Insurance Fraud Criminal Defense Lawyers in Las Vegas and Reno, Nevada (NRS 686A.2815)


Under NRS 686A.2815, Nevada law defines insurance fraud as lying to insurance companies (or government agencies) in order to obtain benefits for which one is not legally eligible. The Nevada Attorney General's (AG) Office prosecutes these types of claims, many of which involve the:

The most common defense to fraudulent claim charges is that the defendant lacked intent to defraud. This offense is typically a category D felony in Nevada, carrying:

In this article, our Las Vegas Nevada criminal defense attorneys discuss:

Also see our article on the Nevada crime of credit card fraud.

Insurance fraud ss
Making a fraudulent claim is a category D felony in Nevada.

1. Definition of insurance fraud in Nevada

Nevada insurance fraud is generally prosecuted in three situations:

  1. A person makes materially false representations on an insurance application;
  2. A person makes false claims to obtain benefits he/she is not entitled to; or
  3. A person lies in order to deny benefits to someone who might otherwise be entitled to them.

Insurance fraud is an "intent crime."2 Therefore, people who make innocent mistakes on their applications or unknowingly give false information are not guilty of fraud.

2. Prosecutors of fraudulent insurance claims in Nevada

Fraudulent claims are investigated and prosecuted by the Nevada Attorney General's Insurance Fraud Unit (IFU).

Insurance fraud binder ss
The Nevada AG investigates fraudulent claims to insurers.

Insurance companies which believe they have been defrauded notify the IFU through the mail or the IFU's online complaint form. The National Insurance Crime Bureau also refers criminal matters to the IFU.

Note that Nevada's Insurance Commissioner's office handles any civil disputes insurance companies have with their policyholders.

3. Nevada insurance fraud crimes

3.1. Automobile insurance

Nevada car insurance fraud occurs when someone falsely claims that their car has been stolen or damaged in order to get money. Defrauding a vehicle insurer is a category D felony, carrying: 

  • one to four (1 - 4) years in prison,
  • possibly up to $5,000 in fines,
  • the prosecutor's costs of investigating and prosecuting the case, and
  • restitution

3.2. Medical insurance

Health care fraud in Nevada typically occurs when doctors or medical staff:

Healthcare insurance fraud ss
Doctors defraud insurers when they bill for procedures they never performed.
  • falsify patient records,
  • fraudulently overbill an insurer, or
  • bill for services they never performed.

This felony crime is also known as medical billing-, HMO-, or Medicare fraud.

As a Nevada state crime, medical fraud is a category D felony, carrying: 

  • one to four (1 - 4) years in prison,
  • possibly up to $5,000 in fines,
  • the prosecutor's costs of investigating and prosecuting the case, and
  • restitution

As a federal crime, federal health care fraud carries potential penalties of up to 10 years in Federal Prison and/or a fine of up to $250,000.3

3.3. Unemployment insurance

A person commits unemployment insurance (UI) fraud in Nevada when he/she lies for the purpose of wrongfully obtaining UI benefits. A common scenario is a person claiming he/she is unemployed while secretly working an under-the-table job.

Nevada UI fraud is a category D felony, carrying: 

  • one to four (1 - 4) years in prison,
  • possibly up to $5,000 in fines,
  • the prosecutor's costs of investigating and prosecuting the case, and
  • restitution

3.4. Welfare

Welfare fraud in Nevada encompasses dozens of possible state and federal offenses. Usually, this crime is committed when someone fraudulently receives or facilitates a wrongful payment of welfare benefits.

Defrauding a welfare insurer is typically a category D felony. Penalties can include:

Insurance fraud red ss
Welfare fraud typically involves fraudulently receiving or facilitating a wrongful payment of welfare benefits.
  • denial of future benefits,
  • one to four (1 - 4) years in prison,
  • possibly up to $5,000 in fines,
  • the prosecutor's costs of investigating and prosecuting the case, and
  • restitution

3.5. Worker's Compensation

A person commits workers' compensation fraud in Nevada when he/she intentionally lies in order to wrongfully obtain benefits or to deny benefits to someone else.

Defrauding a worker's compensation insurer is a category D felony regardless of whether it was committed by the applicant or the employer. Penalties for defrauding a workers' compensation insurer can include:

  • denial of future benefits,
  • one to four (1 - 4) years in prison
  • possibly up to $5,000 in fines,
  • the prosecutor's costs of investigating and prosecuting the case, and
  • restitution
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Charged with making a fraudulent insurance claim in Nevada? Call us for help…

Have you been arrested for making a fraudulent insurance claim in Clark County, Washoe County, or elsewhere in Nevada? Our Nevada criminal defense lawyers fully investigate every aspect of the alleged incident to find the weaknesses in the prosecutor's case.

Then we use those weaknesses to try to get the charges against you reduced or dismissed. And if necessary, we will take the matter to trial in pursuit of a "not guilty" verdict.

To schedule a free consultation, call us at 702-DEFENSE (702-333-3673) or fill out the form on this page.

Arrested in California? See our page on California insurance crimes.

Arrested in Colorado? See our page on Colorado insurance crimes.


Legal References

  1. NRS 686A.291 Criminal penalty for insurance fraud. A person who commits insurance fraud is guilty of a category D felony and shall be punished as provided in NRS 193.130.
  2. NRS 686A.2815 “Insurance fraud” defined.

          1. “Insurance fraud” means knowingly and willfully:

          (a) Presenting or causing to be presented any statement to an insurer, a reinsurer, a producer, a broker or any agent thereof, if the person who presents or causes the presentation of the statement knows that the statement conceals or omits facts, or contains false or misleading information concerning any fact material to an application for the issuance of a policy of insurance.

          (b) Presenting or causing to be presented any statement as a part of, or in support of, a claim for payment or other benefits under a policy of insurance, if the person who presents or causes the presentation of the statement knows that the statement conceals or omits facts, or contains false or misleading information concerning any fact material to that claim.

          (c) Assisting, abetting, soliciting or conspiring with another person to present or cause to be presented any statement to an insurer, a reinsurer, a producer, a broker or any agent thereof, if the person who assists, abets, solicits or conspires knows that the statement conceals or omits facts, or contains false or misleading information concerning any fact material to an application for the issuance of a policy of insurance or a claim for payment or other benefits under such a policy.

          (d) Acting or failing to act with the intent of defrauding or deceiving an insurer, a reinsurer, a producer, a broker or any agent thereof, to obtain a policy of insurance or any proceeds or other benefits under such a policy.

          (e) As a practitioner, an insurer or any agent thereof, acting to assist, conspire with or urge another person to commit any act or omission specified in this section through deceit, misrepresentation or other fraudulent means.

          (f) Accepting any proceeds or other benefits under a policy of insurance, if the person who accepts the proceeds or other benefits knows that the proceeds or other benefits are derived from any act or omission specified in this section.

          (g) Employing a person to procure clients, patients or other persons who obtain services or benefits under a policy of insurance for the purpose of engaging in any act or omission specified in this section, except that such insurance fraud does not include contact or communication by an insurer or an agent or representative of the insurer with a client, patient or other person if the contact or communication is made for a lawful purpose, including, without limitation, communication by an insurer with a holder of a policy of insurance issued by the insurer or with a claimant concerning the settlement of any claims against the policy.

          (h) Participating in, aiding, abetting, conspiring to commit, soliciting another person to commit, or permitting an employee or agent to commit any act or omission specified in this section.

          2. As used in this section, “policy of insurance” means:

          (a) Any policy issued in this State by an authorized insurer; and

          (b) Any policy issued outside this State by an authorized insurer which relates to property that:

                 (1) Is located in this State when any act or omission specified in this section occurs; or

                 (2) Was located in this State when the incident that gave rise to the act or omission specified in this section occurred.
  3. 18 U.S.C. § 1035.

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