Los Angeles Insurance Fraud Defense Lawyers

Are You in Need of an Insurance Fraud Defense Attorney?

Allegation of insurance fraud can expose you to serious criminal penalties, financial consequences, and lasting damage to your reputation. These cases may arise from a single disputed insurance claim or from allegations involving an extensive pattern of fraudulent conduct.

At Werksman Jackson Quinn & Mason LLP, our Los Angeles white-collar crime attorneys represent individuals, business owners, medical professionals, employees, and others accused of insurance-related crimes. We understand how mistakes, disputed valuations, and misunderstandings can attract scrutiny from government agencies, even when there is no criminal intent.

You should contact an insurance fraud attorney right away if:

• You receive a target letter, subpoena, or other notice indicating that you are under investigation.
• Law enforcement or government investigators contact you to ask questions about suspected insurance fraud.
• You are accused of submitting false or misleading information on an insurance application or claim.
• An insurer alleges that you staged, exaggerated, or fabricated an accident, injury, theft, or loss.
• You are accused of billing for services that were never provided or submitting false claims for reimbursement.
• You are suspected of participating in a larger insurance fraud scheme involving other individuals, businesses, or providers.
• A search warrant is executed at your home, office, or business in connection with an insurance fraud investigation.
• You are arrested, charged, or informed that criminal charges may be filed against you for insurance fraud.

Under Investigation for Insurance Fraud? Act Now

What you do during an investigation can affect the outcome of your case. Call Werksman Jackson Quinn & Mason LLP at (213) 688-0460 to discuss your defense during a free consultation.

Why Choose Us Over Other Insurance Fraud Defense Lawyers in Los Angeles?

Do not speak with investigators without having an attorney present. Statements made while attempting to explain an insurance claim can later become evidence against you. Documents provided without careful review may also be interpreted differently from how you intended.

Because serious insurance fraud allegations can result in felony charges, they should be aggressively addressed from the beginning. We are tenacious criminal defense attorneys who are prepared to take on difficult cases and powerful government agencies.

Here’s what sets our firm apart:

• Decades of criminal defense experience. Our firm was founded in 1994 and we have spent decades defending clients against serious criminal accusations.
• Mark Werksman is a former Deputy District Attorney and Assistant United States Attorney: He has practiced criminal law since 1986 and he brings extensive prosecution and defense experience to complex cases.
• AV-rated by Martindale-Hubbell. Our firm has earned the independent rating organization's highest rating for ethical standards and legal ability based on rigorous peer review.
• Alan Jackson has experience in high-profile cases. He served as lead counsel in the internationally followed Karen Read trial.
• Strength in numbers. When you hire our firm, you do not simply get one attorney. You gain a team capable of combining its knowledge, investigative resources, courtroom experience, and strategic insight in your defense.
• Kelly Quinn is a certified specialist in writs and appeals. Her background adds valuable appellate insight to the firm’s representation in complex criminal matters.
• Caleb Mason has a long track record of success in complex criminal cases, effectively navigating challenging legal issues at every stage.

What Is Insurance Fraud?

Insurance fraud involves knowingly making a false or fraudulent statement, representation, or claim with the intent of obtaining an insurance benefit to which you are not entitled.

California Penal Code § 550 addresses numerous forms of insurance-related fraud, including knowingly presenting false or fraudulent claims for payment of a loss or injury and knowingly making false statements in support of claims.

Depending on the conduct alleged, an investigation can also lead to charges involving conspiracy, theft, identity theft, forgery, money laundering, or other offenses. Some insurance fraud matters may be pursued federally through statutes such as mail fraud and racketeering laws.

How a Lawyer Can Help

An experienced insurance fraud defense lawyer will independently investigate what happened instead of accepting the government's version of events. Werksman Jackson Quinn & Mason LLP can identify inconsistencies in the prosecution's theory and determine whether investigators are interpreting ambiguous evidence as proof of fraudulent intent.

We understand how to carefully analyze claim applications, policies, correspondence, medical records, billing records, financial documents, photographs, surveillance footage, recorded statements, and electronic communications. When may also consult accountants, medical professionals, accident reconstruction specialists, insurance experts, or other specialists who can help explain complicated evidence.

Defending Against Insurance Fraud Charges

These cases may involve complicated records, communications, financial transactions, and questions about what the accused knew or intended at the time. A defense attorney can examine the government's evidence, identify weaknesses in its assertions, and determine whether investigators followed proper procedures.

The appropriate defense will depend on the specific charge, available evidence, and circumstances surrounding the alleged conduct. Effective defense strategies may include:

• Lack of fraudulent intent. A mistake, misunderstanding, or inaccurate estimate does not necessarily establish that someone deliberately intended to defraud an insurance company.
• The information was substantially accurate. Prosecutors may characterize a statement as fraudulent even though supporting records, witnesses, or other evidence provide a legitimate basis for it.
• Another person was responsible. Insurance claims frequently involve multiple people, including policyholders, employees, medical providers, repair facilities, billing companies, attorneys, and contractors. Responsibility for another person's false statement should not automatically be attributed to the accused.
• Insufficient evidence. Suspicion is not proof beyond a reasonable doubt. Prosecutors must establish the required elements of the charged offense.
• Unreliable witnesses. Co-defendants, employees, former business partners, or others may have motives to minimize their own responsibility or shift blame.
• Improperly obtained evidence. Depending on the circumstances, the defense may challenge searches, seizures, interrogations, or other investigative methods and seek suppression of unlawfully obtained evidence.

Don't Face Insurance Fraud Allegations Alone

Our criminal defense team is prepared to challenge the evidence, expose weaknesses in the prosecution's case, and protect your rights. Call (213) 688-0460 to learn more today.

Types of Insurance Fraud

The California Department of Insurance investigates several major categories of insurance fraud. These cases range from individual claims to complex alleged schemes involving multiple defendants and substantial financial losses.

Auto Insurance Fraud

Auto insurance fraud can involve false accident claims, exaggerated vehicle damage, inflated repair bills, fabricated theft claims, or misrepresentations concerning how a collision occurred. Repair facilities can also face accusations of billing for unauthorized work, billing for parts that were not used, or falsely describing existing vehicle damage as accident-related damage.

Staged Auto Accidents

Staged accident cases involve allegations that people intentionally caused or fabricated collisions to generate fraudulent property-damage or bodily-injury claims. Investigators may examine accident patterns, vehicle data, medical treatment, prior claims, witness relationships, surveillance footage, phone records, and communications among the people involved.

Vehicle Dumping

Vehicle dumping refers to intentionally abandoning, concealing, destroying, or disposing of a vehicle and then falsely reporting it stolen or damaged to obtain insurance proceeds. These cases can involve financial records, vehicle-location evidence, electronic communications, surveillance footage, and testimony from people allegedly involved in disposing of the vehicle.

Medical Insurance Fraud

Accusations of fraudulent claims involving healthcare benefits can become especially complicated when federal healthcare programs or interstate transactions are involved. These cases may involve physicians, healthcare businesses, billing companies, patients, pharmacies, and other participants.

Common allegations include billing for services never performed, upcoding services, submitting claims for medically unnecessary procedures, falsifying diagnoses, unbundling procedures, or misrepresenting non-covered treatments as covered services.

Life Insurance Fraud

Life insurance fraud investigations can involve false information on applications, forged documents, beneficiary-related schemes, fabricated deaths, or allegations that someone concealed material information to obtain policy benefits. California authorities also investigate serious life insurance cases involving allegations of homicide for financial gain.

Workers' Compensation Fraud

Workers' compensation fraud includes accusations of fabricating an injury, exaggerating disability, or concealing employment while collecting benefits. Medical or legal providers may be accused of billing for services that were never provided or misrepresenting treatment.

Employers can also face accusations involving underreported payroll, employee misclassification, claims-history manipulation, or other false information allegedly used to reduce workers' compensation premiums.

Property Insurance Fraud

Property insurance fraud may involve homeowners, commercial property owners, contractors, or others accused of submitting false or inflated claims following theft, fires, floods, vandalism, or other losses.

Investigators may review photographs, receipts, financial records, property inventories, repair estimates, and the policyholder's financial condition. A dispute over the value of destroyed property does not automatically prove fraud, which is why the details surrounding the claim matter.

Arson

When prosecutors believe someone intentionally caused a fire to collect insurance proceeds, the investigation can potentially involve both insurance fraud and arson allegations.

Investigators may examine the origin and cause of the fire, accelerants, changes made to insurance policies, communications, surveillance footage, and the insured party's actions before and after the incident. Because arson-related charges carry serious penalties, an independent defense investigation can be critical.

Case Results

Mark Werksman represented a 63-year-old payroll service provider accused of a $3 million workers’ compensation insurance fraud scheme involving her business clients. Prosecutors alleged that she failed to obtain workers’ compensation insurance for them. During the four-week trial, the prosecution presented 37 witnesses and relied on extensive financial records. Mark and the firm reviewed hundreds of thousands of pages of discovery and presented a focused rebuttal to the prosecution’s case. After three days of deliberations, the Los Angeles Superior Court jury deadlocked, resulting in a mistrial and preventing prosecutors from obtaining a conviction.

What Clients Are Saying About Us

Thank you for fighting for justice-Patrick B. (5-Star Google Review)

His excellency, Alan Jackson. Thank you for fighting for justice.

Phenomenal attorney!-Jenna Jepson (5-Star Google Review)

Alan Jackson is a phenomenal attorney! He is so quick on his feet, detail oriented, and will zealously represent his clients.

Speak With an Experienced Los Angeles Insurance Fraud Defense Lawyer

Werksman Jackson Quinn & Mason LLP brings decades of criminal defense experience, seasoned trial lawyers, and the resources of an entire defense team to serious white-collar cases. We know how to challenge allegations of fraudulent intent, analyze financial evidence, and prepare cases for the courtroom.

If you are under investigation or facing insurance fraud charges, call (213) 688-0460 to schedule a free consultation with our criminal defense team.

The sooner we understand what investigators are alleging, the sooner we can begin protecting your rights.

Frequently Asked Questions About Insurance Fraud in California

What should I do if I am being investigated for insurance fraud in Los Angeles?

Avoid making statements to investigators or insurance representatives about the allegations before speaking with an attorney. A Los Angeles insurance fraud lawyer can evaluate the investigation, communicate with authorities on your behalf, and help you avoid statements or decisions that could damage your defense.

What is insurance fraud in California?

Insurance fraud involves knowingly making a false or fraudulent claim, statement, or representation with the intent to obtain an insurance benefit improperly. California insurance fraud allegations can involve automobile, healthcare, workers' compensation, life, and property insurance claims.

What are the penalties for insurance fraud in California?

A felony conviction for insurance fraud can result in jail time, fines, restitution, probation, and other consequences, including the loss of a professional license.

What types of cases does an insurance fraud lawyer handle?

An insurance fraud lawyer may defend cases involving staged automobile accidents, fraudulent medical billing, false injury claims, vehicle dumping, workers' compensation fraud, life insurance schemes, property insurance fraud, and allegations involving intentionally damaged or destroyed property.

Can healthcare providers be prosecuted for insurance fraud?

Yes. Physicians, medical practices, billing companies, pharmacies, and other healthcare professionals can face allegations involving billing for services that were not performed, upcoding, medically unnecessary treatment, false diagnoses, or other fraudulent claims. Healthcare fraud investigations may involve federal authorities and additional criminal charges.

Meet Our Attorneys

Mark Werksman

Mark Werksman is a founding partner of Werksman Jackson Quinn & Mason. His career includes experience as both a state and federal prosecutor, providing him with a broad understanding of criminal investigations, charging decisions, negotiations, and trials. Mark represents individuals facing serious state and federal criminal allegations, with substantial experience in white-collar and complex criminal cases. His practice includes fraud, financial crimes, federal offenses, and other matters in which clients may face significant prison exposure and damage to their professional reputations.

Alan Jackson

Alan Jackson is a partner at Werksman Jackson Quinn & Mason LLP and an accomplished criminal defense attorney with extensive experience handling serious and complex criminal cases. Before entering private practice, Alan served as a prosecutor with the Los Angeles County District Attorney’s Office, where he rose to Assistant Head Deputy of the Major Crimes Division. He represents clients facing high-stakes allegations in state and federal courts. Alan is known for his courtroom preparation and trial skills, he develops defense strategies based on the individual facts and evidence of each case.

Kelly Quinn

Kelly Quinn is a partner at Werksman Jackson Quinn & Mason LLP whose practice focuses on protecting clients facing serious criminal allegations and complicated legal proceedings. She represents individuals in matters that can involve significant consequences for their freedom, careers, reputations, and families. Kelly’s work includes criminal defense as well as writ and appellate matters, giving her experience addressing legal issues at both the trial and post-trial stages. Her appellate background is particularly valuable in cases involving complicated questions of law, disputed court rulings, or potential errors in criminal proceedings.

Caleb Mason

Caleb Mason is a partner at Werksman Jackson Quinn & Mason LLP who represents clients in serious criminal cases and complex legal matters. His practice includes defending individuals facing state and federal investigations and prosecutions, including cases involving white-collar offenses and other allegations that can carry substantial personal and professional consequences. Caleb approaches criminal defense by closely examining the legal and factual foundations of the government’s case. This includes analyzing evidence, evaluating the prosecution’s legal theories, identifying weaknesses or inconsistencies, and developing strategies designed around the circumstances confronting each client.

Additional Information

• The Legal Implications of Insurance Fraud: How to Safeguard Your Future
• What Is a Fraudulent Insurance Claim?
• Intent Crimes: What Do They Mean For You?