Filing False Claims Law & Defense
The law on the crimes of insurance fraud, also known as fraudulent claims, is found at penal code sections 548, 549, and 550. This article attempts to summarize the law, defense, and punishment associated with some of the more common insurance fraud and fraudulent claims criminal charges.
PC 548(a) & 550 Law
Every person who willfully injures, destroys, secretes, abandons, or disposes of any property, which at the time is insured against loss or damage by theft, or embezzlement, with intent to defraud or prejudice the insurer, whether the property is the property or in the possession of that person or any other person, is guilty of defrauding an insurer (Abbrev.).
It is unlawful to do any of the following, or to aid, abet, solicit, or conspire with any person to do any of the following (Partial list):
Knowingly present, or cause to be presented, any false or fraudulent claim for the payment of a loss or injury, including payment of a loss or injury under a contract of insurance (PC 550(a)(1)).
Knowingly cause or participate in a vehicular collision, or any other vehicular accident, for the purpose of presenting any false or fraudulent claim (PC 550(a)(3)).
Knowingly present a false or fraudulent claim for the payments of a loss for theft, destruction, damage, or conversion of a motor vehicle, a motor vehicle part, or contents of a motor vehicle (PC 550(a)(4)).
Knowingly make or cause to be made any false or fraudulent claim for payment of a health care benefit (PC 550(a)(6)).
For most insurance fraud cases the district attorney will need to that the defendant did all of the following:
The defendant presented a false or fraudulent claim (a false claim is a claim that is made to deceive for the purpose of gaining financial or legal benefits)
The defendant knew that the claim was false (a claim is the presentation of information, whether verbally or orally)
The defendant intended to defraud at the time the claim was made.
Sentence for PC 548 & 550
Penal code 548(a) & 550: Defraud Insurer, is classified as a felony. If found guilty of PC 548(a), the defendant may face up to five years in prison. Collateral punishment may apply (see below).
In some cases it may be possible to secure a probation sentence without a jail commitment. Suspended jail sentence and split jail sentences may also apply (a split prison sentence is where the defendant serves some of his or her sentence in custody and some of it out of custody on work release.
Penal code 550(a), Insurance Fraud (False Claims), is classified as a felony. If found guilty of PC 550(a), the defendant may face up to five years in jail.
Note: Some PC 550(a) charges are filed as misdemeanors, such as PC 550(a)(6) or 550(a)(8), in which case the maximum misdemeanor sentence is up to one year depending on the specific charge. For the exact maximum sentence for any insurance fraud charge please contact our criminal defense lawyers for a free case analysis.
In some cases is may be possible to have an insurance fraud charge reduced to a misdemeanor or dismissed completely. Every false claims or insurance fraud criminal case is different as the fact are different in every case; therefore, whether any reduction of a criminal charge, or the likelihood of having the charge dismissed, depends largely on the particular facts of the case and the defendant's criminal history. With that said, is is not uncommon for a defendant to plead to a felony insurance fraud case with an option to have thatcharged reduced to a misdemeanor after repayment of any funds received by the defendant via his or her insurance fraud.
CIMT: Insurance fraud is considered a crime involving moral turpitude. This means that the crime invovles deceit or is morally wrong. A criminal convcition for a crime that involves moral turpitude can lead to serious immigration probalems for non U.S. citizens, including deporatation or denial from entry into the United States.
Three Strikes Law: Insurance fraud charges are not considered serious or violent as those terms are defined in California law; therefore, no PC 548 or 550 charge is considered a strike under California's Three Strikes Sentencing Law.
Bail: $25,000 for PC 550(a)(1) in San Bernardino county.
Note: Bail is a surety bond that is intended to serve as assurance that the defendant will appear court when ordered. If the defendant pay s the posted bail amount then he or she will be released from custody while his or her court hearing progresses (also called posting a bond). If the defendant does not appear as ordered after posting the bail then the bail is forfeited and a warrant will issue fo the defendant. Sometimes a required bail may be lowered (or raised) depending on the defendant's flight risk, ability pay the bail, and the defendant's risk to the community as it relates to his or her criminal history and the facts of the current case.
Other penalties include for insurance fraud convictions include: Monetary fines, harsh probation or parole terms, possible loss of employment, civil lawsuits, restitution orders, loss of a professional license (even if there is no relationship between the crime and the profession), and more.
Defenses to PC 548 & 550
Insufficient Evidence: The most common defense to a criminal charge of PC 548 or PC 550 is insufficient evidence. For example, there may not be enough evidence to prove that the defendant intended to defraud at the time he or she made a claim, such as when a person puts in a claim for a stolen vehicle and the vehicle is later discovered, but the defendant does not present the discovery of the vehicle to the insurance company before the claim in paid. Another example of insufficient evidence would be where there is no evidence to support the fact that the claim was presented, such as when a defendant fills out insurance forms for an alleged accidental fire but never presents the forms to the insurance company.
Mistake of Fact: In some PC 548 or 550 cases the defendant will be able to prove that he or she believed the insurance claim was legitimate under the circumstances.
Less common defenses: PC 548 and 550 defenses may also include: misjoinder, suppression of evidence (such as a confession), coerced confessions, double jeopardy, insanity, intoxication, duress, and more.
If you are charged with any violation of California penal code section 548 or 550, insurance fraud, or fraudulent claims, contact our criminal defense attorneys without delay for a free consultation. Our criminal defense law firm has successfully defended against hundreds of misdemeanor and felony charges. Our offices are open seven days a week to assist you. Call today!
Quick Legal Reference
Crime: Present a False Claim
Code: PC 550(a)(1) (CalCrim No. 2000 et seq.)
Wobbler: No. PC 550(a)(1) is not a wobbler. This means that PC 550(a)(1) is only charged as a felony.
Incarceration: PC 550(a)(1) jail sentence range: 2, 3, or 5 years.
Probation: Probation may be available in PC 550(a)(1) cases (assuming other crimes or enhancements that bar a probation sentence are not present). Whether or not a probation sentence is offered by the District Attorney, or granted by the court, depends on several factors, including the defendant's criminal history and the facts of the case.
Work Release or House Arrest: In some cases, a probation sentence can include actual in-custody county jail, house arrest (electronic monitoring), or work release (or some combination of these penalties); however, most in-custody jail sentence orders that are required as a terms of probation are much shorter than the maximum jail sentence.
PC 1170(h)): Yes. PC 550(a)(1) is subject to PC 1170(h) sentencing. This means that any jail or prison sentence may be:
Split (half in-custody / half out-of-custody)
Suspended (possibly never served)
Served in county jail (not state prison)
Strike: PC 550(a)(1) is not a strike offense listed in California's Three Strikes law.
Credits: 50% good conduct credits available.
CIMT: PC 550(a)(1) is a crime involving moral turpitude, which means that an arrest or conviction could lead to the following:
Professional Licensing problems
Impeachment on credibility
Firearms: PC 550(a)(1) convictions bar defendant from owning or possessing a firearm.
Bail: $25,000, or amount stolen, whichever is more
Criminal Defense Lawyers
PC 548 Defraud Insurer
PC 549 Solicit or refer for insurance fraud
PC 550(a)(1) Present false or fraudulent claim
PC 550(a)(2) Present multiple claims for same injury to defraud
PC 550(a)(3) Participate in vehicle accident to defraud
PC 550(a)(4) Present false claim for theft or damage to vehicle
PC 550(a)(7) Present false claim for health insurance benefit
PC 550(b) Present false statement for insurance claim