Attorney for Penal Code 550

Penal Code section 550 is being used to prosecute doctors, attorneys, chiropractors and billing companies for intentional fraud.  Insurance companies who are involved in billing disputes with healthcare providers will make referrals to state prosecutors hoping that criminal charges get filed against the healthcare professional.  In this way, Penal Code section 550 criminalizes what had previously been a simple billing dispute.

Daniel Horowitz is highly experienced in defending doctors and other healthcare providers against Penal Code section 550 fraud charges.  Daniel recently obtained a dismissal of Penal Code section 550 charges in Orange County, a dismissal of Workers Compensation fraud charges in Tehama County and he successfully defended Dr. Wilmer Origel D.C. at a landmark medical fraud trial in Stockton, California.  The prosecutors threw a myriad of invented and politically motivated charges at Dr. Origel.  He later sued the insurance companies who brought these fraudulent charges.  Daniel won a major jury trial victory for Dr. Sohila Bodner in Hayward, California and Dr. Gary Martinovsky who was investigated relating to that case successfully sued the insurance companies who launched this investigation.  

If you are facing insurance fraud charges under Penal Code section 550 or other code sections, Daniel Horowitz is your first choice as your defense lawyer.  Call for an initial consultation (925) 283-1863.

Summary of California Penal Code § 550 – Insurance Fraud

Penal Code § 550 is California’s primary statute criminalizing insurance fraud. It is an extremely broad and heavily prosecuted “wobbler” that covers virtually every conceivable way a person can intentionally defraud (or attempt to defraud) an insurance company.

Key Prohibited Acts (selected subsections)

PC § 550 makes it a crime to knowingly do (or assist someone in doing) any of the following:

• (a)(1) Present or cause to be presented any false or fraudulent claim for payment of a loss or injury.
• (a)(2) Present multiple claims for the same loss or injury with intent to defraud.
• (a)(3) Knowingly present false information on an insurance application.
• (a)(4) Prepare, make, or subscribe any false or fraudulent document (reports, estimates, bills, etc.) with intent that it be used in support of an insurance claim.
• (a)(5) Make or cause to be made any false or fraudulent statement to reduce or deny benefits (common in workers’ comp fraud).
• (a)(6) Cause a motor vehicle collision or participate in staged accidents for the purpose of filing false claims (“capping” or “runner” cases).
• (a)(7) Employ or pay “runners,” “cappers,” or steerers to procure clients or patients to fraudulently obtain benefits.
• (a)(9) Present a claim for medical services that were not actually provided (“billing for services not rendered”).
• (a)(10) Present a claim using a stolen or forged prescription.

There are additional subsections covering health-care insurance, workers’ compensation, auto insurance, and Medicare/Medi-Cal fraud.

Who Can Be Charged?

Liability extends not only to the person filing the false claim, but also to anyone who:

• Assists
• Conspires
• Solicits
• Employs others to commit the fraud

This makes doctors, chiropractors, lawyers, body shop owners, “cappers,” and even claimants all potentially liable.

Punishment (as of 2025)

• Wobbler: can be charged as either a felony or misdemeanor.
  • Misdemeanor: up to 1 year in county jail and/or fine up to $10,000.
  • Felony: 2, 3, or 5 years in state prison and/or fine up to $50,000 (or double the amount of the fraud, whichever is greater).
• Additional civil penalties under Insurance Code § 1871.7: up to $150,000 + assessments + restitution.
• Restitution to the insurance company is virtually always ordered.

Common Examples of PC 550 Charges

• Staged or exaggerated car accidents
• Billing for medical treatment never provided
• Faking or exaggerating injuries in workers’ comp cases
• Submitting inflated repair estimates after a legitimate loss
• Using someone else’s insurance card or policy
• “Patient brokering” in Medi-Cal or rehab scams

Important Notes

• Specific intent to defraud is required (you must know the statement/claim is false).
• Attempted insurance fraud is punished the same as the completed crime.
• Prosecutors often pair § 550 with white-collar enhancements (PC 186.11), grand theft (PC 487), or identity theft (PC 530.5).

In short, Penal Code § 550 is the “catch-all” statute used by district attorneys and the California Department of Insurance to aggressively prosecute virtually any intentional deception involving an insurance claim or policy.

Read about our recent victory in a PC 550 case based upon this motion.

What are some of the Ways to Violate Penal Code section 550?

There are so many ways to be caught in a PC 550 prosecution.  Here are just some of the acts that are prohibited:

1. Presenting a false or fraudulent claim for payment for a loss or injury. 
2. Presenting a fraudulent claim for vehicle theft or damage. 
3. Presenting a fraudulent claim for loss due to theft of, destruction or damage to property. 
4. Signing a document with the intent to support a false or fraudulent claim. 
5. Submitting a claim for healthcare benefit not used. 
6. Overcharging for medical services rendered. 
7. Billing for medical equipment not actually supplied. 
8. Overstating damage suffered in a car accident (to the car) 
9.Overstating the injuries suffered in an accident. 
10. Overstating the injuries and disabilities in a Workers Compensation claim.

Many of these items are simply a dispute between a doctor, a lawyer or an insured person and the insurance company.  Unfortunately, certain prosecutors take the word of the insurance company and launch criminal actions against people who are in a dispute with the insurer.

What Is Fraud?

• Definition: Fraud involves intentionally deceptive actions designed to provide the perpetrator with an unlawful gain or to deny a right to a victim.  This general definition can include promising to perform a service with no intent to do so.  A promise to repave someone's driveway, collecting the money and then not showing up is an example of this.  But more subtle frauds can be a promise that a certain medical service was performed when a lesser service actually took place.  Is this a disagreement about the nature of what was done?  Or was it part of a scheme to defraud an insurance company.  There are many other examples.
• Criminal Aspect: Fraud becomes a crime when it involves a “knowing misrepresentation of the truth or concealment of a material fact to induce another to act to their detriment” (Black’s Law Dictionary). In simpler terms, if someone lies to deprive another person or organization of money or property, it constitutes fraud.
• Examples: Fraud can occur in various contexts, including finance, real estate, investment, and more.  Section 550 focuses on insurance frauds and it is a very broad statute that is creatively used by prosecutors so that almost any insurance reimbursement dispute has the potential of being charged as a PC 550 criminal violation.
• Under Penal Code section 550 it is not necessary that you receive payment or even deceive the insurance company.  The simply filing of a false claim triggers the statute.

View News Release on Penal Code Section 550 Guilty Plea in Contra Costa County

San Bernardino County Penal Code Section 550 Conviction

Marin County Penal Code Section 550 Conviction

Categories of Fraud:

• Against Individuals: Targeting a single person, including identity theft, phishing scams, and Ponzi schemes.
• Internal Organizational Fraud: Deception by employees, managers, or executives within an organization (e.g., embezzlement, tax evasion, lying to investors).
• External Organizational Fraud: Fraud committed against an organization from outside sources (e.g., vendors, customers, intellectual property theft).  Penal Code section 550 targets only external organizational fraud.