Los Angeles Insurance Fraud Defense Attorney

David M. Dudley has dedicated his practice to defending the rights of individuals accused of serious crimes, including insurance fraud. No matter what the optimal result is in any given case, he provides his clients with the maximum probability of obtaining it. He has successfully defended hundreds of fraud cases and fights aggressively and intelligently to obtain dismissals, acquittals, reversals and other requested relief for clients across the country.

What is Health Care Fraud and Abuse?

The FBI, the major agency for exposing health care fraud, takes its role in uncovering, prosecuting and preventing such fraud very seriously. The agency estimates that health care fraud is a $60 billion expense every year to the country. It targets these crimes at every level — national, state and local — working with analysts and investigators to stamp out fraud.

Those charged with health care fraud are up against a well-organized division of the government, trying to prove their guilt. A few years ago, the government created HEAT, the Health Care Fraud Prevention & Enforcement Action Team. Because of the HEAT initiative, the Departments of Justice and Health and Human Services expanded their Medicare Fraud Strike Forces.

If you’ve been charged with health care fraud, whether it is for Medicare payments or your own health care insurance company, you need an experienced and aggressive attorney on your side. Health care fraud also includes charges of embezzlement, surgery center fraud, billing fraud, and disability fraud.

Mr. Dudley, an insurance fraud defense lawyer has helped many clients charged with health insurance fraud obtain reduced or nullified judgments. Sometimes, Mr. Dudley has been able to reduce the amount owed by defendants by millions of dollars.

What Are Other Types of Insurance Fraud?

Mr. Dudley’s practice is not limited to insurance fraud. As an experienced insurance fraud defense attorney in white-collar crimes, he is equipped with the knowledge, skill, and resources to handle any type of criminal case involving fraud. Some of the other areas of insurance fraud that Mr. Dudley can assist you with include (but are not limited to):

• Automobile collision fraud such as swoop and squat, sudden stop and backing
• Automobile fraud, including fraudulent liability claims to auto insurance companies, fake damages, theft, vandalism, embezzlement, and arson
• Medical fraud, including filing false claims, inflating bills, falsifying billing, overcharging a government health insurance agency and embezzlement
• Life insurance fraud, including questionable death or suspicious or false policy application
• Workers’ compensation insurance fraud, including claimant fraud by employee or employer
• Legal provider fraud
• Under-reported wages
• Fire insurance fraud (commercial or residential), including arson for hire or exaggerated fire loss
• Property insurance fraud (residential or commercial)

What are Common Defenses for Insurance Fraud?

If you have been charged with insurance fraud, it will be helpful to understand the basics of the most common and strong defenses you can use.

Lack of Fraudulent Intent

To prove fraud of any kind, including insurance fraud, the prosecutors must be able to demonstrate the intention to be fraudulent. You cannot be convicted of insurance fraud if you did not have the genuine desire to commit the fraud. Your Los Angeles insurance fraud defense lawyer may make the case that you made a mistake or were not in a position where being fraudulent would be a sensible choice for you.

Similarly, you cannot be convicted of insurance fraud if you have the intention to be fraudulent but do not act on it. Both the action and the intention are required to be present to demonstrably prove you committed fraud. Your insurance fraud defense attorney can help you demonstrate that the requirements to be convicted are not present.

Mistake of Fact

While many aspects of insurance can be automated, there are portions that are still subject to human manipulation and management. This means that people are still involved in the process and have the capability to make mistakes. If someone involved with your insurance company misrepresents what you are required to do, you may argue a mistake of fact on their part.

You can also make the argument that another party made a mistake. For example, law enforcement officers might have made a mistake in identifying the allegedly guilty party while investigating, incorrectly pinning the blame on you instead of another individual.

Failure to Meet the Burden of Proof

If the prosecution is not able to demonstrate beyond a reasonable doubt that you committed the crime, they have failed to meet the burden of proof. The American legal system is intrinsically based upon the concept of “innocent until proven guilty,” and if there are any doubts you should be acquitted by the jury.

However, we recommend that you work with a qualified and experienced insurance fraud defense lawyer to demonstrate that any of these defenses are valid. Your insurance fraud defense attorney will be able to effectively, confidently, and quickly portray the case in a more positive light on your behalf, avoiding several mistakes you might make if you acted alone.

Contact an Los Angeles Insurance Fraud Defense Lawyer

Mr. Dudley has handled dozens of cases of insurance fraud, getting his client’s sentences reduced or nullified. He charges a flat rate, much less than larger firms, and provides more successful results. To schedule a consultation with a Los Angeles insurance fraud defense attorney, please contact our office today.

Case Results: Insurance Fraud

• U.S. v. C.V.: The defendant was the office manager for several health clinics which allegedly defrauded the government and several health insurance companies of over $42,000,000 dollars. The United States Attorney named her as a principal conspirator in a multi-count indictment. After litigating numerous pre-trial motions, the defense eventually negotiated a disposition for approximately 22 months of TIME SERVED.
• P. v. M.R.: As the manager of a law office which had purportedly presented millions of dollars in fraudulent liability claims to auto insurance companies, the defendant was charged with felony insurance fraud. Although others in the conspiracy eventually pleaded guilty to offenses which sent them to state prison, the defendant obtained a sentence of PROBATION with no period of incarceration.
• P. v. J.L.: The defendant was allegedly a major “capper” in an automobile insurance fraud ring. Although he was facing numerous felony fraud charges carrying potential state prison sentences, the defendant received a PROBATIONARY sentence without incarceration.
• U.S. v. N.S.: A medical doctor was indicted federally for overcharging a government health insurance agency by more than $100,000 for services he had provided to several patients. Although the defendant was convicted at trial, he received a sentence of only 24 months for his misconduct.
• P. v. J.S.: Accused of organizing an extensive automobile insurance fraud network, the defendant was facing numerous felony fraud charges. Although the defendant was purportedly responsible for almost $1,000,000 in losses to various insurance companies, the defense worked out a deal which resulted in the defendant serving only one year of actual prison time.
• U.S. v. R.D.: An attorney was indicted for mail and wire fraud in federal court after filing an insurance claim for his yacht which he claimed had been destroyed by pirates in the Mediterranean Sea. Convicted at trial, the defendant hired Mr. Dudley for sentencing. At the sentencing hearing, Attorney Dudley persuaded the court to impose a prison term significantly less than that which both the government and the PSR had recommended. In the process, however, the court rejected the defense contention that a two-point upward guideline adjustment did not apply. The court of appeals later agreed with that argument and REVERSED the defendant’s sentence. A subsequent resentencing resulted in the defendant’s prison term being reduced.