Conviction Deserved When Perpetrator Admits He Was Not Injured

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In State of Utah v. Julio Ayala, No. 20170928-CA, 2022 UT App 1, Court of Appeals of Utah (January 6, 2022) the prosecution proved that Julio Ayala was involved in multiple automobile accidents while driving his truck and trailer. Ayala admitted to a private investigator that he had not been injured in the accidents but nonetheless believed he had a right to receive insurance benefits.

Ayala was convicted on one count of a pattern of unlawful activity and one count of felony insurance fraud. Ayala appealed.

Between January 2010 and July 2012, Ayala was involved in five automobile accidents. In each accident, he was rear-ended by another vehicle.

Ayala’s attorney, who was present during the interview, spoke English and Spanish and interjected several times to aid in and clarify the interpretation of the questions the investigator asked Ayala.

During the interview, Ayala admitted that he had not been injured in any of the accidents. Ayala stated that his insurance coverage entitled him to chiropractic treatments following the accidents, even if he had not been injured. Ayala agreed with the private investigator that he had “received treatment for no reason” and added, “[S]ince I am covered because of my insurance and that’s my right.”

ANALYSIS

The hearing testimony and report of the experts did not persuade the trial court that the interpretation was misunderstood by Ayala to any substantial degree, or that Ayala’s responses during the insurance investigation were so missperceived and misstated as to obscure their essential meaning.

The court of appeals concluded that the trial court did not err in convicting Ayala of felony insurance fraud, because sufficient evidence was presented at trial that Ayala received more than $1,500 in insurance benefits in connection with the fraudulent claim related to that count.

ZALMA OPINION

Taking this case up on appeal is an example of why states are loathe to bring insurance fraud cases to trial because of the expense of a trial and an appeal far exceed the amount taken in the fraud. However, if other states emulate Utah any prosecution and conviction will deter others from attempting fraud.

© 2022 – Barry Zalma

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