SAN DIEGO FRAUD LAWYER: 619-200-2808
Insurance fraud is a serious criminal offense in San Diego County and is aggressively prosecuted by the San Diego District Attorney. Individuals accused of insurance fraud may face misdemeanor or felony charges and possible jail or prison time. A conviction may impact future insurance eligibility and damage your credibility and reputation. Additional consequences may include an impact on employment and/or professional licenses.
Under California law, insurance fraud occurs when a person knowingly provides false, misleading, or incomplete information to an insurance company to obtain benefits they are not entitled to receive. Most insurance fraud prosecutions are brought under California Penal Code § 550, although other statutes may apply depending on the circumstances.
It’s important to understand that even minor misstatements can lead to potential fraud allegations. Insurance fraud investigations often begin before a claim is denied. Insurance companies use internal fraud units and refer claims they find suspicious to the California Department of Insurance or local prosecutors.
EXAMPLES OF INSURANCE FRAUD:
Filing a false or exaggerated insurance claim
Submitting claims for losses that occurred before coverage began
Misrepresenting facts about an accident, injury, or loss
Staging an accident or fabricating damage
FELONY OR MISDEMEANOR:
Insurance fraud in San Diego can be charged as either a misdemeanor or a felony, depending on:
The amount of money involved
Prior criminal history
The number of false claims
Whether the conduct appears intentional or part of a pattern
POTENTIAL DEFENSES:
No intent to defraud
Inaccurate information caused by third parties
Miscommunication with insurance adjusters
Legitimate disputes over valuation or coverage
Improper or coercive questioning
Insufficient evidence of false statements
COMMON TYPES OF INSURANCE FRAUD IN SAN DIEGO:
Auto Insurance Fraud:
Auto insurance fraud allegations often involve:
Inflated repair or injury claims
False statements about how an accident occurred
Claims for pre-existing vehicle damage
Health Insurance Fraud:
Health insurance fraud investigations generally focus on:
Billing for services not provided
Misrepresenting medical conditions
Duplicate claims
Workers’ Compensation Insurance Fraud:
Workers’ compensation fraud cases may include:
Claims for non-work-related injuries
Exaggeration of physical limitations
Working while collecting disability benefits
Property Insurance Fraud:
Property insurance fraud allegations can involve:
Inflated loss values
Claims for undamaged property
Fires attributed to covered causes when exclusions apply
Insurance fraud cases are complex, aggressively prosecuted, and require an experienced criminal defense attorney. If you have been arrested or are under investigation for insurance fraud, contact Kern Law, APC, today. We will protect your rights, fight your case, and pursue the best possible outcome for your case.