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Defending Against Insurance Fraud Claims In Texas

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Defending Against Insurance Fraud Claims In Texas


If you are dealing with an insurance claim to recover after a covered loss, that process can be difficult and time-consuming enough. If a mistake or error is made in the insurance claim process, that can lead to even bigger problems – including allegations of insurance fraud.

Insurance fraud occurs when the insured makes a false statement, or intentional omission, in relation to an insurance claim, with the intent to alter the claim for financial benefit. This may include, for example, adding previously-damaged items to an insurance claim following recent storm damage to your home. Insurance fraud can also include staged auto accidents, or reports of stolen items that were not truly stolen.

These types of fraud are more common than you’d expect, costing insurers about $30 billion per year in fraud-related claims and driving up premiums for the rest of us.

Understandably, insurance companies and law enforcement agencies are eager to recoup these costs and prosecute the perpetrators of insurance fraud. While you may not think of yourself as any kind of criminal, it is possible that an inadvertent error or mistake in your insurance claim can lead to an investigation and even a charge of insurance fraud under Texas law.

Legal Standards in Texas for Insurance Fraud: What the Prosecution Must Prove

Under Section 35.02 of the Texas Penal Code, a person commits insurance fraud if, with intent to defraud or deceive an insurer, the person, in support of a claim for payment under an insurance policy:

  1. prepares or causes to be prepared a statement that:
    1. the person knows contains false or misleading material information; and
    2. is presented to an insurer; or
  2. presents or causes to be presented to an insurer a statement that the person knows contains false or misleading material information.

Depending on the facts involved and the nature of the fraud, penalties can include jail time as well as court costs, attorney’s fees, and financial restitution to the insurance company. A conviction of insurance fraud can also create lifelong problems with obtaining insurance in the future.

Defenses to Claims of Insurance Fraud in Texas

Your main defense, if charged with insurance fraud in Texas, is that you had no intent to deceive or commit fraud. Under Texas Code, the prosecution must prove – beyond a reasonable doubt – that a defendant willfully filed a false or inflated claim to the insurer, with the intent to deceive and receive financial benefits that were not rightfully theirs.

You may have mistakenly omitted or entered certain information without knowledge of the error, or certainly without intent to commit fraud. You may have submitted an incomplete version of your claim form, or mistakenly checked the wrong box within an online form.

In some cases, an estimate you received elsewhere may differ from what an insurance adjuster or law enforcement reported. As a result, there may be some discrepancy in the amount of damage but not an intent to defraud the insurer on your part.

When to Contact an Attorney About an Insurance Fraud Claim

If you have been investigated or charged with insurance fraud, you should contact an experienced Pearland fraud attorney as soon as possible. An attorney can review all facts and circumstances of your insurance claim, including the information alleged to be fraudulent. With experienced legal help, you can then prepare a defense to the claims against you, potentially leading to a closure of the investigation or dismissal of charges.

Our Pearland, Texas Defense Attorney Can Help You Defend Against Insurance Fraud Allegations

If any action has been taken against you regarding a potential insurance fraud allegation, you can’t fight that battle alone against insurance companies and law enforcement. You’ll want quality representation that can confront the claims against you and fight to clear your name and reputation. Contact the offices of Keith B. French Law, PLLC, today or call 832-243-6153 for a free case evaluation to get started.


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