The law on the crimes of insurance fraud, also known as fraudulent claims, is found at penal code sections 548, 549, and 550.

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Insurance fraud Laws (PC 548 & 550)

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Penal Code 548(a) Law: 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, or any casualty 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 (PC 548(a).

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Penal Code 550(a) Law

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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:

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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.

 

Sentence for PC 548 & 550

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Penal code 548(a): 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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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 prison.

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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 a felony insurance fraud charge reduced to a misdemeanor insurance fraud. Every false claims, or insurance fraud, criminal case is different and whether or not an insurance fraud case will be reduced to a misdemeanor depends on the exact criminal charge, the facts of the case, and the defendant's criminal history.

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Probation: A probation sentence is a period of supervision in lieu of jail or prison. A probation sentence may be summary (misdemeanor probation), which has no probation officer that monitors the defendant, or formal (felony probation), which is monitored by a probation officer.

 

Probation sentences are allowed in PC 548 and PC 550 cases; however, whether or not a probation sentence is granted depends largely on the facts of the case and the defendant's criminal history.

 

Sometimes, a term of probation is to serve a jail sentence, but most jail sentences that are made a part of a probation sentence may be served out of custody on work release or house arrest. This applies to both felony and misdemeanor charges of insurance fraud. 

 

Three Strikes Sentencing Law: Insurance fraud is not a strike offense under California's Three Strikes Sentencing Law; insurance fraud is not considered a serious or violent offense.

 

CIMT: Insurance fraud cases are considered crimes involving moral turpitude, which means the crimes are considered to be morally wrong or involve deceit. Crimes of moral turpitude carry severe consequences for immigration and professional licensing concerns (i.e. doctor, lawyer, dentist, therapist, etc.).

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Other penalties for insurance fraud convictions include: Monetary fines, harsh probation or parole terms, possible loss of employment, civil lawsuits, restitution orders, criminal protective orders, and more.

 

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 made an insurance claim, such as when a defendant 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 defense: 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 include suppression of evidence, coerced confessions, double jeopardy, duress, and more.

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If you are charged with any violation of California penal code section 548 or 550, insurance fraud, fraudulent claims, or auto insurance fraud, contact our criminal defense attorneys without delay for a free consultation. Our criminal defense lawyers have handled hundreds of misdemeanor and felony crimes. Our lawyers are available everyday assist you. Call today!

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909-913-3138

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