Insurance fraud involves any intentional act of deception aimed at receiving unauthorized benefits from an insurance policy. This can happen at various stages of the insurance process, from application to claims and renewals. A violation of Arizona’s insurance fraud laws is typically charged as a Class 6 felony, but the penalties can escalate depending on the amount involved and whether the fraud was part of a broader scheme.
Yes. Under A.R.S. § 20-466.01, insurance fraud is charged as a Class 6 felony in Arizona – the least serious felony class, but a felony nonetheless. A conviction carries up to 2 years in prison, fines up to $150,000, and a civil penalty of $5,000 per violation. If the fraud involves a broader scheme or exceeds certain dollar thresholds, prosecutors may upgrade charges to a Class 2 felony under A.R.S. § 13-2310, which carries up to 12.5 years in prison.
Insurance fraud comes in many forms, including:
Understanding the types of insurance fraud can help you see what prosecutors are likely to focus on. If you’ve been contacted by an investigator or insurance company, do not speak with them without legal representation.
Car insurance fraud is one of the most common insurance fraud charges in Maricopa County. Common examples include staging a vehicle collision, filing a theft claim for a car that was not stolen, exaggerating repair costs after a real accident, or insuring a vehicle under a false address to reduce premiums. Car insurance fraud is prosecuted under A.R.S. § 20-466.01 and is typically charged as a Class 6 felony. When the fraud involves multiple claims or a coordinated scheme, the charge may escalate to fraudulent schemes under A.R.S. § 13-2310. If you have been contacted by an insurance company investigator or law enforcement regarding a vehicle claim, speak with a Phoenix car insurance fraud attorney before providing any statement.
Unemployment insurance fraud in Arizona involves making false statements to the Arizona Department of Economic Security (DES) to obtain benefits you are not entitled to receive. This includes working while collecting benefits, misrepresenting your reason for job separation, or collecting benefits using a false identity. Charges are brought under A.R.S. § 23-791 and can result in felony charges, repayment of all benefits collected, and additional civil penalties. DES has a dedicated Office of Special Investigations that coordinates with the Arizona AG’s office. If you have received a DES overpayment notice or fraud referral letter, consulting a Phoenix unemployment insurance fraud attorney immediately is essential.
Knowingly lying on an insurance application – such as misrepresenting your driving record, health history, or the value of property – is a criminal offense in Arizona, not simply a civil matter that results in policy cancellation. A material misrepresentation made intentionally at the time of application or renewal may be charged under A.R.S. § 20-466.01. The key element prosecutors must prove is that the misrepresentation was knowing and intentional, not a good-faith error. Our defense attorneys examine whether the alleged misstatement was truly material and whether the prosecution can establish the intent element required for a criminal conviction.
Prosecutors in Arizona often charge insurance fraud under two separate statutes, depending on the scale of the alleged conduct. A single false claim is typically charged under A.R.S. § 20-466.01 as a Class 6 felony. However, when the prosecution believes the fraud was part of a pattern or scheme – multiple claims, multiple victims, or a coordinated effort – they will add or substitute a charge of fraudulent schemes under A.R.S. § 13-2310, a Class 2 felony carrying up to 12.5 years in prison.
This distinction is critical for your defense. A Class 6 felony and a Class 2 felony are not the same fight. Our Phoenix fraudulent schemes defense attorneys analyze how the charges are framed and challenge whether the prosecution can establish the “scheme or artifice” element required under § 13-2310. If you have been charged with both insurance fraud and fraudulent schemes – or if investigators are building a case that involves multiple transactions – contact us immediately.
Most insurance fraud cases begin not with an arrest but with an investigation — often one you are not immediately aware of. Insurance companies maintain Special Investigations Units (SIUs) that flag suspicious claims using data analytics and field investigators. If a claim is flagged, the SIU may conduct surveillance, request recorded statements, review medical or repair records, and refer the matter to the Arizona Department of Insurance (ADOI) or law enforcement.
The ADOI’s Fraud Unit works in coordination with county prosecutors and, in larger cases, the Arizona Attorney General’s Office. Federal agencies, including the FBI and HHS-OIG, become involved when healthcare or wire fraud elements are present.
What you should do if you are under investigation: Do not provide a recorded statement to an insurance investigator or law enforcement without an attorney present. Anything you say can be used to build a criminal case. Contact Feldman Royle Ahl as soon as you are contacted — before charges are filed is often when a defense attorney can have the most impact.
Under A.R.S. § 20-466.01, insurance fraud is a Class 6 felony carrying up to 2 years in prison, fines up to $150,000, and a $5,000 civil penalty per violation. When prosecutors stack an additional fraudulent scheme charge under A.R.S. § 13-2310 – a Class 2 felony – prison exposure rises to 12.5 years. Federal charges involving Medicare or Medicaid carry up to 10 years per offense and are prosecuted separately in federal court.
In Arizona, insurance fraud is a crime that’s usually charged as a Class 6 felony under A.R.S. § 20-463. The penalties can include:
In cases involving larger financial losses or repeat offenses, charges may be enhanced, and you could face felony insurance fraud prosecution under additional statutes, including fraudulent schemes, theft, or conspiracy.
If you’re concerned about insurance fraud jail time or need guidance about your options, contact a Phoenix insurance fraud lawyer immediately. When financial transactions are scrutinized beyond the initial fraud allegation, defendants may also face money laundering charges in Maricopa County.
When federal programs such as Medicare or Medicaid are involved,insurance fraud may be prosecuted in federal court. Federal convictions carry up to 10 years per offense – significantly higher than state-level Class 6 felony exposure – with no parole in the federal system.
At Feldman Royle Ahl, we offer aggressive and customized insurance fraud defense services. Every case is different—but common defense strategies include:
Whether you are under investigation or have already been charged, our Phoenix insurance fraud attorneys can help protect your rights, negotiate with prosecutors, and fight for a reduction or dismissal of charges.
Even an accusation of insurance fraud can have long-lasting consequences, both legally and professionally. If you’re a healthcare provider, business owner, or policyholder, your livelihood could be on the line.
Working with a skilled insurance fraud defense lawyer in Phoenix gives you the advantage of experienced counsel who understands both state and federal insurance laws. At Feldman Royle Ahl, we take swift action to analyze the case, protect your interests, and begin building your defense from day one.
Car insurance fraud is one of the most frequently prosecuted types in Phoenix – cases often begin as civil disputes with insurers before escalating to criminal charges. If you have been contacted by an investigator or received a target letter, do not respond without legal counsel.
Insurance fraud investigations in Arizona typically begin with the insurer’s Special Investigations Unit (SIU), which refers cases to the Maricopa County Attorney’s Office or the Arizona Department of Insurance. We know how SIU investigators build their files, what they look for in claim patterns, and where their analyses commonly go wrong. That inside knowledge shapes how we challenge the evidence from the start.
Many of our clients come to us during the investigation stage, before any formal charges have been made. This is the most valuable window in any insurance fraud case. Early intervention allows us to communicate directly with investigators and prosecutors, provide context that shapes how the case is viewed, and in some situations, prevent charges from being filed at all.
Waiting until an arrest is made costs you options.
Every insurance fraud charge under A.R.S. § 20-463 requires the prosecution to prove that you knowingly made a false statement with the intent to deceive. That standard is harder to meet than it appears. Mistakes on claims forms, reliance on advice from an agent, honest disagreements over valuations, and good-faith belief that a claim was valid are all legitimate defenses. We examine every statement you made and every document in the file to identify where the prosecution’s intent argument breaks down.
Complex insurance fraud cases – particularly those involving health billing, business interruption claims, or multi-count indictments – often require independent expert analysis. We work with forensic accountants, insurance industry consultants, and billing specialists who can identify flaws in the way the prosecution has calculated alleged losses or characterized standard industry practices as fraud.
When insurance fraud involves federal programs such as Medicare or Medicaid, cases are prosecuted in federal court under a different set of rules, with significantly higher sentencing exposure. The attorneys at Feldman Royle Ahl are experienced in both the Maricopa County Superior Court and the United States District Court for the District of Arizona. You will not need a separate federal attorney – we handle both.
If you are facing an insurance fraud investigation or charge in Phoenix or anywhere in Maricopa County, contact Feldman Royle Ahl today. The earlier we are involved, the more options we have to protect you. Call (602) 899-8000 for a free, confidential consultation.
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