On behalf of Law Offices of Kathleen G. Alvarado posted in criminal law on Wednesday, March 21, 2018.

Most people in Riverside, California, have had to fill out an application for insurance, as the average person will have automobile insurance and some insurance to cover their home or, if they rent, their personal belongings. Most people have also likely filled out an application for health insurance either through their employers or through an insurance exchange. Some have also have probably had to file insurance claims because of a car accident or some sort of problem with their home.

While they might not realize it, in all of these cases, residents expose themselves to being accused of insurance fraud, which is a serious crime in California. After all, insurance fraud charges do not cover simply flagrant cases, such as where a person stages or makes up an insurance claim out of whole cloth.

A person can find himself or herself facing criminal charges simply because they allegedly padded a claim by asking for money to which they were clearly not entitled. This is true even if an insurance company catches the issue and denies the suspicious part of the claim. Even an omission that may seem minor, like not mentioning a medical diagnosis on a life insurance application, can lead to a fraud accusation.

The key in California insurance fraud cases is that a person has to have planned to deceive the insurance company. Simply making a mistake or even being a little careless or sloppy when applying for insurance or making an insurance claim is not a crime.

The problem, however, is that sometimes a person’s behavior can “look bad,” leaving authorities to believe a Riverside resident was trying to commit fraud even if he or she was not. Despite all the talk about “reasonable doubt,” it can be hard at this point for a person to explain his or her honest mistake to the satisfaction of the authorities or, for that matter, to a judge or jury.

The best thing for a person to do is make doubly sure that, when dealing with an insurance company, he or she is truthful and complete with respect to all statements. If a person does wind up getting accused of fraud, they can seek the help of an experienced California criminal law attorney.