• Vancouver at night

Insurance Fraud

The Charge

People charged with insurance fraud are alleged to have attempted to obtain insurance funds or some other benefit that they are not entitled to under their policy. Police and Crown counsel treat insurance fraud seriously because fraudulent claims account for a significant portion of all claims received by insurers and cost billions of dollars to insurance providers. Types of insurance fraud are diverse and occur in all areas of insurance. They can vary in range of severity, from minor exaggeration of a claim to deliberately causing an accident or damage. Those charged with insurance fraud are generally prosecuted under s. 380 of the Criminal Code – Fraud over $5000.  If the fraudulent misrepresentation involves a claim for loss or damage of a motor vehicle, people may be charged uinder s. 42 of the Insurance (Vehicle) Act. British Columbia law subjects those convicted of defrauding I.C.B.C. to fines of up to $50,000 and jail for up to 2 years.

The Investigation

Whether under the Criminal Code or the Insurance (Vehicle) Act, a person being investigated for insurance fraud is typically suspected of making a false representation to the insurer. Often, the first contact a suspect will have is not with police, but rather, with an insurance adjuster or an investigator employed by the insurer. Significantly, because it is not the government dealing with the suspect through a police agent, an insurance fraud suspect has no right to be advised of their right to silence or their right to counsel before they are engaged in conversation by a civilian investigator.  For this reason, we strongly advise anyone being investigated of insurance fraud to contact us before going into any type of interview. We are generally able to assist people with their obligation to provide information to an insurer without providing information that may incriminate them.

When retained by clients who are being investigated for insurance fraud, our goal is to assist our client with their obligations to communicate with the insurer, and to decrease the chance of a charge being approved. In those cases, however, where police are recommending charges, our job is to work toward ensuring that our clients are not arrested in a public or embarrassing way. Rather, we will work with police and Crown and attempt to bring our client to answer to the charge in an out-of-custody, businesslike fashion.

Recent Successes

R. vs. A.O. - Vancouver Provincial Court

Charge: Possession of a loaded restricted handgun, without a permit.
Issue: Whether the Crown could prove that our client did anything more than briefly touch the gun while he a passenger in a vehicle.
Result: Mr. Mines was able to persuade the trial judge that our client's actions were minimal and that his youthful age and lack of record allowed him to be granted  a conditional discharge. No conviction. No jail.

R. vs. S.S. - Nelson Provincial Court

Charges: Possession for the Purpose of Trafficking (MDMA, Ketamine, Cocaine).
Issue: Given the nature of the search and seizure, the rehabilitative steps we were able to guide our client through, and given the recent changes to the mandatory minimum jail sentence for this offence, whether our client was eligible for a non-custodial sentence.
Result: Notwithstanding the large amount of drugs involved (approximately 2 kgs), Mr. Johnson was able to persuade the court to impose a conditional sentence of two years, less one day. No jail.

R. vs. D.M. - Vancouver Provincial Court

Charges: Assault.
Issue: Given the provocation that preceded the incident, what  the appropriate sentence would be.
Result: Mr. Gauthier was able to persuade the court to sentence our client to a period of probation of 12 months. No jail.

R. vs. B.K. - New Westminster Provincial Court

Charge: Indecent Act.
Issue: Given the rehabilitative steps we were able to guide our client through, whether it was in the public interest to proceed with the prosecution.
Result: Mr. Mines was able to persuade Crown counsel to enter a stay of proceedings upon our client completing an extensive course of counselling. No criminal record.

R. vs. K.L. - Vancouver Provincial Court

Charges: Theft Over $5000 (from employer).
Issue: Given the rehabilitative steps we were able to guide our client through, whether she would be sentenced to jail.
Result: After steering our client through counselling and arranging her repayment of the misappropriated funds, Mr. Mines was able to persuade Crown counsel to not seek a. jail sentence. After hearing Mr. Mines' submissions on our client's behalf, the court granted a suspended sentence and placed our client on probation for 18 months. No jail.

R. vs. A.A. - North Vancouver Provincial Court

Charges: Sexual Assault; Uttering threats; assault, Breach of Release Order.
Issue: Whether there was a substantial likelihood of conviction.
Result: Mr. Mines was able to persuade Crown counsel that there was no realistic chance of conviction on the sex assault charge and Crown proceeded only on the assault charge to which our client pleaded guilty. After hearing Mr. Mines' submissions, the court granted our client a conditional discharge and Crown entered stays of proceeding on the remaining 3 counts. No jail, no criminal conviction.

R. vs. A.S. - Vancouver Provincial Court

Charge: Driving while prohibited.
Issue: Whether it was in the public interest to proceed with this charge which carries a mandatory one year driving prohibition upon conviction.
Result: Mr. Mines was able to provide Crown counsel with information that concluded our client was not at all responsible for the motor vehicle accident and persuaded Crown to proceed on the lesser offence of driving without aa valid license. Our client was sentenced to a fine and a 3 month driving prohibition.

R. vs. L.M. - Vancouver Provincial Court

Charges: Mischief Over $5000; Assault Police Officer.
Issue: Whether the sentence ought to emphasize punishment or rehabilitation in this matter where our client was alleged to have caused over $100,000 in damage to his building.
Result: Mr. Gauthier was able to provide Crown counsel with materials confirming the rehabilitative steps our client had taken for his mental health. The cRown stayed the assault police officer charge and, after hearing Mr. Gauthier's submissions, the Court granted our client a conditional discharge and placed him on probation. No jail.

R. vs. D.R. - Vancouver Provincial Court

Charge: Assault (domestic).
Issue: Whether it was in the public interest to proceed with the prosecution.
Result: Mr. Mines was able to persuade Crown counsel to enter a stay of proceedings on the assault charge. Our client entered into a 12 month Peace Bond. No criminal record.

R. vs. B.Z. - Port Coquitlam Provincial Court

Charge: Assault (domestic).
Issue: Given the rehabilitative steps we were able to direct our client through, whether it was in the public interest to proceed with this prosecution.
Result: Mr. Johnson was able to provide Crown counsel with information that allowed him to persuade Crown to enter a stay of proceedings. No criminal record.

R. vs. M.C. - Vancouver Provincial Court

Charges: Driving While Prohibited.
Issue: Whether it was in the public interest for Crown to proceed with the prosecution of this offence which carries a 12 month mandatory minimum driving prohibition.
Result: Mr. Johnson was able to persuade Crown counsel to proceed on the lesser offence of driving without a valid licence. Our client received a $500 fine and a 30 day driving prohibition.

R. vs. M.L. - Surrey Provincial Court

Charges: Sexual Interference.
Issue: Whether the Crown could prove that our client sexually interfered with his niece.
Result: After a 6 day trial, Mr. Johnson was able to persuade the trial judge that there was reasonable doubt as to the complainant's credibility and reliability. Not guilty. No jail. No criminal record.

The Defence

Crown counsel has the obligation to prove insurance fraud beyond a reasonable doubt. What this means, essentially, is that Crown must prove that the accused, with the intention to defraud, provided false information to the insurer. Generally, a defence to insurance fraud is that the accused did not intend to provide a false statement, but rather, the information was provided in good faith. The common denominator of any insurance fraud claim is, therefore, the intent to defraud. In evaluating whether a person had the intent to defraud, it is important to analyze their experience and background. Is this a motorist’s first claim? Did they completely misrepresent a fact or merely exaggerate the fact? Did the person know that what they misrepresented was wrong?

We’re always happy to hear from clients during the investigation stage of their case. This is because we are often able to offer these clients the best potential outcome – the chance of no charges being approved at all. In our many years of defending fraud charges, we’ve learned that many complainants are more interested in being compensated for their loss than they are in pursuing a criminal conviction. Our goal, therefore, is to attempt to negotiate a civil settlement of a suspected fraudulent insurance claim. A civil settlement will often result in the complainant not wanting the criminal charges to proceed but, even when charges do proceed, restitution will be seen as a mitigating factor by the court.

In cases where Crown does proceed with insurance fraud prosecutions, our job is to prepare for trial so as to challenge any evidence that is not properly brought before the court. This may include challenging search warrants or production orders. It may also include exclusion arguments based on the Canada Evidence Act which sets out the rules that Crown counsel must comply with in order to tender business records, banking records and electronic documents into the trial process. Ultimately, our goal is to work toward keeping our clients out of custody and/or preventing them from being convicted of insurance fraud.

Start with a free consultation.

If you are being investigated by police or if you’ve been charged with a criminal or driving offence, don’t face the problem alone. Being accused of an offence is stressful. The prospects of a criminal record or jail sentence can be daunting. Even if you think there is no defence, we may be able to help. To schedule a free initial consultation with one of our Vancouver lawyers, contact us now.