Nevada Insurance Fraud Laws (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:

• Nevada crime of car insurance fraud,
• Nevada crime of health insurance fraud,
• Nevada crime of unemployment fraud (NRS 612.445),
• Nevada crime of welfare fraud, or
• Nevada crime of workers’ comp fraud

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:

• 1 -- 4 years in Nevada State Prison,
• possibly up to $5,000 in fines,
• the AG’s costs of investigating and prosecuting the case, and
• victim restitution¹

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

• 1. Definition of fraudulent insurance claims
• 2. Investigations and prosecution
• 3. Common fraudulent claim crimes
  • 3.1. Automobile insurance fraud
  • 3.2. Medical insurance fraud
  • 3.3. Unemployment fraud
  • 3.4. Welfare fraud
  • 3.5. Workers’ compensation fraud

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

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 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:

• 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:

• 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

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 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