Oakland Insurance Fraud Defense Lawyer

Oakland Insurance Fraud Defense Attorney

Insurance fraud laws are in place in California to address deceptive practices that undermine the insurance industry. Insurance fraud impacts insurers, policyholders, and the broader economy. Insurance fraud can result in higher premium costs and financial instability. California takes insurance fraud very seriously, and if you are accused of committing insurance fraud, you will need an experienced Oakland insurance fraud defense lawyer.

Choosing an Oakland Insurance Fraud Defense Lawyer

According to California law, any act that defrauds an insurance company qualifies as insurance fraud if the individual knowingly and deliberately commits an act with the intention of committing fraud.

If you are facing charges of insurance fraud, it is in your best interest to secure legal counsel. Louis J. Goodman is a former Alameda County deputy district attorney who has been helping clients for over 30 years. Mr. Goodman has a thorough understanding of the justice system and can help navigate the process of defending your rights if charged with insurance fraud.

The Law Office of Louis J. Goodman will discuss the specifics of your case and prepare a personalized defense. An experienced insurance fraud defense lawyer can examine the evidence in your case and work to have charges dismissed or reduced.

How Is Insurance Fraud Investigated in California?

The California Department of Insurance, Insurance Fraud Division, is a law enforcement unit within the Department of Insurance that investigates allegations of fraud. The Golden Gate regional office that serves Alameda County is located at 1100 Rose Drive, Suite 100, Benicia, California 94510.

The agency has nine regional offices in California that employ 275 staff members, including 230 sworn peace officers. Officers receive extensive training in conducting fraud investigations, surveillance, and undercover operations. They conduct interviews with suspects and witnesses.

The fraud division was established in 1979 and comprises four separate fraud programs that cover automobile insurance fraud, property, life, workers’ compensation fraud, and casualty fraud, as well as disability and healthcare fraud. Insurance fraud in California totals over $15 billion annually, averaging $500 per state resident. Insurance fraud is second only to tax evasion as the most costly crime in the nation, according to the National Insurance Crime Bureau (NICB).

Automobile Insurance Fraud and Its Cost

Automobile insurance fraud occurs when an individual knowingly lies in order to obtain a benefit they would not otherwise be entitled to receive. Purchasing an insurance policy after an accident and then lying about when the accident occurred is referred to as “crash and buy” and is a type of fraud.

Another common type of automobile insurance fraud involves sudden stops, where an individual causes a rear-end collision by suddenly stopping for no reason. “Stuffed passengers” refers to a type of fraud in which individuals who were not in the vehicle at the time of a collision file a claim for damages or injuries. A right-of-way collision may be used to commit fraud when an oncoming driver signals for you to enter the roadway and then causes a collision on purpose.

Property, Life, and Casualty Fraud and Its Cost

Types of fraud under the property, life, and casualty category include staged robberies or life insurance schemes involving murder for financial gain. Filing a false claim or exaggerating the severity of a claim for damages as a result of a natural disaster, such as a wildfire, wind, flood, or earthquake, is also fraud.

In fiscal year 2022-23, the Fraud Division identified and reported 4,094 suspected fraud claims, opened 73 new cases, made 29 arrests, and referred 39 submissions for prosecutions. The potential loss of these investigations was $318,284,399.

Workers’ Compensation Fraud and Its Cost

Workers’ compensation fraud may include a staged incident of injury while at work. It also covers a false claim filed by an individual that did not happen on the job or in relationship to the job. Individuals lying about their inability to do various tasks in relation to a claim may also be committing fraud.

In the fiscal year 2022-23, the Fraud Division identified and reported 2,846 suspected fraud cases, opened 597 new cases, made 164 arrests, and referred 257 cases to prosecuting authorities. Potential losses totaled $404,424,635.

Healthcare Fraud and Its Cost

Disability and healthcare fraud covers false claims outside of workers’ compensation, dental claims, and posing as someone else to receive benefits.

There were 675 suspected fraud claims, 50 new cases, 24 arrests, and 50 referrals to prosecuting authorities during Fiscal Year 2022-23. Losses as a result of these cases are estimated at $109,808,342.

Penalties for Fraud in California

Various factors influence the penalty for insurance fraud in California. Factors that will be considered include the type of insurance fraud that was committed, the value of the fraud, whether anyone was injured as a result of the fraud, and the criminal history of the individual accused. If an individual has previously been convicted of a felony insurance fraud charge, additional jail time may be added to the sentence.

Insurance fraud can carry a misdemeanor or felony charge in California. A misdemeanor charge is punishable by one year of incarceration in a county jail and a fine of up to $10,000. A felony fraud conviction can result in up to five years in prison. The maximum fine for a felony varies depending on the type of fraud committed.

Workers’ compensation fraud has a maximum fine of $150,000 or three times the amount of the fraud. A fine of up to $50,000 may result if an individual purposely damages an insured vehicle with the intention of collecting insurance. Unemployment fraud carries a maximum fine of $20,000. An individual convicted of insurance fraud in California may also receive probation or be required to perform community service.

Committing fraud may also lead to civil penalties as described under the California Insurance Code. A civil case can be filed by the state or an individual who was harmed by the fraudulent activity. Fines up to $10,000 can be assessed for each fraudulent act. Treble damages may also be required, which will require the defendant to pay three times the damages that resulted from the fraud.

Contact the Law Office of Louis J. Goodman

If you are under investigation for insurance fraud, California’s strict penalties and thorough fraud investigators may seem daunting. Legal representation in an insurance fraud case will help protect your rights and explain your options. An experienced Oakland insurance fraud defense lawyer can help decipher the complexities of your situation and avoid errors when navigating the legal process. Contact the Law Office of Louis J. Goodman to discuss your case and explore the benefits of having a skilled attorney in your corner.