• JC Serrano

Most Common Types of Insurance Fraud in California

Updated: Jun 5

Find A Criminal Defense Lawyer for Insurance Fraud Charges


The seriousness of a fraud charge is often underestimated. As a result of insufficient legal representation, thousands of people who have been wrongfully convicted face unnecessary sentences and penalties. The truth is that a fraud conviction can have far-reaching consequences in your life. If you have been convicted of fraud, you must retain the services of a Criminal Defense Attorney with the necessary expertise to safeguard your future and reputation.


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Fraud comes in many forms and is one of the most popular forms of white-collar crime. Even if the word "fraud" isn't included in the proceedings against you, suspected crimes like embezzlement may be classified as fraud and subject you to the same penalties. Any suspected crime in which someone is accused of using deceit or dishonesty for financial or personal gain is referred to as fraud.


Insurance Fraud Offenses in California


When you try to collect insurance premiums or benefits to which you are not otherwise entitled, you are committing California insurance fraud.


Insurance Fraud in Automobiles


When a person makes an intentionally false insurance claim or otherwise deceives an insurance provider in order to obtain benefits to which he or she is not legally entitled, this is known as automobile insurance fraud. In California, insurance fraud is typically charged as a crime, punishable by up to five years in state prison. You might need a Criminal Law Attorney to help you overcome it.


You commit auto insurance fraud if you do any of the following things, according to the California Penal Code:

  • To collect car insurance proceeds, intentionally harm, cover, or abandon your vehicle.

  • Submit a knowingly false auto insurance claim for a vehicle loss due to injury, destruction, or theft.

  • With the purpose to defraud, make two (2) or more auto insurance claims for the same loss.

  • Intentionally cause or engage in a car accident in order to fraudulently claim auto insurance proceeds

  • Present or plan any written or oral declaration that includes false or misleading details as part of an insurance claim or false claims that you reside in California on an application for car insurance.

It is also a form of criminal auto insurance fraud for the following reasons:

  • A business owner or employee soliciting, referring or accepting any business from someone who plans to commit auto insurance fraud.

  • An auto repair shop owner or employee is offering insurance brokers or adjusters a fee or profit-sharing agreement (a "kickback") in exchange for referring policyholders to their shop (this offense overlaps with commercial bribery in California).


Sanctions


The majority of forms of auto insurance fraud in California are felonies.


However, certain types of auto insurance fraud in California are wobblers, meaning they can be prosecuted as either misdemeanors or felonies, such as preparing or filing false claims or the forms that company or auto shop members perpetrate.

  • Vehicle insurance fraud will result in felony prison sentences ranging from sixteen (16) months to five (5) years.

  • As a misdemeanor, auto insurance fraud will result in a one-year county jail sentence and/or a fine.

  • Employees or company owners defrauding auto insurance

  • Owners, officials, and employees of auto-related companies may break California's auto insurance laws in a variety of ways, exposing themselves to criminal liability.

There are same of them:

  • Any form of business that solicits accepts, or refers business to or from any individual or entity with knowledge of, or careless disregard for, that person's or entity's intention to commit auto insurance fraud.

  • An auto repair shop that pays an insurance agent, broker, or adjuster a commission, fee, profit-sharing, or other forms of compensation in return for referring policyholders to shop for auto insurance-covered repairs.

What does California law mean when it comes to auto insurance fraud?

  • In California, the legal concept of auto insurance fraud varies depending on which portion of the California Penal Code you are accused of violating.

  • We'll go over the most common types of California auto insurance fraud in this section.


PC 548 Penal Code causing damage to a car or abandoning it


The following are prohibited under California Penal Code 548 PC:

  • An automobile or other motor vehicle that is protected against loss or damage is injured, destroyed, hidden, abandoned, or disposed of.

  • With the intention of defrauding or causing harm to the insurance provider.

The term "intent to defraud" refers to the intention to deceive the insurance provider into defrauding them of money or damaging their legal, financial, or property rights. Even if the insurance provider never loses money as a result of your conduct, and even if the vehicle is not yours, you may be found guilty of auto insurance fraud by damaging, destroying, or hiding/abandoning a car.


Fraudulent claims are punishable under Penal Code 550 PC.


Several types of California car insurance fraud are covered by California Penal Code 550 PC. Presenting a false or fraudulent claim for theft, loss, injury, or conversion of a motor vehicle is one of these.


This form of auto insurance fraud is legally described as follows:

  • You made a false or fraudulent demand for reimbursement for a theft loss.

  • A motor vehicle, a motor vehicle component, or the contents of a motor vehicle is destroyed, damaged, or converted.

  • You were well aware that the assertion was misleading or deceptive.

  • You wanted to defraud when you filed the lawsuit.

  • No one needs to incur a financial loss due to what you did, as it is with Penal Code 548 damaging or abandoning a car.


Multiple allegations under Penal Code 550 PC


Another way to break California's automobile insurance fraud laws is to:

  • Present two (2) or more claims to the same or different auto insurers for the same loss

  • You are aware that you are filing two (2) or more claims for the same loss

  • With the intention of defrauding

  • Penal Code 550(a) addresses the "multiple claims" form of auto insurance fraud

  • Penal Code 550 PC is a charge of causing an accident

If you do any of the following, you are in violation of California Penal Code 550(a)(3) PC:

  • Involved in or caused a car accident

  • Knowing that the accident is being staged in order to file a false or fraudulent insurance claim

  • To defraud others


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If all of the following are true, you are deemed to have committed auto insurance fraud by "causing" an accident:

  • The accident was a direct, normal, and likely result of your actions;

  • Without your intervention, the accident would not have occurred.


False statements are punishable under Penal Code 550 PC.


The court can also consider any of the following a violation of California Penal Code 550, subsections (b)(1)-(4):

  • Presenting any written or oral argument in support of or in opposition to a claim for an auto insurance premium or other gains when recognizing that the statement contains inaccurate or misleading details about any material fact;

  • Knowingly preparing or making some written or oral statement as part of or in opposition to a claim for an auto insurance premium or other rewards that contains inaccurate or misleading details concerning any material fact;

  • Preparing or making some oral or written assertion to an auto insurer for the purpose of receiving car insurance that you live in California while you actually live somewhere else.

Consider one of our prescreened California Lawyers in your California Attorney Search.


Employees or company owners defrauding auto insurance


Owners, officials, and employees of auto-related companies may break California's auto insurance laws in a variety of ways, exposing themselves to criminal liability.


There are some of them:

  • Any business that solicits accepts, or refers business to or from any person or entity with knowledge of, or reckless disregard for, that person's or entity's intent to commit auto insurance fraud.

  • An auto repair shop that pays an insurance agent, broker, or adjuster a commission, fee, profit-sharing, or other forms of compensation in return for referring policyholders to shop for auto insurance-covered repairs.


California's anti-fraud regulations apply to healthcare insurance fraud.


Life insurance billing fraud, health insurance fraud, HMO fraud, Medicare fraud, and Medi-Cal fraud are all terms used to describe health care fraud. Both criminal and law enforcement activity in these areas is booming these days.


It's easy to understand why. In today's America, anyone other than the patient pays for a lot of health care, whether it's a private medical insurance provider or a government medical insurance policy like Medicare or Medi-Cal.


To make matters worse, payment processing systems are often complex. This opens the door to a plethora of fraud possibilities. However, the perplexing bureaucracy of medical bills provides plenty of ways for officials to falsely accuse individuals of healthcare fraud. Seek advice from your Criminal Law Attorney to help you with your case.


Frequently, for conduct that is simply the product of honest blunders.


Government services like Medi-Cal (California's government-provided health insurance program for low-income, elderly, and disabled people) are involved in a significant number of healthcare fraud cases. As a result, it may be considered "taxpayer ripoff." As a result, prosecutors can gain political points by going after people they accuse of healthcare fraud, even though they haven't done anything wrong.


Here are some examples of conduct that may result in healthcare fraud charges in California: