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Insurance Fraud

Insurance fraud is a serious crime in the state of Texas and across the nation. It can occur in several ways since the offense itself is very diverse. The criminal charge of identity theft can encapsulate a wide range of fraudulent offenses that can involve car insurance, health insurance, homeowner’s insurance and other types of insurance policies. Common parties guilty of insurance fraud include:

  • Insurance Agents
  • Insurance Adjusters
  • Doctors and hospitals
  • Policyholders

The penalties for insurance fraud of any type is nothing to take lightly. If you’re in need of legal counsel, our Texas insurance fraud attorneys at The Gracia Law Firm, P.C. are dedicated to defending individuals accused of all types of white-collar crimes. We can aggressively defend the insurance fraud charges you are facing.

Brownsville White Collar Crime Attorney in Texas

Fraudulently misrepresenting assets in an insurance claim or faking a medical condition are all examples of insurance fraud. Unfortunately, insurance fraud carries heavy consequences. If you are in need of an insurance fraud attorney, contact The Gracia Law Firm, P.C. today. Your rights and freedom are on the line.

It is in your best interest to seek effective legal representation. At The Gracia Law Firm, P.C. , we offer a free consultation with one of our attorneys in order to help you get started. If you find yourself in Brownsville, Texas or in the surrounding areas of Cameron County, Hidalgo County, and Willacy County, call us today at 956-504-2211.


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Information Center


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What is Insurance Fraud in Texas?

Insurance fraud is a very serious criminal offense. This form of fraud occurs when an individual misrepresents a fact or lies in order to receive a financial gain under an insurance policy. Under Texas Penal Code Sec. 35.02, he or she commits an offense if, with intent to deceive an insurer they do one of the following:

  • Prepares a statement that they know contains false or misleading material information and presents said statement to an insurer; or
  • Solicits, offers, pays, or receives a benefit in connection with the furnishing of goods or services for which a claim for payment is submitted under an insurance policy.

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Insurance Fraud Texas Penalties

If you have been charged with identity theft allegations, penalties can be serious. They can result in jail time, prison time, probation and steep fines. In the state of Texas, penalties for identity theft are determined on the value of the claim.

  • Less than $100 —Class C Misdemeanor punishable by:
  • A $500 fine.
  • At least $100, but no more than $750— Class B Misdemeanor punishable by:
  • Up to 180 days in jail and/or a $10,000 fine.
  • At least $750, but no more than $2,500 — Class A Misdemeanor punishable by:
  • Up to 1 year in jail and/or a $4,000 fine.
  • At least $2,500, but no more than $30,000 — State jail felony punishable by:
  • Up to 2 years in jail and a $10,000 fine.
  • At least $30,000, but no more than $150,000 – Third degree felony punishable by:
  • Up to 10 years in prison and a $10,000 fine.
  • At least $150,000, but no more than $300,000— Second degree felony punishable by:
  • Up to 20 years in prison and a $10,000 fine.
  • $300,000 or more— First degree felony punishable by:
  • Up to 99 years in jail and a $10,000 fine.

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Common Insurance Fraud Schemes in Cameron County

Many people believe insurance fraud only occurs when someone makes a false claim on an auto accident. The truth is insurance fraud can occur in several ways. Common insurance fraud schemes in Texas include:

  • Staged Car Accident — A staged car accident can occur if a driver stages a motor vehicle accident to recover money for the auto damages. This is also known as “auto insurance fraud” in Texas.
  • Staged Home Fire — This fraud scheme can occur if homeowners hire individuals to set fire to a home. A staged home fire can also be set up if homeowners hire people to vandalize the home, creating the impression that the homeowner has been victimized.
  • Storm Fraud — It’s common for storm fraud to occur after floods and hurricanes. They will often enhance the damage their homes sustained or submit fake claims for damage to obtain more money.
  • Faked Death — Faked death occurs when an individual purchases a life insurance policy, names his or her spouse as a beneficiary, and then fakes their death in order to obtain the death benefit.

Additional insurance fraud schemes include:

●   Filing false or fraudulent insurance claims by physicians or medical professionals for improperly billing PIP, Medicaid/Medicare

●      Fraud by falsifying insurance documents

●      Fraud by exaggerating losses sustained after a burglary or theft

●      Fraud by faking or exaggerating an illness or disability

●      Medicaid/Medicare fraud

●      Social security disability fraud

●      Commercial property insurance fraud

Property insurance fraud occurs when an individual sets fire to a building or other type of property to collect insurance benefits or to claim personal property lost in a burglary. Workers compensation claim fraud occurs when someone fakes an injury and attempts to receive benefits from their employer.


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Additional Insurance Fraud Resources

Texas Department of Insurance –  Texas Department of Insurance regulates the state’s insurance industry and oversees the administration of the Texas workers’ compensation system. Visit the website to read the insurance fraud guide. It details how to report suspected fraud and common insurance fraud schemes.

The Insurance Council of Texas (ICT) – ICT serves property and casualty insurance carriers and their customers by educating members and consumers on Texas insurance issues. It is the largest state-based insurance trade association in North America. Visit the website to read recent news, learn about industry updates and more.


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Insurance Fraud Attorney in Brownsville, Texas

Have you or someone you know been accused of insurance fraud? Contact one of our white collar crime attorneys at The Gracia Law Firm, P.C. today. Our team has the best knowledge and skills to help you obtain the best outcome for your case. We are eager to hear your side of the story and start building your defense.

Insurance fraud crimes require the help of experienced counsel and The Gracia Law Firm, P.C. can help defend you in court.  Please call 956-504-2211 to set up your initial consultation free of charge. We are standing by to take your call. The Gracia Law Firm, P.C. defends clients who have been convicted of insurance fraud in Brownsville, Texas and surrounding counties including Cameron County, Willacy County, and Hidalgo County. We also represent individuals that live in Rio Grande Valley, Houston, San Benito, and Mercedes, TX.


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