• 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. V.B. – Vancouver Provincial Court

.Charges: Assault; Uttering Threats (domestic).
Issue: Given the rehabilitative steps we were able to guide our client through, whether it was in the public interest to proceed with the criminal prosecution.
Result: Mr. Gauthier was able to provide information to Crown counsel on our client's behalf which resulted in Crown deciding to enterr a stay of proceedings on both charges. Stay of proceedings. No criminal record.

R. vs. T.C.C. – Richmond Provincial Court

Charges: Assault of a Peace Officer.
Issue: Whether it was in the public interest for our client to be granted a discharge for his actions in spitting in the face of an RCMP officer at the Vancouver Airport.
Result: Mr. Gauthier presented information to the Court and after hearing his submissions, the Court granted our client a conditional discharge. No criminal record.

R. vs. F.S. – North Vancouver Provincial Court

Charge: Theft Under $5000.
Issue: Whether Crown could prove the number and value of the electronic devices they alleged our client stole from his workplace.
Result: Mr. Mines was able to persuade Crown counsel to allege that the theft involved  only 7 devices worth only $1000. After hearing Mr. Mines submissions, the Court granted our client a conditional discharge. No criminal conviction.

R. vs. M. G. – Sechelt RCMP investigation

Charges: Criminal harassment; Distributing intimate images without consent.
Issue: Whether the Crown could prove the circumstantial evidence they sought to rely on and whether jail was the  appropriate sentence.
Result: Mr. Gauthier was able to convince Crown counsel to not rely on much of the aggravating evidence and, on our client's guilty plea to not seek a jail sentence. After hearing Mr. Gauthier's submissions, the Court granted our client a suspended sentence with probation. No jail.

R. vs. E.K. – Vancouver Provincial Court

Charges: Criminal harassment; Distributing intimate images without consent.
Issue: Whether the Crown could prove the circumstantial evidence they sought to rely on and whether jail was the  appropriate sentence.
Result: Mr. Gauthier was able to convince Crown counsel to not rely on much of the aggravating evidence and, on our client's guilty plea to not seek a jail sentence. After hearing Mr. Gauthier's submissions, the Court granted our client a suspended sentence with probation. No jail.

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

Charge: Assault (domestic).
Issues: Whether there was a substantial likelihood of a conviction and whether it was in the public interest to proceed with the prosecution.
Result: Mr. Mines was able to provide information to Crown counsel that resulted in Crown electing to stay the proceedings and to end the prosecution. No criminal record.

R. vs. H.S. – Vancouver Provincial Court

Charge: Assault with a weapon.
Issue: Whether there was a substantial likelihood of a conviction.
Result: Mr. Mines was able to provide information to Crown counsel which resulted in Crown deciding to end the prosecution not approve any charges.  No criminal record.

R. vs. J.L. – UBC RCMP Investigation

Charges: Assault.
Issue: Whether there was a substantial likelihood of obtaining a criminal conviction and whether it was in the public interest for police to recommend charges.
Result: Mr. Gauthier was able to provide information to police whic resulted in police closing their investigation. No charges recommended. No criminal record.

R. vs. T.A. – West Shore RCMP investigation

Charge: Assault (Domestic).
Issue: Whether it was in the public interest for the Crown to proceed with a criminal prosecution.
Result: Mr. Gauthier provided information to Crown Counsel that convinced them not to approve charges against the client. No criminal prosecution. No criminal record.

R. vs. J.S. – Surrey Provincial Court

Charge: Sexual Assault (reduced to common assault.)
Issue: Whether Crown counsel could prove that our client touched the complainant for a sexual purpose.
Result: Mr. Mines was able tp persuade Crown counsel that our client did not intend to touch the complainant in a sexual manner. The Crown agreed to proceed on the lesser charge of common assault and, after hearing Mr. Mines' submissions, the Judge granted our client a conditional discharge. No criminal conviction. No jail. No sex offender registry.

R. vs. N.R. – Sechelt Provincial Court

Charge: Assault Causing Bodily Harm.
Issue: Whether it was in the pubic interest for our client to be sentenced to a conditional discharge for this offence which resulted in a serious facial cut to the complainant.

R. vs. S.K. – Surrey Provincial Court

Charges: Assault; Assault with a Weapon, Breach of a Release Order.
Issue: Whether our client could be released on bail given Crown's concerns for his willingness to attend court and potential to commit further offences.
Result: Mr. Johnston was able to persuade the Judge to release our client on the least onerous conditions.

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.