a fair assessment of the strength of the theory of liability to determine how best to proceed. You also deserve representation that will bring skill and expertise to examining the subpoenas and investigatory requests, an independent investigation and financial audit to fully understand the weight of evidence, and the savvy one gets from years of experience representing businesses involved in the insurance industry in the Los Angeles and San Bernadino areas. Our offices are conveniently located in Encino and Ontario. Only seasoned insurance fraud defense attorneys can realistically evaluate the evidence, the credibility of witnesses, and the predilection of the investigators and, eventually, the judge assigned to the trial. Contact us today for your initial consultation.