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White Collar Crime

White Collar Crime

Insurance Fraud

Individuals and businesses alike often have many different kinds of insurance policies that are intended to financially protect them in the event of an accident or some other catastrophe. Some people may submit claims to their insurance companies (insurers) in which they exaggerate or fabricate the harm suffered in order to obtain compensation they are not entitled to.

When a person submits a fraudulent insurance claim in Texas, that individual can face criminal charges. It is important to note that state law in Texas specifically requires proof of criminal intent, and many people accused of alleged insurance fraud may have simply made honest mistakes or oversights when filing their claims.

Attorney for Insurance Fraud Offenses in Georgetown, TX

Do you believe that you might be under investigation or were you already arrested for alleged insurance fraud in Central Texas? You should not make any kind of statements to authorities until you have legal counsel. Contact Law Office of Michael J. Price P.C. as soon as possible.

Georgetown criminal defense lawyer Michael J. Price aggressively defends clients accused of white collar crimes all over Williamson County and Bell County, including Round Rock, Taylor, Temple, Killeen, Leander, and several surrounding communities. He can review your case and help you understand all of your legal options when you call (512) 354-1880 to take advantage of a free, confidential consultation.


Overview of Insurance Fraud in Texas


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Insurance Fraud Charges in Williamson County

State law in Texas establishes three ways in which a person may commit insurance fraud. Under Texas Penal Code § 35.02(a), an alleged offender commits insurance fraud if, with intent to defraud or deceive an insurer, he or she, in support of a claim for payment under an insurance policy presents or causes to be presented to an insurer a statement that the person knows contains false or misleading material information or prepares or causes to be prepared a statement that:

  • the person knows contains false or misleading material information; and
  • is presented to an insurer.

Texas Penal Code § 35.02(a-1) states that a person also commits insurance fraud if he or she, with intent to defraud or deceive an insurer and in support of an application for an insurance policy presents or causes to be presented to an insurer a statement that the person knows contains false or misleading material information or prepares or causes to be prepared a statement that the person knows contains false or misleading material information and is presented to an insurer. Texas Penal Code § 35.02(b) further establishes that an alleged offender commits insurance fraud if, with intent to defraud or deceive an insurer, he or she solicits, offers, pays, or receives a benefit in connection with the furnishing of goods or services for which a claim for payment is submitted under an insurance policy.


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Insurance Fraud Penalties in Georgetown

Violations of Texas Penal Code § 35.02(a) and Texas Penal Code § 35.02(b) are classified based on the value of the claim involved. If an alleged offender proves by a preponderance of the evidence that a portion of the claim for payment under an insurance policy resulted from a valid loss, injury, expense, or service covered by the policy, the value of the claim is equal to the difference between the total claim amount and the amount of the valid portion of the claim.

Texas Penal Code § 35.02(c) grades violations of Texas Penal Code § 35.02(a) and Texas Penal Code § 35.02(b) as follows based on the value of the claim involved:

  • Less than $100 — Class C misdemeanor punishable by a fine of up to $500;
  • $100 or more but less than $750 — Class B misdemeanor punishable by up to 180 days in jail and/or a fine of up to $2,000;
  • $750 or more but less than $2,500 — Class A misdemeanor punishable by up to one year in jail and/or a fine of up to $4,000;
  • $2,500 or more but less than $30,000 — State jail felony punishable by up to two years in state jail and/or a fine of up to $10,000;
  • $30,000 or more but less than $150,000 — Third-degree felony punishable by up to 10 years in prison and/or a fine of up to $10,000;
  • $150,000 or more but less than $300,000 — Second-degree felony punishable by up to 20 years in prison and/or a fine of up to $10,000; or
  • $300,000 or more — First-degree felony punishable by up to 99 years or life in prison and/or a fine of up to $10,000.

Insurance fraud is also classified as a first-degree felony if an act committed in connection with the commission of the alleged offense places a person at risk of death or serious bodily injury. Any violation of Texas Penal Code § 35.02(a-1) is classified as a state jail felony.

Courts can also order an alleged offender convicted of an insurance fraud offense to pay restitution, including court costs and attorney's fees, to an affected insurer. When conduct that constitutes an insurance fraud offense also constitutes an offense under any other law, the alleged offender can be prosecuted under Texas Penal Code § 35.02, the other law, or both.


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Texas Resources for Insurance Fraud Crimes

Insurance Fraud | Texas Department of Insurance (TDI) — The TDI is the state agency that regulates insurers and other companies that conduct insurance business, and the TDI Fraud Unit is a law enforcement agency that employs both commissioned and non-commissioned investigators to enforce laws relating to fraudulent insurance acts. On this website, you can learn more about what insurance fraud is, types of insurance fraud schemes, and prevention tips. You can also find information about how to report suspected fraud.

Insurance Fraud | Texas Association of Special Investigation Units (TASIU) — The TASIU carries out the mission of the International Association of Special Investigation Units (IASIU) locally by providing members and antifraud partners with the training and networking advantages they need to fight insurance fraud. Visit this website to find insurance fraud statistics and National Insurance Crime Bureau (NICB) brochures and fact sheets on insurance fraud. You can also learn more about the TASIU.


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Law Office of Michael J. Price P.C. | Georgetown Insurance Fraud Defense Lawyer

If you were arrested or think that you could be under investigation in Central Texas for allegedly committing insurance fraud, it will be in your best interest to immediately seek legal representation. Law Office of Michael J. Price P.C. can fight to help you achieve the most favorable outcome to your case that results in the fewest possible penalties.

Michael J. Price is an experienced criminal defense attorney in Georgetown who represents individuals in Cedar Park, Harker Heights, Hutto, Benton, Georgetown, and many other nearby areas of Williamson County and Bell County. Call (512) 354-1880 or submit an online contact form today to have our lawyer provide a complete evaluation of your case during a free initial consultation.


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