The law on the crimes of insurance fraud, also known as fraudulent claims, is found at penal code sections 548, 549, and 550. This article attempts to summarize the law, defense, and punishment associated with some of the more common insurance fraud and fraudulent claims criminal charges.

 

PC 548(a) & 550 Law

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Every person who willfully injures, destroys, secretes, abandons, or disposes of any property, which at the time is insured against loss or damage by theft, or embezzlement, with intent to defraud or prejudice the insurer, whether the property is the property or in the possession of that person or any other person, is guilty of defrauding an insurer (Abbrev.).

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It is unlawful to do any of the following, or to aid, abet, solicit, or conspire with any person to do any of the following (Partial list):

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Knowingly present, or cause to be presented, any false or fraudulent claim for the payment of a loss or injury, including payment of a loss or injury under a contract of insurance (PC 550(a)(1)).

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Knowingly cause or participate in a vehicular collision, or any other vehicular accident, for the purpose of presenting any false or fraudulent claim (PC 550(a)(3)).

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Knowingly present a false or fraudulent claim for the payments of a loss for theft, destruction, damage, or conversion of a motor vehicle, a motor vehicle part, or contents of a motor vehicle (PC 550(a)(4)).

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Knowingly make or cause to be made any false or fraudulent claim for payment of a health care benefit (PC 550(a)(6)).

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For most insurance fraud cases the district attorney will need to that the defendant did all of the following:

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• The defendant presented a false or fraudulent claim (a false claim is a claim that is made to deceive for the purpose of gaining financial or legal benefits)

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• The defendant knew that the claim was false (a claim is the presentation of information, whether verbally or orally)

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• The defendant intended to defraud at the time the claim was made.

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Sentence for PC 548 & 550

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Penal code 548(a) & 550: Defraud Insurer, is classified as a felony. If found guilty of PC 548(a), the defendant may face up to five years in prison. Collateral punishment may apply (see below).

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In some cases it may be possible to secure a probation sentence without a jail commitment. Suspended jail sentence and split jail sentences may also apply (a split prison sentence is  where the defendant serves some of his or her sentence in custody and some of it out of custody on work release.

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Penal code 550(a), Insurance Fraud (False Claims), is classified as a felony. If found guilty of PC 550(a), the defendant may face up to five years in jail.

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Note: Some PC 550(a) charges are filed as misdemeanors, such as PC 550(a)(6) or 550(a)(8), in which case the maximum misdemeanor sentence is up to one year depending on the specific charge. For the exact maximum sentence for any insurance fraud charge please contact our criminal defense lawyers for a free case analysis.

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In some cases is may be possible to have an insurance fraud charge reduced to a misdemeanor or dismissed completely. Every false claims or insurance fraud criminal case is different as the fact are different in every case; therefore, whether any reduction of a criminal charge, or the likelihood of having the charge dismissed, depends largely on the particular facts of the case and the defendant's criminal history. With that said, is is not uncommon for a defendant to plead to a felony insurance fraud case with an option to have thatcharged reduced to a misdemeanor after repayment of any funds received by the defendant via his or her insurance fraud.

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CIMT: Insurance fraud is considered a crime involving moral turpitude. This means that the crime invovles deceit or is morally wrong. A criminal convcition for a crime that involves moral turpitude can lead to serious immigration probalems for non U.S. citizens, including deporatation or denial from entry into the United States.

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Three Strikes Law: Insurance fraud charges are not considered serious or violent as those terms are defined in California law; therefore, no PC 548 or 550 charge is considered a strike under California's Three Strikes Sentencing Law.

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Bail: $25,000 for PC 550(a)(1) in San Bernardino county.

 

Note: Bail is a surety bond that is intended to serve as assurance that the defendant will appear court when ordered. If the defendant pay s the posted bail amount then he or she will be released from custody while his or her court hearing progresses (also called posting a bond). If the defendant does not appear as ordered after posting the bail then the bail is forfeited and a warrant will issue fo the defendant. Sometimes a required bail may be lowered (or raised) depending on the defendant's flight risk, ability pay the bail, and the defendant's risk to the community as it relates to his or her criminal history and the facts of the current case.

 

Other penalties include for insurance fraud convictions include: Monetary fines, harsh probation or parole terms, possible loss of employment, civil lawsuits, restitution orders, loss of a professional license (even if there is no relationship between the crime and the profession), and more.

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Defenses to PC 548 & 550

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Insufficient Evidence: The most common defense to a criminal charge of PC 548 or PC 550 is insufficient evidence. For example, there may not be enough evidence to prove that the defendant intended to defraud at the time he or she made a claim, such as when a person puts in a claim for a stolen vehicle and the vehicle is later discovered, but the defendant does not present the discovery of the vehicle to the insurance company before the claim in paid. Another example of insufficient evidence would be where there is no evidence to support the fact that the claim was presented, such as when a defendant fills out insurance forms for an alleged accidental fire but never presents the forms to the insurance company.

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Mistake of Fact: In some PC 548 or 550 cases the defendant will be able to prove that he or she believed the insurance claim was legitimate under the circumstances.

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Less common defenses: PC 548 and 550 defenses may also include: misjoinder, suppression of evidence (such as a confession), coerced confessions, double jeopardy, insanity, intoxication, duress, and more.

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If you are charged with any violation of California penal code section 548 or 550, insurance fraud, or fraudulent claims, contact our criminal defense attorneys without delay for a free consultation. Our criminal defense law firm has successfully defended against hundreds of misdemeanor and felony charges. Our offices are open seven days a week to assist you. Call today!

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909-913-3138​

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