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Last Modified on Nov 19, 2025
Being accused of insurance fraud can be an overwhelming and isolating experience, especially when it comes to the connection between insurance fraud & professional licenses. Fortunately, with the help of an insurance fraud lawyer, you can determine what steps to take to protect your licensure and build a criminal defense against your fraud charges.
An Overview of Insurance Fraud & Professional Licenses in California
There are several kinds of insurance fraud that you may be charged with, including healthcare fraud, auto insurance fraud, property and homeowner’s insurance fraud, and workers’ compensation fraud. Typically, charges will fall into one of two categories: misdemeanor or felony.
It is estimated that insurance fraud costs American consumers at least $308.6 billion every year. One study has even determined that roughly 10%-20% of insurance claims are fraudulent. If you are accused of committing insurance fraud in a professional capacity, you may be facing more severe repercussions in the event of a conviction.
Potential Licensure Consequences for an Insurance Fraud Conviction in California
The Golden State takes insurance fraud very seriously, which means you and your career can take a severe hit if you are convicted of the crime you have been charged with. Some examples of potential consequences include the following:
- Facing criminal charges. Being charged with insurance fraud can lead to a criminal conviction, which will likely heavily influence your licensing board’s decision regarding whether you will be allowed to continue practicing.
- Experiencing disciplinary action. You must contend with more than just suspension or revocation when you have been accused of committing insurance fraud. Your licensing board can take additional disciplinary action as well, including placing your license on probation or even levying a civil penalty against you.
- Having your license suspended or revoked. If you have been charged and/or convicted of committing insurance fraud in a professional capacity, your professional license can be suspended or revoked, either permanently or temporarily. The final result depends on the findings and decision-making of your licensing board.
The Difference Between Misdemeanor and Felony Penalties
Insurance fraud cases are often considered “wobblers,” which means they can be filed as either a misdemeanor or a felony. Depending on the charges, you can face varied penalties if you are convicted. Misdemeanor penalties usually mean spending up to one year in county jail, as well as paying a fine of up to $10,000. Felony charges, however, can result in two to five years in state prison and paying a fine of up to $50,000 or double the value of the fraud, depending on whichever is higher.
What Should I Do If I Am Accused of Insurance Fraud in California?
If you have been charged with insurance fraud in the state of California, a conviction could be devastating. You could end up paying hefty fines, losing your professional license(s), and even serving time in prison. There are, however, things you can do to try to avoid a conviction, including the following steps:
- Hire an insurance fraud lawyer in California. When you hire an insurance fraud lawyer, you can receive the help you need to protect your hard-earned career and licensure from the negative consequences of such accusations. Your lawyer can represent you, your rights, and your desired outcomes while advocating on your behalf.
- Avoid providing any additional information. Do not give any additional information to your licensing agency until you have spent time consulting with your insurance fraud lawyer.
- Follow your agency’s instructions. You do not want to overcomplicate things by failing to follow your agency’s instructions. Be sure to fill out and mail any of their required forms, such as a Notice of Defense. You will also want to retain a copy for your own records.
- Prepare your defense with your lawyer. With the help of your insurance fraud lawyer, you can build and deliver your defense, presenting evidence of potentially mitigating factors or rehabilitation.
Experienced Insurance Fraud Defense Attorney
Louis J. Goodman has more than three decades of legal experience. As a former District Attorney and a Judge Pro Tem, he has a well-rounded understanding of the courtroom. He is passionate about protecting clients’ individual rights, and he is more than prepared to take on your insurance fraud case.
FAQs
Who Is in Charge of Investigating Insurance Fraud in California?
Insurance fraud cases are investigated by the California Department of Insurance (CDI), as well as the local district attorney, who will help head up the prosecution’s case against those accused of insurance fraud. While they are not responsible for building a case, the board that secures your professional licensure may also look into your case when deciding if license suspension or revocation is appropriate in the event of a conviction.
How Much Does It Cost to Hire an Insurance Fraud Defense Lawyer in California?
Each insurance fraud case is unique, which means the cost of hiring an insurance fraud lawyer tends to vary case by case in California. There are several different variables that may influence your overall cost, such as the level of complexity your case presents, the profession you work in, who you hire to represent you, the severity of your charges, and the amount of time your case requires to come to a conclusion.
How Can Being Convicted of Insurance Fraud Impact My Professional Licenses in California?
When you are convicted of insurance fraud, you may end up facing severe professional license consequences, such as the suspension or revocation of your license(s). This is common, as committing insurance fraud is considered an act of dishonesty and theft that is a violation of your professional duties.
The specific impact of your conviction tends to vary based on the nature of the accusation and your profession, but professional licensing boards can take many different types of action in response.
How Long Will My Insurance Fraud Case Take to Resolve in California?
Like the cost of hiring a lawyer, the time each insurance fraud case takes to resolve is unique in the state of California. This is because of the wide variety of influential variables involved, such as the availability of the other parties involved in your case, the schedule of your local courthouse, and the complexity of your case. Hiring an insurance fraud lawyer can help you keep your case on track by avoiding unnecessary setbacks.
Get More Information Today
With many satisfied clients, Louis J. Goodman has proven his dedication to helping defend people during some of the hardest points in their lives. Contact the Law Office of Louis J. Goodman today to learn more about how he can help you receive the advocacy and insight your case needs.
