• Top 1% of Defence Law Firms

  • Defended over 50,000 Cases

  • 5 star google reviews

  • 40 Years of Criminal Law Expertise

Fraud Offences Articles

What Happens for a First Offence of Insurance Fraud?

Insurance Fraud

If you or someone close faces a first insurance fraud charge, feeling anxious and eager to begin developing your defence is understandable. Insurance fraud is sternly addressed by UK courts, so engaging an expert defence solicitor as early as possible is critical. This article unravels the complexity of insurance fraud claims. We explain the offence, provide examples, discuss sentencing of first-timers, and analyse imprisonment risks. We also outline how to get in touch with our team if you need robust legal assistance to get you through the process.

What is the offence of insurance fraud?

Insurance fraud is an offence under the Fraud Act 2006. It involves dishonestly making false representations or failing to disclose information to obtain insurance cover or make an insurance claim.

These provisions can all apply to insurance fraud.

To establish insurance fraud, the prosecution generally must prove:

  • Dishonest conduct by the defendant, either through false representations, failure to disclose information, or abuse of position.
  • Intent by the defendant to make a gain or cause loss through their dishonesty.
  • The fraud was committed in relation to an insurance policy or claim.

Insurance fraud is triable either way and can lead to unlimited fines and up to 10 years imprisonment depending on its extent and severity. Prosecution often occurs in the Crown Court given the complexity and seriousness of cases. The court will consider factors like the value of fraudulent claims and deliberateness of the defendant’s dishonesty when imposing penalties.

What are some examples of insurance fraud?

Examples of this offence include:

  • Staging or exaggerating accidents or injuries to make false insurance claims.
  • Deliberately causing damage or loss to property to collect insurance payouts.
  • Lying about pre-existing medical conditions on private health insurance applications.
  • Filing claims for treatments or injuries that never actually occurred.
  • Inflating the value of stolen or damaged items on claims forms.
  • Faking death certificates or identities to collect life insurance benefits.
  • Selling details of real accidents/injuries to others to allow them to make fraudulent claims.
  • Deliberately failing to disclose modifications made to vehicles when purchasing insurance.
  • Professional crash for cash scams involving networks of fraudsters.
  • Setting fires to property in order to submit arson claims.
  • Healthcare fraud where patients and doctors collude to claim against insurance companies for unnecessary procedures.

What happens if you are suspected of committing insurance fraud in the UK?

If you are suspected of insurance fraud in England and Wales, you are likely to face investigation and potential prosecution under the Fraud Act 2006.

Here’s a general outline of what could happen:

  1. Initial investigation – if insurance fraud is suspected, the insurer or police will initiate an investigation. This may involve gathering evidence like claim forms, medical reports, financial records, and witness statements. You may be interviewed under caution, where anything said could be used as evidence later. Having a solicitor present is advisable.
  2. Arrest or voluntary interview – you could be arrested or asked to voluntarily attend an interview at a police station. Even if voluntary, this is serious and may result in charges. Legal representation is recommended.
  3. Charging decision – after investigating, authorities will consult the Crown Prosecution Service on whether to charge you. They will consider if there is sufficient evidence and if it is in the public interest.
  4. Court process – if charged, your case may be tried in the Magistrates’ Court or Crown Court before a jury.
  5. Sentencing – if convicted, the court will consider various factors when deciding your sentence. While maximum penalties depend on the offence, non-custodial sentences are possible for first offences depending on circumstances. Potential options include fines, community service, or suspended sentences.

Seeking urgent legal advice is vital if you or someone you care about is facing such accusations, as the exact investigation and prosecution process will depend heavily on your specific situation.

What is the sentence for insurance fraud in the UK?

Insurance fraud is typically prosecuted under the Fraud Act 2006 and as such, it carries a maximum sentence of 10 years’ imprisonment.

Aggravating factors like being part of an organised criminal operation, defrauding multiple insurers, abusing a position of authority, or targeting vulnerable victims can increase the sentence. Mitigating factors like early guilty pleas, showing remorse, or making restitution, on the other hand, may reduce it.

Additional penalties may include asset seizure under the Proceeds of Crime Act 2002, being barred from working in the financial sector, fines, and compensation orders. Insurers often have specialised investigation units and share fraud data to detect patterns of abuse. Insurance companies may pursue civil litigation against fraudsters in addition to any criminal proceedings brought by the CPS.

For years now, government and insurance industry bodies have been working together to crack down on insurance cheats through information sharing, analytics, stronger penalties, and raising public awareness. Insurance fraud pushes up premiums for all customers, so insurers take a strict approach to deterring potential scammers and the courts mirror that in their punishments.

Are there any defences to insurance fraud?

There are several potential defences that can be raised in response to allegations of insurance fraud:

  • Lack of intent – the prosecution must prove that you had dishonest intent. If you can demonstrate that you had an honest belief or made a mistake and lacked the intention to deceive, this could provide a defence against the allegations of insurance fraud.
  • Lack of knowledge – if you can show that you were unaware of the fraudulent nature of the insurance claim or were misled by someone else, this may serve as a defence. It is important to demonstrate that you had no knowledge or involvement in the fraudulent activity.
  • Mistaken interpretation – if you can argue that you misinterpreted the terms or requirements of the insurance policy, leading to unintentional misrepresentation or fraudulent behaviour, this may provide a defence. It is crucial to show that your actions were based on an honest mistake rather than intentional deception.
  • Procedural errors – if there were procedural errors during the investigation or in the handling of the insurance claim, it may be possible to have the case dismissed on procedural grounds. This defence focuses on any irregularities or violations of proper procedures that may have compromised the integrity of the investigation.
  • Insufficient evidence – skilled defence lawyers will scrutinise the strength of the prosecution’s evidence, looking for inconsistencies, unreliable witnesses, or gaps in the evidence chain. Challenging the sufficiency of evidence and raising reasonable doubt can be an effective defence strategy.
  • Coercion or duress – if you can demonstrate that you were coerced or under duress to engage in insurance fraud, this may serve as a defence. Your defence must establish that the coercion was immediate or imminent and that you had no reasonable alternative.

Note that even though many people think it is ‘OK’ to rip off large companies with millions or even billions of pounds in profit, insurance fraud is still a serious offence with severe consequences. Any potential defences need to be discussed with expert legal advisors to ensure the greatest likelihood of success.

Will I go to prison if it is my first time committing insurance fraud?

It is difficult to predict whether a first time insurance fraud offence will result in imprisonment, as courts will consider numerous factors when determining an appropriate sentence.

While insurance fraud is undoubtedly serious, courts do recognise first offences as a mitigating factor which may warrant a more lenient sentence, subject to the precise circumstances. Demonstrating sincere remorse, cooperating fully with investigations, voluntarily compensating victims, and having otherwise positive character references may all assist first-time offenders in arguing against an immediate custodial sentence.

That said, the scale and sophistication of the fraud will weigh heavily – large or systematic frauds betraying significant trust are less likely to attract a suspended sentence, meaning you could go to prison for them even if it is your first time. The prosecution will likely emphasise the need for deterrence given rising insurance costs from fraud, and offenders bear the brunt of the deterrence efforts.

Judges have discretion, but rarely exercise leniency, for deliberate and cynical insurance scams. For minor opportunistic offences though, strong advocacy around mitigating factors may persuade a judge to impose a suspended sentence or community service instead of prison.

Given the nuances involved, those facing allegations should urgently engage an experienced criminal defence lawyer for case-specific advice on the realistic prospects of avoiding imprisonment.

Where to get further help

If you or someone close to you is being charged with insurance fraud, getting specialist legal help immediately is your best move. For first time offenders, charges can sometimes be dropped pre-trial through the robust advocacy of experienced fraud solicitors. Contact Stuart Miller Solicitors today for a free case assessment and guidance through this challenging process.


  • Responsive

    A legal expert will consult you within 24 hours of making an enquiry.

  • Empathetic

    We will always treat you with trust, understanding and respect.

  • Specialised

    Your case will be handled by an expert who specialises in your type of offence.

  • Proactive

    We will take early action to end proceedings as soon as it is practically and legally possible to do so.

  • Engaged

    You will be kept updated on your case at all times. We will provide a named contact available to answer your questions.

  • Caring

    We understand this is a difficult and stressful time for you and your family. Our team will support you every step of the way.

  • Tenacious

    We will never give up on your case. We fight tirelessly to get you the best possible outcome.

Google Rating
Based on 346 reviews

Further Reading


Call 24 hours a day, 7 days a week.