Unemployment Insurance Fraud is to knowingly present or cause to be presented any false or fraudulent claim for the payment of a loss or injury under a contract of insurance, including to make any written or oral statement intended to presented to any insurer in support or opposition to any claim or payment knowing that the statement contains any false or misleading information.
What does the prosecutor have to prove?
1. Defendant knowingly made or caused to be made a false or fraudulent claim for payment of a health care benefit. or
1. Defendant knowingly submitted a claim for a health care benefit that was not used by, or on b behalf of, the claimant. or
1. Defendant knowingly presented multiple claims for payment of the same health care benefit. or
1. Defendant knowingly presented for payment an undercharge for health care benefits on behalf of a specific claimant.
2. Defendant did so with the specific intent to defraud.
3. The value of the claim is four hundred dollars ($400) or more. [or]
3. The value of the fraud is fifty thousand dollars ($50,000 or more.) [or]
3. The value of the claim is four hundred dollars ($400) or less. [or]
3. The value of the claim is four hundred dollars ($400) or more in a 12 consecutive month period.
With probation 0-364 days
Misdemeanor: 0-364 days