Picture a parent with a steady job and no record who files a claim after a car accident. Months later, a letter arrives from an investigator, or a detective calls. Suddenly that person is being accused of a crime.
This is exactly the kind of case Marcus E. DeBose focuses on. Insurance fraud allegations often land on people who have never been in a courtroom, and the fear is real: losing a job, savings, a professional license, a reputation in the community, and possibly freedom. Marcus takes the time to understand what happened and why, then tells that story to the prosecutor and the judge.
How insurance fraud cases usually start
Most cases do not begin with an arrest. They often start quietly:
- The insurer's special investigations unit reviews a claim and asks for documents
- You are asked for a recorded statement or an examination under oath
- The insurer refers the claim to the California Department of Insurance or the district attorney
- A detective contacts you, or you receive notice of a court date
Before you explain, call. Statements made to an insurance investigator or a detective can later be used by prosecutors. It is generally wise to speak with a defense attorney before you answer questions, even if you believe you can clear things up yourself.
The laws involved
Penal Code section 550
This is California's main insurance fraud statute. It covers knowingly presenting a false or fraudulent claim, or a false statement in support of a claim, including claims after a vehicle accident, a theft or property damage. Depending on the subsection charged and the amount involved, a Section 550 charge may be a felony or a wobbler.
Insurance Code section 1871.4
This law addresses false or fraudulent statements made to obtain or deny workers' compensation benefits. It can be charged as a felony or a misdemeanor.
What the prosecution generally has to prove
An insurance claim that turns out to be wrong is not automatically a crime. Prosecutors generally must show that a false or misleading statement was made knowingly and with the intent to defraud. Honest mistakes, confusing forms, a misunderstanding with an adjuster, or a repair shop's paperwork can all play a part. Looking closely at who said what, and when, is often the heart of the defense.
Possible paths forward
Every case is different, but depending on the facts and your history, options may include:
- Responding to the investigation before any charges are filed
- Challenging whether there was intent to defraud
- Seeking a misdemeanor instead of a felony where the law allows it, see felony defense
- A negotiated resolution that may involve paying money back
- Taking the case to trial when that is the right choice
For a first-time defendant, how the case is presented can make a real difference. A long work history, family responsibilities and an otherwise clean record are part of your story.
Talk to Marcus before you talk to anyone else
If an insurer, investigator or detective has contacted you, book a free consultation. You can meet Marcus at his Mission Valley office, or talk by phone or Zoom. Hablamos español. See also white collar crimes.
This page is general information about California law, not legal advice for your situation. Every case is different, and past results do not guarantee a similar outcome.