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Houston Insurance Fraud

Attorney Greg Tsioros

Insurance Fraud

Insurance Fraud Defense in Houston: Brazoria, Ft. Bend, Galveston, Harris & Montgomery Counties

Insurance fraud is one type of fraudulent offense that has been gaining prominence over the years in Texas and across the United States. Criminologists have found various reasons for this, and the most commonly mentioned in this regard include:

  • The rising use of the Internet to crimes
  • The sheer growth of the risk management industry
  • The ongoing shift in policies and regulations in Texas and the U.S.

Chapter 35 of the Texas Penal Code explains the crime of insurance deception. There is not a single definition for fraudulent offenses involving insurance. There is, however, a single aspect of the process that seems to be present in just about any criminal case related to the industry, and that is the claim. Coincidentally, the claims process is the most contentious in the insurance field.

How Do People Defraud Their Insurance Providers?

Examples of deceptive claims include:

  • Health care fraud perpetrated by a medical equipment vendor who charges the Medicaid or Medicare systems for products not delivered or services not rendered. In some cases, the products or services are delivered, but there are suspicions of overcharging.
  • Uninsured drivers who file claims for damages or injuries only after they have obtained coverage.
  • Forged identification documents in connection with health care fraud.
Penalties for Deceiving Insurance Programs

As long as these cases do not involve injury or death, they are treated as white-collar offenses. The severity of the penalties is estimated depending on the alleged amount of loss. For example, a case involving a false claim estimated between $500 and $1,500 could be prosecuted as a Class A misdemeanor in Texas, which may result in a fine up to $4,000 and up to a year in jail.

Defense Options for False Insurance Claims

As with other criminal offenses, prosecutors have the burden of proof insofar as making a determination of culpability. Fraud prosecutions tend to be very complex and thus allow counsel to raise a number of effective legal defenses. For example, deliberate intent can be argued down to a lapse in judgment, and the same goes for calculating the true amount of the alleged loss.

Talk to an Insurance Fraud Attorney in Houston, TX

Consult with the Law Office of Greg Tsioros at (832) 752-5972 to learn more about the legal defenses for the charges against you.