Most Californians have at least some dealings with the insurance industry.
For example, automobile liability insurance is mandatory in this state. Also, just about anyone who has a mortgage on their home must carry homeowner’s coverage.
Health insurance and life insurance are also products with which most people in the Sacramento area have some familiarity.
Those in the world of business also have dealings with insurance, and not just as policyholders.
Doctors, lawyers, contractors and other professionals frequently submit claims or payment requests to insurance companies. Many others serve as insurance agents or other professionals.
California has strict laws that require all those who work in or with the insurance industry to behave above-board.
While insurance fraud laws are detailed, the bottom line is that a person may not make false statements to an insurance company if the intention is to get money or other benefits to which they would not otherwise be entitled.
At the outset, this might seem straightforward enough. Indeed, these laws do prohibit behavior like burning down one’s own house or staging a car accident to collect insurance funds.
However, it is surprisingly how far these laws can reach.
To give just one example, if authorities believe that a doctor’s office padded a health insurance claim by double billing, billing for services not performed or the like the doctor could face insurance fraud charges.
Likewise, an insurance professional who allegedly aided a client in inflating their damages could in some circumstances face charges.
Insurance fraud charges can ruin a professional’s career
Most of the time, authorities will prosecute insurance fraud as a felony white collar crime. The consequences can include months or even years in jail or prison, a hefty fine and court-ordered restitution.
Any felony conviction can damage a person’s reputation and career opportunities. In some situations, an insurance fraud conviction could bar a person from practicing their profession. For example, insurance professionals legally may not continue to work in the insurance industry.
Sometimes, the best option is for someone accused of insurance fraud to admit their mistakes and negotiate an appropriate consequence.
However, insurance companies frequently work closely with police and prosecutors to aggressively investigate perceived cases of insurance fraud.
Sometimes, the end result is people get falsely accused of fraud when, at worst, all they did was make an understandable mistake.
Californians accused of insurance fraud or a related offense should consider their legal options carefully.