Fremont Insurance Fraud Defense Lawyer

Fremont Insurance Fraud Defense Attorney

Insurance is complex. Even at its most basic, policies can be convoluted, stipulations confusing, and processes obscure. It is not uncommon to make mistakes, misinterpret facts, or misunderstand intentions. Due to such instances, innocent people are often charged with insurance fraud through no fault of their own. If you find yourself in such a situation, our Fremont insurance fraud defense lawyers are here to help.

For over three decades, the Law Office of Louis J. Goodman has been assisting the people of Fremont and beyond by providing them with a rigorous legal defense across a variety of matters. Whether you are facing allegations and have been contacted by insurance investigators or the police, it is always good to have informed counsel by your side. Our skilled criminal defense attorneys in Dublin have a track record of success in insurance litigation and stand ready to work on your behalf.

What Is Insurance Fraud?

Under California Insurance Code Section 1871, insurance fraud consists of providing false information to an insurance company, with the intended result of money or services being rewarded to an individual to whom they are not entitled.

Some commonly held categories of insurance fraud include automobile fraud (548-551 PC), workers’ compensation fraud (549-550 PC), property, life, and casualty fraud (550 PC), and disability and healthcare fraud (550 (a)(1) PC).

While the regulations vary for different kinds of fraud, if there is a suspicion of false statements, multiple claims regarding one event, intentional destruction of property or evidence, or any other kind of misrepresentation of facts, a company may file insurance fraud charges.

Soft and Hard Insurance Fraud

Among fraud allegations, there is a division between what are considered “hard” and “soft” forms of insurance fraud. Hard fraud occurs when a policy member intentionally destroys property for the purpose of deception in the hopes of receiving an eventual payout.

Soft fraud occurs when a policyholder makes a false statement when filing a claim in the hopes of receiving a lower insurance rate. Between the two forms, soft frauds are more common and are difficult to prove, while hard frauds are easier to provide evidence for. Suspected hard frauds are typically treated more sternly and often (although not exclusively) involve felony charges.

Insurance Fraud Investigations

Typically, an investigation will begin with a report of alleged fraud by a functionary of the insurance company. Following this, evidence will be collected, including bank records, statements by witnesses, financial statements, communication records, and any digital records that may be relevant.

After the evidence has been collected, the case is presented to the district attorney. At this stage, the veracity of the evidence will be examined, as well as the possibility of conviction if charges are presented. If the district attorney feels there is sufficient reason to prosecute, charges will be formally filed. This begins the courtroom litigation process.

Misdemeanor and Felony Convictions and Their Consequences

Insurance fraud is taken seriously in California. A case may be charged as a felony if the amount alleged stolen exceeds $950. A successful prosecution can result in a range of consequences, depending on whether they are misdemeanor or felony charges.

In general, if a person is convicted of a misdemeanor charge, they may face up to six months in jail and a fine of $1000. The consequences of a felony charge are harsher, including up to five years in prison as well as a potential fine of up to $50,000.

Building a Strong Defense

When facing an insurance fraud investigation, it is important to protect yourself as soon as possible. This means refraining from speaking with insurance investigators or the District Attorney before you have contacted a lawyer. An experienced attorney will be able to guide you on how to approach defending yourself against allegations.

It is important to remember that the burden of proof lies with the prosecution. A skilled lawyer will be able to identify problems with a prosecutor’s case and use them to advocate on your behalf. Common defenses can include.

• Problems of evidence. This is not uncommon when being prosecuted for insurance fraud. Often, material evidence can be either weak or misinterpreted, and a skilled counselor will be able to defend their client against its use. As long as a plausible alternative narrative can be presented by the defense, then there remains a reasonable doubt, and a conviction cannot be made.
• Likewise, it is important to understand that fraud is a very specific category of crime. It can only occur where intent to defraud aligns with the actions taken by the defendant. If it can be shown that a defendant either did not understand their actions or had honest intentions, then no fraud has taken place.
• Lastly, there is human error. People make mistakes and misunderstand regulations. Often, it is the case that insurance providers make a mistake in their accusations, or those investigating misinterpret the facts. A mistake of fact is a legitimate and common defense, and a skilled attorney will be able to identify when it is appropriate.

Speak With an Experienced Fremont Insurance Fraud Defense Lawyer

It is not uncommon for insurance fraud allegations to be leveled against an individual even when there was no intent to commit wrongdoing. In 2022, for example, only 18% of workers’ compensation fraud cases brought before the California Department of Insurance ended in arrests. This shows that although the accusation of insurance fraud may be intimidating, it is by no means a guarantee of conviction.

To improve your chances of a strong legal defense, it is critical to consult with an experienced attorney as soon as allegations are made. At the Law Office of Louis J. Goodman, we have been defending the interests of clients in Fremont, the greater Alameda County, and beyond to ensure those facing accusations are not left without advocacy.

California takes its insurance fraud laws very seriously. Don’t allow yourself to face consequences for unfounded allegations. Secure a strong defense and contact us for a consultation today to learn how we can help you.