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What Are the Penalties for Insurance Fraud?

March 3, 2020

Insurance fraud is when a person attempts to gain financially by lying to an insurance company. They could lie on the insurance claim or directly to an insurance adjuster. The insured person could be guilty of insurance fraud, but others could commit insurance fraud, as well. For example, doctors, hospitals, agents, or adjusters can also commit insurance fraud.

Why would someone want to defraud an insurer? Mostly, they seek to make money through deceitful behavior. 

Examples of Insurance Fraud

Here’s an example of insurance fraud:

Suppose a dentist has been struggling to keep their business afloat. They are having a hard time drumming up business, but they see a way to help. If they bill their patients’ insurance companies for dental procedures they aren’t even doing, they could receive more money. 

The dentist bills insurance companies for dental X-rays that weren’t performed. This would be insurance fraud.

Another example:

You were injured at work. You exaggerate your injury because you want the workers compensation insurance company to pay you more money while you are out recovering from your injury. You intentionally lie to the doctor about how much pain you’re in so you can get more money from the insurer. This is also insurance fraud.

Penalties for Insurance Fraud in Texas

Most crimes in Texas come with penalties attached if convicted. Many crimes are punished based on the classification of the misdemeanor or felony you’re convicted of. 

For example, a Class 3 misdemeanor in Texas could be punished by a fine no greater than $500. A first-degree felony could be punished by life imprisonment or a term between five and ninety-nine years. You can also receive a fine up to $10,000.

Insurance fraud can be charged as a misdemeanor or a felony in the state of Texas. Your charge will be based on the amount of money you stole from the insurance company.

For example, if you defrauded an insurance company out of less than $100 dollars, you could be charged with a Class C misdemeanor. See additional penalties below.

Value of Insurance Fraud Penalties
$100-$749 Class B misdemeanor
$750-$2,499 Class A misdemeanor
$2,500-$29,999 State jail felony
$30,000-$149,999 Felony of the third degree
$150,000-$299,999 Felony of the second degree
$300,000 or more Felony of the first degree

Unless your charge can be pled down to a lesser offense, you are looking at some serious penalties. In some cases, you could be looking at more than one count of insurance fraud, which means more than one conviction.

Need Help from a Criminal Defense Lawyer in Texas?

You are facing some serious legal consequences if you are convicted of insurance fraud in Texas. In addition to legal penalties, your life may never be the same again. 

You might want to fight your charges, and you might need some help from a Texas criminal defense lawyer. Talk to a lawyer at Chris Lewis & Associates P.C. to learn what defense options could be available in your situation. Dial 214-665-6930 or complete the online contact form below.


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