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Insurance Fraud

The purpose of insurance is to provide coverage to their policyholders after they’ve suffered a loss. Whether the contract is intended for the home, health, work, or liability, policyholders are expected to be truthful and not misrepresent facts when filing a claim. This includes all initial paperwork and any subsequent claims filed later on.

However, some policyholders may not completely understand the intricacies of the claims process and then make a devastating mistake that could be interpreted as misrepresenting facts. In some cases, policyholders may drastically exaggerate their losses or even completely lie about damages in an effort to make a profit from their claim. Policyholders caught in the act of lying on an insurance application or claim can face upwards to a felony.

Insurance Fraud Attorney in Austin, Texas

If you are currently being investigated or have been arrested for insurance fraud or any type of fraud, then it’s imperative you retain legal counsel as soon as possible. Kevin Bennett of The Law Office of Kevin Bennett has spent years and years defending his clients from fraud or financial crimes with promising results. His experience allows him insight into how the prosecution approaches white collar cases, and he can utilize that knowledge to undermine every argument they have up their sleeve.

Call The Law Office of Kevin Bennett now at (512) 476-4626 to set up your first consultation free of charge. The Law Office of Kevin Bennett is located in Austin but accepts clients throughout the greater Travis County area including Pflugerville, Lakeway, Bee Cave, Lago Vista, Manor, Hudson Bend, and West Lake Hills.

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Insurance Fraud Under the Texas Penal Code

The crime of insurance fraud is defined under the Texas Penal Code under Section 35.015. The statute states alleged offenders will face a state jail felony if they, with intent to defraud or deceive the insurance company, do either of the following:

  • Provide the insurer with a statement they know contains false or misleading material information; OR
  • Prepare a statement they know contains misleading or false material information to their insurance company

The penalties for insurance fraud become much more serious when, with intent to defraud or deceive the insurer, the offender is alleged to do any of the following:

  • In an attempt to obtain compensation, the offender presents or causes to be presented to the insurance company a statement they’re aware contains false or misleading material information;
  • In an attempt to obtain compensation, the offender prepares or causes to be prepared a statement they know has false or misleading information; or
  • The offender offers, solicits, pays, or receives a benefit in connection with the furnishing of goods or services for a claim they submitted under their insurance policy

The classification of the crime with any of the cases above will depend on the value of the claim filed. If the value of the claim isn’t readily available, then the court will automatically use the fair market value of the claim. The fair market value of the claim will be at the time and place of which the offense happened.


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Can Someone Go to Jail for Insurance Fraud in Texas?

 

Value of the Claim

Offense Classification  

Jail/Prison Term

 

Fine

Less than $100 Class C Misdemeanor N/A $500
At least $100, but no more than $750 Class B Misdemeanor $2,000 Up to 180 days in jail
At least $750, but no more than $2,500 Class A Misdemeanor $4,000 Up to one year in jail
At least $2,500, but no more than $30,000 State Jail Felony $10,000 Up to two years in jail
At least $30,000, but no more than $150,000 Third-Degree Felony $10,000 Up to 10 years in prison
At least $150,000, but no more than $300,000 Second-Degree Felony $10,000 Up to 20 years in prison
$300,000 or more First-Degree Felony $10,000 Up to 99 years in prison

Prosecutors must prove every element beyond a reasonable doubt to convict a person of insurance fraud. An experienced fraud defense attorney can examine the facts of the case and then prove to the court why your “fraud” was simply just an honest mistake.


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Additional Resources

Insurance Fraud Guide | TDI – Visit the official website for the Texas Department of Insurance to learn more about insurance fraud schemes, healthcare provider fraud, fraud directed towards seniors, auto accident fraud schemes, and resources for victims of fraud.

Insurance Fraud Laws in Texas – Visit the official website for the Texas Statutes to learn more about their statutory language for insurance fraud. Access the site to read up on the elements of fraud, related legal definitions, how they put value on a claim, and other information.


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Insurance Claims Fraud Attorney in Austin, Texas

Are you facing charges for insurance fraud? If so, we urge you to contact Kevin Bennett of The Law Office of Kevin Bennett. Attorney Bennett has been practicing in the greater Travis County area for years and successfully defended hundreds of clients. Let him guide you through the judicial system with little to no penalty by calling his office today.

Set up your first consultation with The Law Office of Kevin Bennett by calling (512) 476-4626. The Law Office of Kevin Bennett accepts clients throughout the greater Austin metropolitan area including Lakeway, Bee Cave, Pflugerville, Manor, Hudson Bend, and West Lake Hills.


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