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What Must Prosecutors Attempt to Prove in Insurance Fraud Cases?

Insurance fraud is a severe criminal charge that could result in stiff penalties for the accused. However, the line between insurance fraud and real insurance cases is small, which means prosecuting fraud cases is not easy. Let’s examine what prosecutors precisely attempt to prove when pursuing insurance fraud convictions.

What Do Prosecutors Need to Argue for a Successful Conviction?

First, prosecutors must prove that the accused knowingly committed the alleged criminal act. Insurance is confusing, and if someone accidentally gives false information or claims a benefit he or she didn’t qualify for, the accused’s ignorance could be a viable defense.

Therefore, the prosecution must attempt to prove beyond a reasonable doubt that the accused knew what they were doing when he or she “committed” the alleged fraud.

Second, prosecutors must attempt to prove that the accused committed fraud against an organization or business. There are many kinds of fraud, so prosecutors will have to key in on the specific method of fraud that the accused “committed” to obtain a successful conviction.

Common forms of fraud include:

  • Creating false documents;
  • Planning a fraud with another party (car theft for auto insurance, burglary for home insurance, auto accident for personal injury insurance, etc.)
  • Faking injuries from an accident;
  • Submitting a health care claim for services that never occurred;
  • Submitting multiple applications for the same issue.

There are many steps that prosecutors can take to attempt to prove fraud, but there are also many defenses an experienced fraud attorney can make on your behalf.

Have You Been Accused of Fraud?

If you or a loved one is accused of any fraud charge, the Law Office of George Gedulin is here to help! Our experienced attorneys have fought and won cases for clients who were charged with committing fraud, so we know how to defend your case.

Call (858) 281-4605 now for a free consultation concerning your fraud case.