Insurance fraud is a serious crime that can result in severe criminal penalties, including imprisonment and substantial fines. These cases involve false claims or misrepresentations made to insurance companies to obtain money or benefits to which a person is not legally entitled. Whether the case involves auto insurance, healthcare, or workers’ compensation, the consequences can be severe and long-lasting.
Perlman & Cohen helps you defend your rights if you are accused of insurance fraud in Los Angeles or throughout California. Our experienced Los Angeles insurance fraud lawyers have handled complex fraud investigations involving both state and federal laws. We know how to challenge insufficient evidence, question fraudulent intent, and raise reasonable doubt in court.
With a skilled fraud lawyer from our firm by your side, you can build a strong legal defense and fight for the best possible result in your case.
Under California Penal Code § 550, insurance fraud occurs when a person knowingly makes or assists in making a false insurance claim or false statements to an insurance carrier with the intent to defraud.
The fraud may involve exaggerating losses, staging accidents, or submitting fake bills to private insurance companies or government programs. Because of the specific intent required to commit this crime, prosecutors must prove that the person acted knowingly to deceive an insurer for money or benefits.
There are many common types of insurance fraud cases in California. Fraudulent activity can involve submitting multiple claims for the same event, inflating damages, or falsifying medical records. Understanding the different types of fraud helps show how these crimes occur and why a strong legal defense is so important.
Filing false accident or theft claims under auto insurance policies is a crime. Common examples include reporting a staged car accident, claiming for stolen property that was never stolen, or exaggerating vehicle damage. Auto insurance fraud can result in felony charges and severe criminal penalties.
Health care fraud occurs when a healthcare provider or patient submits false billing statements for unnecessary procedures or fake treatments. These cases often involve fraudulent intent to obtain payment for services that were never provided. Both state and federal governments aggressively prosecute healthcare fraud.
Workers' compensation fraud under Insurance Code § 1871.4 occurs when an employee files a fraudulent insurance claim for a work-related injury or disability that never actually occurred. Submitting false statements about an injury can result in fines, imprisonment for up to five years, and loss of employment.
Property insurance fraud involves misrepresenting losses after events such as fires, thefts, or natural disasters. Some offenders inflate repair costs or file fraudulent claims for damage that never occurred. Insurance companies closely investigate these types of cases to detect signs of false reports.
This occurs when someone provides false information on life insurance applications or claims death benefits under false circumstances. Life insurance fraud can lead to felony prosecution and severe criminal penalties, particularly when the act involves the use of forged documents or fake identities.
In Los Angeles, insurance fraud can occur in many ways and across different industries. Law enforcement and insurance investigators often uncover fraud through audits, witness interviews, and inconsistencies in billing or claims.
Here are several examples of fraudulent activity that commonly lead to criminal charges:
Organizing or participating in fake car accidents to collect money from auto insurance companies is a form of fraud. Prosecutors often use surveillance, phone records, and witness testimony to prove intent. These staged crashes can also put innocent drivers and passengers at risk, turning a fraudulent insurance claim into a dangerous and costly crime.
Submitting false claims for medical procedures or billing for services never performed is one of the most common forms of healthcare fraud. Doctors, patients, and billing staff may all face charges if fraudulent activity is discovered.
In many cases, investigators review billing patterns, medical records, and payment histories to uncover this type of fraud.
Some individuals file fake disability or workers’ compensation claims, pretending they cannot work due to injury. These actions lead to criminal prosecution and loss of insurance benefits. Investigators often visit workplaces, interview coworkers, and gather evidence through surveillance to determine whether a person is truly injured or committing fraud.
Filing false reports about stolen property or staging fires for insurance money is considered insurance fraud. Insurance carriers thoroughly investigate these claims and report suspicious cases to the authorities. These investigations can take months and often involve cooperation between local police, fire departments, and state fraud divisions.
Providing inaccurate details or lying on a life insurance application to obtain coverage or higher benefits is also a violation of the law. Perlman & Cohen has defended clients accused of these serious insurance fraud cases throughout Los Angeles.
The penalties for insurance fraud depend on the type of fraudulent claim, the amount of money involved, and whether the case is charged as a misdemeanor or felony offense. Both state and federal laws impose severe punishments for convictions of fraud.
A misdemeanor insurance fraud conviction can result in up to one year in county jail and fines up to $10,000. Defendants may also be ordered to repay the amount received from any fraudulent insurance claim.
Felony insurance fraud carries a sentence of 2 to 5 years in state prison and fines of up to $50,000 or double the amount of the fraud, whichever is greater. A felony offense may also result in the loss of professional licenses and a permanent criminal record.
Both state and federal governments investigate and prosecute insurance fraud. While California handles most cases under state law, some are prosecuted federally when they involve multiple states, large sums of money, or federal agencies.
State prosecutors handle cases under California Penal Code § 550 and Insurance Code § 1871.4. Most cases involve individual defendants or small businesses accused of submitting false claims.
State investigations often begin when insurance companies notice irregularities in billing or claim patterns and report them to authorities. In many situations, these cases can lead to serious allegations of fraud, even if the person made a mistake without any fraudulent intent.
The federal government prosecutes large-scale healthcare fraud, welfare fraud, and schemes involving private insurance companies or Medicare. Federal penalties are often more severe and can include lengthy prison sentences.
Federal and state investigators frequently share information and collaborate on fraud investigations. This cooperation increases the very real possibility of serious charges if prosecutors can prove fraudulent intent.
What is considered insurance fraud in California?
Insurance fraud occurs when someone files or assists in filing a false insurance claim to obtain money or benefits to which they are not entitled.
Can I go to jail for insurance fraud?
Yes. Depending on the amount and specific intent to defraud, you could face up to five years in prison and large fines.
How do investigators prove insurance fraud?
Prosecutors rely on evidence such as false statements, forged documents, and inconsistent billing records. They must prove fraudulent intent beyond a reasonable doubt.
What are the most common defenses to insurance fraud charges?
Common defenses include insufficient evidence, lack of intent, or a genuine mistake in paperwork. An experienced fraud lawyer can assess which defense applies to your case.
Do I need an attorney for an insurance fraud investigation?
Yes. A Los Angeles insurance fraud lawyer can protect your rights, deal with investigators, and prepare a strong legal defense to help you achieve a better outcome.
If you are under investigation or have been charged with insurance fraud, you need immediate legal help. Perlman & Cohen provides aggressive defense for clients accused of filing fraudulent claims, making false statements, or engaging in other fraudulent activities involving insurance companies. Our attorneys understand how prosecutors build their cases and know how to challenge weak evidence and protect your rights.
Our Los Angeles insurance fraud lawyers have years of experience defending people in both state and federal court. We focus on obtaining favorable results through dismissals, reduced charges, or case resolutions that protect your freedom and reputation.
Contact us today to schedule a free and confidential consultation with a trusted fraud lawyer who will fight for your future.
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