The San Diego District Attorney prosecutes Insurance Fraud cases very seriously, because of the amount of money that is lost every year to fraud and the public trust that is violated. Insurance Fraud cases can be prosecuted as felonies and the consequences can include state prison, probation, fines, restitution, as well as other potential consequences. Automobile Insurance, Healthcare, and Worker’s Compensation Fraud are the most common types of Insurance Fraud, although all forms of insurance are susceptible to Fraud.
Insurance Fraud generally occurs when someone knowingly lies to obtain an advantage or benefit, to which they are not otherwise entitled. Or someone knowingly denies a benefit that is due and to which someone is entitled.
The San Diego District Attorney may file Insurance Fraud cases under the following examples:
- The person had the intent to defraud: Insurance fraud is a “specific” intent crime. This means the prosecutor must prove that the person involved knowingly committed an act to defraud.
- An act is completed: Simply making a misrepresentation, oral or written, to an insurer with the knowledge that it is untrue is sufficient to be charged with Insurance Fraud.
- The act and intent must come together: The prosecutor must prove the act and intent. One without the other is not a crime.
- Actual loss: Actual loss of money or property is not needed if the person has committed an act and had the intent to commit the crime.
Defenses:
An experienced criminal defense attorney that handles Insurance Fraud cases is critically important to a successful defense. There may be many defenses applicable to your case. For example, there may be Constitutional grounds under the Fourth and Fifth Amendments to challenge unlawfully seized property and statements that violated your Miranda Rights. Maybe there was not an intent to defraud – the statements or actions taken were made by mistake or accident. Is there an identification issue, and the person charged, is not the person who committed the fraud? There may be many more defenses that are case specific.
Insurance Fraud is a very serious allegation and requires an experienced criminal defense attorney. If you are under investigation or have been arrested or charged with Insurance Fraud, contact Kern Law, APC today. We have 20 years of successfully representing clients, and we offer free consultations.