Insurance Fraud

Insurance, although complicated, is incredibly important and crucial to have if you’ve suffered some type of loss. The contract may be intended for the home, your health, your work, liability purposes, or other reasons, but in the end all policyholders are expected to follow procedures when filing a claim. Additionally, it’s incredibly important policyholders are honest and provide accurate paperwork when filing a claim/applying for a policy. Any inaccurate information could be seen as forgery or fraudulent by law enforcement.

If you or someone you know has been charged with insurance fraud in Texas, it’s within your best interest to contact a defense attorney as soon as possible. Policyholders who have lied on their application or claim could be charged with upwards to a felony. That means you could be facing time in prison if you’re convicted of insurance fraud. Not only that, but you may be required to pay large court fines and restitution as part of your sentencing.

For these reasons and more, we highly encourage you to contact Brain Benken of The Benken Law Firm.

Houston Insurance Fraud Defense Lawyer | Harris County, Texas

Are you currently being investigated for insurance fraud by your provider or law enforcement? If so, it’s crucial you call The Benken Law Firm. Brian Benken of The Benken Law Firm has spent over three decades defending his clients from all types of financial crimes including insurance fraud of all types such as motor vehicle insurance fraud, health insurance fraud, among others. He can utilize his vast experience to build an effective and efficient defense plan for your case.

Call The Benken Law Firm today at (713) 223 - 4051 to set up your first consultation free of charge. The Benken Law Firm accepts clients throughout the greater Harris County and Houston as well as other communities including River Oaks, Memorial Area, Meyerland, and Sharpstown.

Information Center:

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Insurance Fraud Texas Penal Code

Any attempt to defraud or deceive an insurance company of any type is illegal in the state of Texas. The penalty for insurance fraud in the state of Texas depends on the value of the money/goods fraudulently obtained by the policyholder. According to the Texas Penal Code Section 31.05, the crime of insurance fraud is defined as:

  • Have intent to deceive or defraud an insurance provider by:
    • Giving a statement they know consists of false or misleading information
    • Arrange a statement knowing it contains false material information or is misleading to the insurance provider

Any of the above actions will result in a state jail felony upon conviction. However, the consequences for insurance fraud become much more serious if you intended to defraud or deceive your insurance provider by doing any of the following:

  • As an attempt to obtain compensation from a claim, you knowingly present or caused to be presented a statement to the insurance company with false or misleading material information on it
  • As an attempt to obtain compensation from a claim, prepare or cause to be prepared a statement knowingly it has fake or misleading material information
  • Pays, offers, solicits or receives a type of benefit in connection with a claim submitted under the insurance policy

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Is Insurance Fraud a Felony?

Insurance fraud can be a felony depending on the value of the claim filed or the benefits the policyholder was trying to obtain. If the value of the claim isn’t readily available for the court, then they will assign a fair market value to the claim instead.


Claim’s Fair Market Value

Crime Classification

Max Jail/Prison Sentence


Possible Fine

< $100 Class C Misdemeanor N/A $500
$100- $750 Class B Misdemeanor 180 days in jail $2,000
$750 — $2,500 Class A Misdemeanor One year in jail $4,000
$2,500 — $30,000 State Jail Felony 2 years in jail $10,000
$30,000 — $150,000 Third-Degree Felony 10 years in prison $10,000
$150,000 — $300,000 Second-Degree Felony 20 years in prison $10,000
 > $300,000 First-Degree Felony 99 years in prison $10,000

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Additional Resources

TDI Fraud Unit — Visit the official website for the Texas Department of Insurance to learn more about Insurance Fraud Unit. Access the site to learn more about their training, types of fraud, how to report fraud to the unit, the investigation process, and other resources.

Coalition Against Insurance Fraud – Visit the official website for the national Coalition Against Insurance Fraud, the U. S’s only alliance to unite all groups against insurance fraud. Access the site to read up on the elements of fraud, the Coalition’s actions to fight fraud, get alerts for recent fraud scams, and other important information.

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Insurance Fraud Houston Texas Attorney

If you or someone you know has been arrested for insurance fraud or any other crime, then it’s within your best interest to call Brian Benken. He has been practicing criminal defense since 1991 and will utilize all his resources and skills to develop a sturdy defense plan for your case. Call him today at (713) 223 - 4051 to set up your first consultation free of charge.

The Benken Law Firm has offices in Houston, but accepts clients throughout Harris County and every part of the state of Texas.

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(713) 223 - 4051
Benken Law