Criminal Law

2003. Insurance Fraud: Health-Care Claims - Total Value

If you find the defendant guilty of insurance fraud in connection with health-care claims, you must then decide whether the People have proved that the total value of the (claim[s] involved/ [or] amount at issue) was more than $400 [within a period of 12 consecutive months].

The People have the burden of proving this allegation beyond a reasonable doubt. If the People have not met this burden, you must find that this allegation has not been proved.

Bench Notes

Instructional Duty

If the defendant is charged with a felony based on the total value of the claims, the court has a sua sponte duty to instruct on this element.

This instruction must be given with the appropriate instruction on the other elements of the offense, CALCRIM No. 2000, Insurance Fraud: Fraudulent Claims, CALCRIM No. 2001, Insurance Fraud: Multiple Claims, or CALCRIM No. 2002, Insurance Fraud: Vehicle Accident.

The court must provide the jury with a verdict form on which the jury will indicate if the prosecution has or has not been proved that the total value of the claims exceeded $400.

Give the bracketed "within a period of 12 consecutive months" if the facts show several claims filed over a period of time.


Elements. Pen. Code, § 550(c)(2).

Secondary Sources

2 Witkin & Epstein, California Criminal Law (3d ed. 2000) Crimes Against Property, § 186.

6 Millman, Sevilla & Tarlow, California Criminal Defense Practice, Ch. 143, Crimes Against Property, § 143.01[1][a], [f], [i] (Matthew Bender).

(New January 2006)