If you've received word from an insurance company expressing the belief that a claim you filed was fraudulent, you need to take decisive action in addressing the situation. And while it may seem that filing an inaccurate or even false claim is a victimless crime, insurance companies take the matter very seriously. Insurance fraud, whether it involves property, auto, business or any other type of policy, is a crime and the state of California is well prepared to prosecute offenders.
It is very important to understand what constitutes insurance fraud. Some people may believe that a fraud is committed only if an insurance company pays off on a bogus claim. However, this is not the case. In California, the criteria for insurance fraud are as follows:
- The accused party had the intent to defraud the insurance company.
- The act to defraud was completed. The act could include either written or oral misrepresentation submitted to an insurer with the knowledge the claim was false.
- The insurer need not suffer an actual monetary loss, so long as the accused knowingly intended to commit the act.
But the key word here is "intent." A prosecutor must be able to demonstrate that a defendant clearly intended to defraud the insurer. And this is where having a knowledgeable criminal defense attorney can be so important.
In such cases, a prosecutor may attempt to bully a defendant into accepting a plea bargain when in reality, there is no way to prove the defendant's intent. So, if you have been charged with insurance fraud, your best move is to say nothing and sign nothing before you speak to an attorney. An attorney can protect your rights and work to prove that if there was a problem with your claim, it was not done with intent and thus is not a criminal act.