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Insurance Fraud in Texas

Houston Insurance Fraud Lawyer

The insurance fraud statute in Texas is broadly construed. In many of these cases, an overly aggressive prosecution can target a persons who make an honest mistake on an insurance claim instead of a person trying to defraud an insurance companies.

The insurance fraud statute in Texas was enacted to combat the serious problem of insurance fraud that costs the industry and consumers billions of dollars each year. The legislature determined that insurance fraud affects consumers as well as companies and drives up the cost of insurance policies for everyone. By enacting tough punishments for insurance fraud, the legislature intended to deter people from committing this form of fraud in order to help reduce the cost of insurance for consumers.

Insurance fraud cases are difficult to prosecute because there are often no witnesses. The crime is usually carried out through a person making false statements or reports. The insurance fraud statute makes it easier for the prosecutor to prove this offense because the statute focuses on statements that the person knew to be cause and were done with the intent to defraud or deceive an insurer.

Houston Insurance Fraud Lawyer

If you have been charged with insurance fraud in the greater Houston area, then contact an experienced criminal defense attorney for Harris County, Texas. Matt Horak has the experience to fight these white collar criminal cases aggressively. Call Horak Law locally at (713) 225-8000 or toll-free at (800) 225-8009 today to schedule a free consultation.


Issues in Insurance Fraud in Harris County


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Punishment for Insurance Fraud

Under Texas Penal Code Section 35.02(d), the punishment level for the criminal offense of insurance fraud is determined by the “value of the claim.” In most insurance fraud situations the value of the property fraudulently claimed to have been lost will approximate the amount claimed under the insurance policy. The statutory scheme provides:

When the value of the claim is:

  • Less than $50 then the punishment level for this offense is a Class C misdemeanor;  
  • $50 or more but less than $500 then the punishment level for this offense is a Class B misdemeanor;
  • $500 or more but less than $1,500 then the punishment level for this offense is a Class A misdemeanor;
  • $1,500 or more but less than $20,000 punishment level for this offense is a state jail felony;
  • $20,000 or more but less than $100,000 punishment level for this offense is a felony of the third degree;
  • $100,000 or more but less than $200,000 punishment level for this offense is a felony of the second degree; 
  • $200,000 or more then the punishment level for this offense is a first degree felony.

In Logan v. State, 89 S.W.3d 619 (Tex. Crim. App. 2002), the court decided that the “value of the claim” in Section 35.02(d) means just the fraudulent portion of the claim and not the entire amount of the claim.


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Types of Insurance Fraud Claims

Section 35.02(a) provides that:

(a) A person commits an offense if, with the intent to defraud or deceive an insurer, the person causes to be prepared or presents to an insurer in support of a claim for payment under a health or property and casualty insurance policy a statement that the person knows contains false or misleading information concerning a matter that is material to the claim, and the matter affects a person's right to a payment or the amount of payment to which a person is entitled.

Many insurance fraud cases involve allegations of arson, particularly arson to a house to collect under the homeowner’s insurance policy for the value of the structure and the person property destroyed in the fire. Other types of insurance fraud cases involve organized insurance fraud rings.

Different types of insurance fraud cases can also include false or misleading statements made to health insurance companies, property insurance companies and casualty insurance companies to collect money on a policy. 


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Finding an Attorney for a Fradulent Insurance Claim Case

If you were accused of making a fraudlent claim to an insurance company under a health, property or casualty policy, then contact an experienced Houston criminal defense attorney. With offices in Houston and The Woodlands, Texas, Matt Horak defends individuals against insurance fraud cases in Harris County and Montgomery County, Texas.


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Our Office in The Woodlands
1790 Hughes Landing Blvd #400 The Woodlands, TX 77380 (281) 907-4990
Our Office in Houston
5300 Memorial Dr #750 A Houston, TX 77007 (713) 225-8000
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Matt Horak Matt Horak is Board Certified in Criminal Law by the Texas Board of Legal Specialization since 2014