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What is Insurance Fraud?

Insurance fraud is an act committed with the intent to deliberately obtain a payment from the insurance company to which you are not legally entitled. It is often committed by applicants, policy holders and claimants. This crime can be tried in either state or federal court depending on the circumstances of the case. If you are convicted of insurance fraud in Texas, in addition to a large fine, you may face prison time, depending on the specific circumstances and the severity of the charges.

This crime is one of the most commonly charged white collar crimes in Texas. Insurance fraud can be linked to various things, such as:

  • Auto insurance
  • Worker’s compensation claims
  • Medical insurance
  • Homeowner insurance
  • Life insurance policies

Because there are many innocent parties that can be affected by insurance fraud, the state of Texas does not take these offenses lightly. Since investigating a fraud claim and taking it to court can be a costly process, insurance companies often end up passing the expenses to their customers.

Insurance Fraud Sentencing Guidelines in Texas

Depending on the significance of the crime, insurance fraud can result in a Class C misdemeanor to a first degree felony charge in Texas. Sentencing varies significantly depending on the type of insurance fraud, as well as the circumstances of the case. The following are the consequences for insurance fraud offenses in Texas as they are listed in Chapter 35 of the Texas Penal Code.

  • a Class C misdemeanor if the value of the claim is less than $100
  • a Class B misdemeanor if the value of the claim is $100 or more but less than $750
  • a Class A misdemeanor if the value of the claim is $750 or more but less than $2,500
  • a state jail felony if the value of the claim is $2,500 or more but less than $30,000
  • a felony of the third degree if the value of the claim is $30,000 or more but less than $150,000
  • a felony of the second degree if the value of the claim is $150,000 or more but less than $300,000
  • a felony of the first degree if:
  1. The value of the claim is $300,000 or more; or
  2. An act committed in connection with the commission of the offense places a person at risk of death or serious bodily injury.
  3. An offense under Subsection (a-1) is a state jail felony.
  4. The court shall order a defendant convicted of an offense under this section to pay restitution, including court costs and attorney’s fees, to an affected insurer.
  5. If conduct that constitutes an offense under this section also constitutes an offense under any other law, the actor may be prosecuted under this section, the other law, or both.
  6. For purposes of this section, if the actor proves by a preponderance of the evidence that a portion of the claim for payment under an insurance policy resulted from a valid loss, injury, expense, or service covered by the policy, the value of the claim is equal to the difference between the total claim amount and the amount of the valid portion of the claim.
  7. If it is shown on the trial of an offense under this section that the actor submitted a bill for goods or services in support of a claim for payment under an insurance policy to the insurer issuing the policy, a rebuttable presumption exists that the actor caused the claim for payment to be prepared or presented.

Finding an Attorney You Can Trust

In many cases, committing insurance fraud will hinder your eligibility to apply for certain jobs, ability to chase educational opportunities and can result in the revocation of a professional license. If you are facing insurance fraud charges, contact me immediately to start building your defense. I will aggressively fight for your case and work to get you the best possible outcome.

  • "Mr Shaeffer was up front from the beginning, and I respected that. He told me they have a solid case against me. He is a very out of the box thinker, and very organized. He told me the sad reality of" - Nicoli

  • "I found Mr. Shaeffer to be very responsive, effective, and strategic. There was never any doubt in my mind that he had my best interest at the forefront of his efforts in handling my case." - Ron

  • "When you have been wrongfully accused of having an affair with a student, you must acquire legal counsel before you even speak to the police, even if you are the person who reports the rumors. Tylden Schaeffer advised me to not have a second interview with the police department and found time in his schedule to meet with me that day. After the meeting, I had a path to move forward on and that included a well written statement that Mr. Schaeffer crafted. After submitting this in lieu of a second interview with the police, there were no more problems with the school district or police department. Mr. Schaeffer did a superb job and had me resting more easily following our meetings. I would highly recommend Mr. Schaeffer to anyone in need of a Criminal Defense Attorney." - Anonymous

  • "Tylden has been nothing but excellent while representing me. He’s been very upfront, honest, and cooperative with not only myself, but with my family as well. I don’t just feel like a number, he treats you like if you’re his only client. I’d definitely recommend him to anybody I know if they are in need of legal help. 5 out of 5 stars. I highly recommend Tylden Shaeffer!" - Joel

  • "Mr Shaeffer was up front from the beginning, and I respected that. He told me they have a solid case against me. He is a very out of the box thinker, and very organized. He told me the sad reality of what could potentially be the outcome of my case, and it was dim. However he asked me what i wanted and was creative enough to deliver at an extremely affordable price. He has the knowledge to defend you, and the experience to win. I’m very happy with how he handled my case. His office is also only blocks away from the court house and he is always prompt. I don’t usually write reviews, but Mr. Tylden Shaeffer deserves to be recognized." - Nicoli

  • "When I got charged with my DWI I already expected to go through a long, painful process from the beginning. But, Mr. Shaeffer and his staff made my whole experience quick and easy with their great communication and professionalism. He was always straight forward and I could tell he had my best interest in mind. He made sure I didn’t get charged with “extreme intoxication”, while also reducing my fines and the length of my probation. I highly recommend him to anyone!" - Alex

  • "Mr. Shaeffer is a great attorney , very professional, very nice and is willing to work with you and help u threw any situation u may have or need help with . I recommend Mr. Shaeffer to anyone who needs help with any kind of legal issues or problems. Anyone who has asked me about an attorney i most definitely tell them Mr. Shaeffer and give them his info. Thank you for all your help and everything u have done for me and my family. You are a awesome attorney! Highly Recommend" - Anonymous

  • "Tylden is a fantastic attorney. He thoroughly prepared for my case and did an amazing job of relating to the judge and jury. I highly recommend Tylden. Would recommend to anyone!" - Skyler

  • "Tylden got my felony reduced to a misdemeanor. He saved my life. I didn’t have to pester him for information and updates about my case and his staff is well informed and helpful. He personally attended each and every one of my hearings and was just as concerned about restoring my reputation as I was. He recently got a motion for non-disclosure filed and approved by the judge so I will never have to admit this mistake ever happened. I would recommend Tylden to anyone! He is a highly intelligent and competent attorney. The Best!" - Anonymous

  • "I was represented by Mr. Shaeffer years ago (2004). He would travel from San Antonio all the way to Del Rio to represent me. My father and I were accused of wrong doing by federal agents and we had done nothing. We, my father and I were on trial simultaneously. We had hired an attorney and found out later he was friends with the prosecutor and wanted us to accept a plea bargain. “We did nothing wrong”, I cried to him. He insisted that we accept due to it being impossible to beat the Government. My father and I were close to giving up when we met Mr. Shaeffer. Mr. Shaeffer believed in us and fought for us. Because of him, I never saw prison walls nor was I ever away from my family. It was one of the most difficult times in my life, but thankfully we met a Godsend attorney and justice prevailed." - Anonymous

Case Results
Intoxication Manslaughter – Reduced Sentence

While client was already on probation for DWI when arrested for Intoxication Manslaughter. Client pleaded guilty to the jury and jury awarded probation where State sought prison term from the jury.

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