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Insurance Fraud (False or Fraudulent Claims) Defense

California Penal Code 548 & 550

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.

Common insurance fraud Laws (PC 548 & 550)

Penal Code 548(a) 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, or any casualty 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.

Penal Code 550(a) Law

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 & Punishment for PC 548 & 550

Penal code 548(a), 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 prison commitment. Suspended prison sentence and split prison sentences may also apply (a split prison sentence is a sentence where the defendant serves some of his or her sentence in custody and some of it out of custody on work release or electronic monitoring.

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 prison.

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 office 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.

Collateral punishment: 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. However, PC 548 and 550 charges are considered crimes of moral turpitude, which means the crimes are considered to be morally wrong. Crimes of moral turpitude carry severe consequences for immigration and professional licensing concerns. Most non-U.S. citizens will be deported for any criminal conviction of PC 548 or 550.  Professionals that hold a California professional license issued from a Bar, Board, or Commission will likely lose their privilege to practice in their respective professions.

Other penalties include for insurance fraud convictions include: Monetary fines, harsh probation or parole terms, possible loss of employment, civil lawsuits, restitution orders, and more.

Defenses to Presenting a False Claim

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 out. 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 defense: 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 statute of limitation, 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. charged with misdemeanor and felony charges. Our offices are open 24/7 to assist you. Call today!


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Related Crime to Insurance Fraud (PC 548 & 550(a))

  • 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)(5) Make a writing to support a false or fraudulent insurance claim
  • PC 550(a)(7) Present a false or fraudulent claim for a health insurance benefit
  • PC 550(a)(8) Present multiple claims for a health care benefit  with intent to defraud
  • PC 550(b)(1) Present false statement to support an insurance claim

California Insurance Fraud Law & Defense PC 548, 549, 550(a), 550(b), 550(e) & More!


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