Insurance Fraud Laws California – California Top Insurance Lawyers

Posted by Raoul Severo | Apr 20, 2020 | 0 Comments

What is Insurance Fraud?

It refers to any kind of deceitful act performed to defraud an specific type of insurance or the process of itself with the aim to obtain an inappropriate payment from an insurer. The Insurance Fraud happens when an insurer wittingly denies some benefit that is due, or when a claimant attempts to obtain some benefit or advantage they are not entitled to. This fraudulent act can involve from a single person to even a complex scheme with multiple parties across the country or within a state.

Types of Insurance Fraud

There are many types of insurance fraud around the world, but the most common frauds in California are the following:

  • Life insurance Fraud
  • Property Insurance Fraud
  • Auto Insurance Fraud
  • Health Care Fraud
  • Unemployment Fraud
  • Home Insurance Fraud
  • Worker's Compensation Fraud
  • Renter's Insurance Fraud

Example of Insurance Fraud in California

  • Fake Billing or over billing of health insurance companies by hospitals or medical professionals
  • Auto repair bill which has fake installments of parts and face the insurance companies to get more money as compensation
  • False reporting of workers employed by employers attempting to lower workers' compensation insurance rates for actual payroll workers
  • Getting many insurance claims for the same 
  • reason or same damages
  • Making false documents of property to get more insurance rate by the companies

Insurance Fraud Laws in California

The California Insurance Claims Fraud Prevention Act is a state law established to prevent and stop the false insurance policies and false claims by or from the private or other insurance companies. It also comes under the California Penal Code PC to ensure its prohibition among the state. The prosecutor in the case of insurance fraud must prove the fraudulent intention of the accused. Under the California statute it comes under following codes

  • California Penal Code Sections: 548 to 551
  • California Insurance Code Sections: 1871 to 1871.9

Penalties of Insurance Fraud in California

The penalties of insurance fraud in California varies according to nature of the fraud and the circumstances of the case:

  • As Misdemeanor in California the punishments may up to one year in jail or a fine up to $10000 or both
  • As Felony in California the punishment may up to 2, 3 or 5 years in a county jail
  • In some cases the fine exceeds up to $50,000 or double the defrauded amount
  • In case of worker's compensation fraud, the value of fine exceeds up to $150,000
  • Possible restitution to the victim

Common Defenses

  • Lack on intention
  • Insufficient evidence
  • False Accusation
  • By mistake
  • Ambiguity in prosecution case

California Insurance Defense Attorney

An allegation of charge of insurance fraud can leave you battling with an insurance company and prosecutor for both your money and your rights. The assistance of a competent lawyer and experienced insurance attorney can help manage the threats much more effectively than you could on your own. Get help today by reaching an expert California Criminal Defense Attorney for insurance at the Law Office of Raoul Severo in California.

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