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WHAT IS INSURANCE FRAUD IN NEVADA?
Insurance Fraud under NRS 686A.291 occurs when a person knowingly and willfully presents a false or fraudulent insurance claim, makes material misrepresentations in an insurance application, or assists another person in committing insurance fraud. Common forms include staging accidents, exaggerating injuries, filing claims for property damage that did not occur, and misrepresenting facts on insurance applications. Nevada's Insurance Fraud Unit actively investigates these cases.
WHAT THE PROSECUTION MUST PROVE
To convict you of Insurance Fraud in Nevada, the prosecution must prove each of the following elements beyond a reasonable doubt:
The defendant made a false or fraudulent statement or claim
The statement was material to the insurance claim or application
The defendant acted knowingly and with intent to defraud
The insurance company was damaged or at risk of being damaged
If the prosecution cannot prove any single element beyond a reasonable doubt, you cannot be convicted.
PENALTIES FOR INSURANCE FRAUD IN NEVADA
Value Under $650 (Gross Misdemeanor)
Up to 364 days in jail and fines up to $2,000
Value $650 to $3,500 (Category D Felony)
1 to 4 years in prison and fines up to $5,000
Value Over $3,500 (Category C Felony)
1 to 5 years in prison and fines up to $10,000
Additional Consequences
Restitution to insurance company, loss of insurance license if applicable
THOMAS'S DEFENSE TIPS
Insights from Thomas Boley — Las Vegas criminal defense attorney with 18+ years defending insurance fraud charges
Many insurance fraud cases arise from exaggerated personal injury claims after accidents. The line between legitimate advocacy for fair compensation and fraud can be complex. I carefully analyze whether the alleged misrepresentations were knowing and intentional versus honest mistakes.
Insurance companies have Special Investigations Units (SIUs) that conduct extensive surveillance and investigation before referring cases for prosecution. I obtain all SIU investigation records to understand the full scope of the evidence.
Medical provider fraud — billing for services not rendered or upcoding — is increasingly prosecuted. If a healthcare provider is involved, the investigation often extends to them as well.
Restitution is almost always required. In appropriate cases, negotiating a civil resolution with the insurance company can prevent criminal prosecution.
The above represents general observations from years of criminal defense practice in Nevada. Every case is different — contact Thomas for advice specific to your situation.
COMMON DEFENSES TO INSURANCE FRAUD
Every case is unique, but these are the defenses most commonly raised in insurance fraud cases in Nevada:
The claim was not false — the losses were genuine
Lack of intent to defraud — honest mistake or misunderstanding
The misrepresentation was not material to the claim
The defendant relied on advice of counsel or an agent
The insurance company was not actually damaged