State of Tennessee v. Reuben Eugene Mitchell ( 2019 )


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  •                                                                                          12/20/2019
    IN THE SUPREME COURT OF TENNESSEE
    AT KNOXVILLE
    September 5, 2019 Session
    STATE OF TENNESSEE V. REUBEN EUGENE MITCHELL
    Appeal by Permission from the Court of Criminal Appeals
    Criminal Court for Knox County
    No. 102034      Steven W. Sword, Judge
    No. E2017-01739-SC-R11-CD
    The defendant, Reuben Eugene Mitchell, was convicted of one count of arson and one
    count of presenting a false or fraudulent insurance claim. The Court of Criminal Appeals
    affirmed the defendant’s arson conviction but reversed his conviction for presenting a
    false or fraudulent insurance claim. We granted the State’s application to appeal to
    address whether the proof at trial was sufficient to support the defendant’s conviction for
    presenting a false or fraudulent insurance claim. Our review leads us to conclude that the
    evidence was sufficient. Accordingly, we reverse in part the judgment of the Court of
    Criminal Appeals and reinstate the defendant’s conviction for presenting a false or
    fraudulent insurance claim.
    Tenn. R. App. P. 11 Appeal by Permission;
    Judgment of the Court of Criminal Appeals Affirmed in Part,
    Reversed in Part; Judgments of the Trial Court Affirmed
    ROGER A. PAGE, J., delivered the opinion of the Court, in which JEFFREY S. BIVINS, C.J.,
    and CORNELIA A. CLARK, SHARON G. LEE, and HOLLY KIRBY, JJ., joined.
    Herbert H. Slatery III, Attorney General and Reporter; Andrée S. Blumstein, Solicitor
    General; Katherine C. Redding, Assistant Attorney General; Randall E. Nichols, District
    Attorney General; and William C. Bright and Andrea Kline, Assistant District Attorneys
    General, for the appellant, the State of Tennessee.
    Joshua D. Hedrick, Knoxville, Tennessee, for the appellee, Reuben Eugene Mitchell.
    1
    OPINION
    I. FACTUAL AND PROCEDURAL BACKGROUND
    After a fire caused extensive damage to his house, the defendant was charged with
    one count of arson1 and one count of presenting a false or fraudulent insurance claim.2
    At the ensuing jury trial, the following evidence was adduced.
    On November 30, 2011, the defendant applied to Allstate Property and Casualty
    Insurance Company (“Allstate”) for a homeowner’s insurance policy. On December 1,
    2011, Allstate issued the homeowner’s policy, number 9 63 861797, naming the
    defendant as the insured and the defendant’s residence as the insured dwelling (“the
    Policy”). A copy of the Policy, which covered the house, “other structures,” personal
    property, and “additional living expense,” was admitted into evidence. As to the
    dwelling, the Policy covered “sudden and accidental direct physical loss.”    It also
    provided liability protection.
    In the portion titled “Section I Conditions,” beginning on page 16, the Policy
    contains multiple provisions directing what the insured “Must Do After A Loss.” One of
    the requirements is to “immediately give” Allstate or its agent “notice.” Also required,
    “within 60 days after the loss,” is a “signed, sworn proof of the loss” including “the
    actual cash value and amount of loss for each item damaged, destroyed or stolen.”
    Nowhere in the criteria for “What You Must Do After A Loss” is the insured required to
    “file” a “claim” for a loss resulting from fire damage.
    On the evening of December 5, 2011, just a few days after the Policy was issued, a
    fire caused extensive damage to the living room area of the defendant’s residence. The
    defendant was not at home, and neighbors called the fire department. Although the fire
    had been extinguished, the defendant called the fire department after he arrived home the
    morning after the fire. The defendant, who testified at trial, also called Allstate and told
    Allstate that there had been a house fire. He acknowledged that he called Allstate “to
    report the loss” and that his call was to “start the process to file a claim.” However, the
    defendant also testified that he did not fill out any claim forms for Allstate, and he denied
    telling anyone at Allstate that he wanted to be paid for a property loss or that he wanted
    1
    The indictment charged that the defendant “did knowingly damage, by fire a structure . . .
    without the consent of all persons having a possessory and proprietary interest in said structure[.]” See
    Tenn. Code Ann. § 39-14-301(a)(1) (2010) (defining arson as “knowingly damag[ing] any structure by
    means of a fire or explosion . . . [w]ithout the consent of all persons who have a possessory, proprietary or
    security interest therein”).
    2
    The indictment charged that the defendant “did unlawfully and intentionally present and cause
    to be presented to Allstate Insurance Company, a false and fraudulent claim for the payment of a loss
    upon a contract of insurance coverage for property located at” the address of his residence. See Tenn.
    Code Ann. § 39-14-133 (2010).
    2
    Allstate to make repairs. He stated that he did not fill out a list of property that he lost
    and wanted replaced but added that an Allstate representative did so.
    After reporting the fire, the defendant met with two Allstate representatives, Mr.
    David Gray and Ms. Heather Stover. According to Mr. Gray, a “large loss adjuster,” the
    defendant told Mr. Gray that “he had been home, and he had had a fire going in the
    fireplace and had to leave the home and shortly after he left, the fire took place in the
    home.”
    On December 9, 2011, Ms. Stover, a “large loss contents adjuster,” presented the
    defendant with a document titled “Advance Payment Agreement” and a check for $1,000.
    The Advance Payment Agreement, signed by the defendant on December 9, 2011, was
    admitted into evidence. This document references “Claim No.: 0228336426” and “Policy
    No.: 000963861797.” It also lists the defendant as the “Policyholder(s),” the defendant’s
    residence as the “Address of Insured Property,” and “[f]ire” as the “Type of Damage.”
    The Advance Payment Agreement further provides as follows:
    In consideration of the advance payment described below, the
    policyholder(s) (“you”) and Allstate (“we”) agree as follows:
    Before any benefit can be paid under this policy, you have an
    obligation to fully comply with all policy requirements in submitting the
    claim. We have an obligation to investigate and determine if the policy is
    valid, if the claim is valid and the extent of coverage that may be applicable
    to the loss, if any. We will continue to investigate the claim. If there are
    requirements in the policy which you have not yet completed, you need to
    comply with those requirements.
    In the meantime, in good faith and to prevent any undue hardship
    which this loss may cause you, we advance $1,000.00 on the loss under the
    following terms and conditions:
    1) that this advance shall not be considered payment under any
    portion of the policy;
    2) that if either the policy or the claim is not valid and payment is
    not required by us, you will repay the advance; and
    3) we, in making this advance, reserve and do not waive any right or
    requirement under the policy described above, whether procedural or
    substantive.
    3
    By signing this agreement, you accept the advance payment fully
    understanding that we reserve all rights and requirements under the policy
    described above, including the right to receive from you proper notice and
    proof of loss, and the right to ask you to take an examination under oath. If
    the claim is honored, we may apply the advance against any benefit due
    under the policy, and if it is determined that any part of the policy or the
    claim is not valid, and no payment is due, you will repay the advance to us
    in full.
    The parties hereby acknowledge and agree to the terms set forth
    above.
    (Emphases added). The defendant acknowledged taking the $1,000 payment and signing
    the Advance Payment Agreement.
    When questioned about the Advance Payment Agreement, Ms. Stover explained:
    “When we have a customer who has had a fire claim with extensive damage, we offer an
    advance payment just for them to start getting some of the things they need right away,
    and it’s taken off of their total settlement if and when we pay the claim.” She added that
    “any time we do have a fire claim that’s extensive damage such as this one, we do offer
    an advance payment just for people to get started replacing some of their personal
    property.” Asked about the process following an advance payment, Ms. Stover further
    explained:
    Well, normally, we . . . prepare estimates. We have to do an investigation;
    our cause and origin begins the investigation. And if everything comes
    back okay with the investigation, then we proceed with paying the claim,
    but in this situation, it went to our special investigations unit and when it
    does that, . . . it’s removed from the adjuster’s handling and into the special
    investigations unit where they do a more extensive investigation.
    According to Ms. Stover, at the time she delivered the check to the defendant,
    “everything had been done to start the processing of the claim.” She reiterated that any
    advance payment would be deducted from the total proceeds payable on a valid claim. If
    no valid claim were eventually processed, the advance payment would have to be repaid
    by the recipient. On cross-examination, Ms. Stover asserted that the advance payment
    was “issued in good faith that we will pay the claim.” She also acknowledged that she
    did not receive a claim form or a signed, sworn proof of loss document from the
    defendant.
    Allstate hired EFI Global, a nationwide company that conducted investigations
    into the causes and origins of fires, to investigate the cause and origin of the fire. Gary
    M. Young, an investigator with EFI Global, reported to the scene and spoke with the
    4
    defendant. The defendant acknowledged speaking with Mr. Young over the phone and
    stated that Mr. Young told him that Allstate “wanted to investigate [the fire] first before
    they file a claim.”
    Mr. Young subsequently prepared a written report about the cause of the fire,
    dated December 30, 2011 (“the Report”). A copy of the Report was admitted into
    evidence, and in it, Mr. Young opined that “this fire was intentionally precipitated, by
    introducing accelerant underneath and behind the loveseat in the living room, and then
    igniting the accelerant with a manually and intentionally introduced ignition source.”
    The Report also noted: “I questioned [the defendant] as to whether or not he has any
    opinion as to the cause for this fire loss. He revealed that it is his opinion that this fire
    was apparently caused by some problem with the wood burning fireplace.”
    E. Metts Hardy of EFI Global, the Vice President of fire investigations for EFI
    Global, reviewed and signed the Report. Because Mr. Young was deceased by the time
    of trial, Mr. Hardy testified about EFI’s investigation. The trial court recognized Mr.
    Hardy as “an expert in the area of origin and cause relating to fires.” Mr. Hardy opined at
    trial that the fire had been intentionally set and had not originated in the fireplace. Based
    on this information, Allstate did not pay the defendant any further money under the
    Policy. Rather, this prosecution commenced on December 28, 2011, less than a month
    after the fire. Allstate cancelled the Policy on February 14, 2012.
    The defendant offered a different explanation of the fire. He explained that, due to
    his failure to pay his bills, both water and electricity to the house had been cut off weeks
    before the fire. On the evening of December 5, he arrived home during the early evening
    and began a fire in the fireplace. He started the fire with a small starter log, some
    kindling wood, and starter gel. He stated that there were no large pieces of wood in the
    fireplace when he began the fire.
    After starting the fire, the defendant claimed that he received a phone call
    informing him that his sister was critically ill. He “went into panic mode” and, to
    extinguish the fire, he “grabbed some wet logs” and threw the wet logs into the fireplace.
    He explained that the logs had been out in the rain all week and he thought that they
    would put out the fire he started. He stated that, after he threw the wet logs into the
    fireplace, it “looked like” the fire was extinguished. He then left the house.
    The defendant claimed that he drove to his sister’s house, where she was being
    prepared for transport in an ambulance. He followed the ambulance to the hospital and
    did not leave until the next morning. He did not realize that his house had caught fire
    until his return home on December 6, 2011. As to the presence of an accelerant, the
    defendant explained that he had recently refinished the living room floor and used
    polyurethane, a flammable substance.
    5
    After considering the evidence, the jury rejected the defendant’s explanation of the
    fire and convicted him of arson. The jury also convicted the defendant of presenting a
    false or fraudulent insurance claim in the amount of $10,000 or more but less than
    $60,000. After a subsequent hearing, the trial court sentenced the defendant as a Range I,
    standard offender to four years of incarceration on each conviction, to be served
    concurrently and suspended to supervised probation.
    The defendant appealed, and the Court of Criminal Appeals affirmed the
    defendant’s conviction of arson. State v. Mitchell, No. E2017-01739-CCA-R3-CD, 
    2018 WL 6439502
    , at *13 (Tenn. Crim. App. Dec. 7, 2018). However, a majority of the Court
    of Criminal Appeals panel concluded that the evidence was insufficient to support the
    false or fraudulent insurance claim conviction and, therefore, reversed that conviction and
    dismissed the charge. 
    Id. We granted
    the State’s ensuing application for permission to
    appeal to address whether the proof at trial was sufficient to support the defendant’s
    conviction for presenting a false or fraudulent insurance claim.
    II. STANDARD OF REVIEW
    The standard for appellate review of a claim challenging the sufficiency of the
    State’s evidence is “whether, after viewing the evidence in the light most favorable to the
    prosecution, any rational trier of fact could have found the essential elements of the crime
    beyond a reasonable doubt.” Jackson v. Virginia, 
    443 U.S. 307
    , 319 (1979) (citing
    Johnson v. Louisiana, 
    406 U.S. 356
    , 362 (1972)); see Tenn. R. App. P. 13(e); State v.
    Davis, 
    354 S.W.3d 718
    , 729 (Tenn. 2011). To obtain relief on a claim of insufficient
    evidence, the defendant must demonstrate that no reasonable trier of fact could have
    found the essential elements of the offense beyond a reasonable doubt. See 
    Jackson, 443 U.S. at 319
    . This standard of review is identical whether the conviction is predicated on
    direct or circumstantial evidence, or a combination of both. State v. Dorantes, 
    331 S.W.3d 370
    , 379 (Tenn. 2011) (citing State v. Hanson, 
    279 S.W.3d 265
    , 275 (Tenn.
    2009)); State v. Brown, 
    551 S.W.2d 329
    , 331 (Tenn. 1977) (quoting Farmer v. State, 
    343 S.W.2d 895
    , 896 (Tenn. 1961)).
    On appellate review, “‘we afford the prosecution the strongest legitimate view of
    the evidence as well as all reasonable and legitimate inferences which may be drawn
    therefrom.’” 
    Davis, 354 S.W.3d at 729
    (quoting State v. Majors, 
    318 S.W.3d 850
    , 857
    (Tenn. 2010)); see also State v. Williams, 
    657 S.W.2d 405
    , 410 (Tenn. 1983). In a jury
    trial, questions involving the credibility of witnesses and the weight and value to be given
    the evidence, as well as all factual issues raised by the evidence, are resolved by the jury
    as trier of fact. State v. Bland, 
    958 S.W.2d 651
    , 659 (Tenn. 1997); State v. Pruett, 
    788 S.W.2d 559
    , 561 (Tenn. 1990) (citations omitted). This Court presumes that the jury has
    afforded the State all reasonable inferences from the evidence and resolved all conflicts
    in the testimony in favor of the State; as such, we will not substitute our own inferences
    drawn from the evidence for those drawn by the jury, nor will we re-weigh or re-evaluate
    6
    the evidence. 
    Dorantes, 331 S.W.3d at 379
    ; State v. Lewter, 
    313 S.W.3d 745
    , 748 (Tenn.
    2010); Liakas v. State, 
    286 S.W.2d 856
    , 859 (Tenn. 1956). Because a jury conviction
    removes the presumption of innocence that the defendant enjoyed at trial and replaces it
    with one of guilt at the appellate level, the burden of proof shifts from the State to the
    convicted defendant, who must demonstrate to this Court that the evidence is insufficient
    to support the jury’s findings. 
    Davis, 354 S.W.3d at 729
    (quoting State v. Sisk, 
    343 S.W.3d 60
    , 65 (Tenn. 2011)).
    III. ANALYSIS
    In conducting our sufficiency review, we must evaluate the proof in light of the
    elements of the crime. See State v. Gentry, 
    538 S.W.3d 413
    , 420 (Tenn. 2017)
    (recognizing that the first step of a sufficiency review is to “‘examine the relevant
    statute(s) in order to determine the elements’ of the offense that must be proven by the
    prosecution beyond a reasonable doubt” (quoting State v. Stephens, 
    521 S.W.3d 718
    ,
    723-24 (Tenn. 2017)). Accordingly, our review of the evidence in this case depends
    upon our construction of the false or fraudulent insurance claims statute, Tennessee Code
    Annotated section 39-14-133, which provides:
    Any person who intentionally presents or causes to be presented a
    false or fraudulent claim, or any proof in support of such claim, for the
    payment of a loss, or other benefits, upon any contract of insurance
    coverage, or automobile comprehensive or collision insurance, or certificate
    of such insurance or prepares, makes or subscribes to a false or fraudulent
    account, certificate, affidavit or proof of loss, or other documents or
    writing, with intent that the same may be presented or used in support of
    such claim, is punished as in the case of theft.
    Tenn. Code Ann. § 39-14-133 (2010).
    When engaging in statutory interpretation, “well-defined precepts apply.” State v.
    McNack, 
    356 S.W.3d 906
    , 908 (Tenn. 2011). “The most basic principle of statutory
    construction is to ascertain and give effect to the legislative intent without unduly
    restricting or expanding a statute’s coverage beyond its intended scope.” Owens v. State,
    
    908 S.W.2d 923
    , 926 (Tenn. 1995) (citing State v. Sliger, 
    846 S.W.2d 262
    , 263 (Tenn.
    1993)); see also Carter v. Bell, 
    279 S.W.3d 560
    , 564 (Tenn. 2009) (citing State v.
    Sherman, 
    266 S.W.3d 395
    , 401 (Tenn. 2008)). In construing statutes, Tennessee law
    provides that courts are to avoid a construction that leads to absurd results. Tennessean v.
    Metro. Gov’t of Nashville, 
    485 S.W.3d 857
    , 872 (Tenn. 2016). “Furthermore, the
    ‘common law is not displaced by a legislative enactment, except to the extent required by
    the statute itself.’” Wlodarz v. State, 
    361 S.W.3d 490
    , 496 (Tenn. 2012) (quoting
    Houghton v. Aramark Educ. Res., Inc., 
    90 S.W.3d 676
    , 679 (Tenn. 2002)), abrogated on
    other grounds by Frazier v. State, 
    495 S.W.3d 246
    (Tenn. 2016). “When statutory
    7
    language is clear and unambiguous, we must apply its plain meaning in its normal and
    accepted use, without a forced interpretation that would extend the meaning of the
    language . . . .” 
    Carter, 279 S.W.3d at 564
    (citations omitted).
    The false insurance claim statute criminalizes two courses of conduct. The
    elements of the first prohibited course of conduct are as follows: (1) intentionally; (2)
    presenting or causing to be presented; (3) a false or fraudulent; (4) claim or any proof in
    support of such claim; (5) for the payment of a loss or other benefit; (6) upon any
    contract of insurance coverage. See Tenn. Code Ann. § 39-14-133. The elements of the
    second prohibited course of conduct are as follows: (1) preparing, making, or
    subscribing to; (2) a false or fraudulent; (3) account, certificate, affidavit or proof of loss,
    or other documents or writing; (4) with intent; (5) that the same may be presented or used
    in support of; (6) a claim for the payment of a loss or other benefit; (7) upon any contract
    of insurance coverage. See 
    id. The defendant
    was charged with engaging in the first
    prohibited course of conduct.
    The majority of the Court of Criminal Appeals panel held that the proof was
    insufficient to support the defendant’s conviction of this offense because “[t]he defendant
    legally, and under the policy, did not initiate a claim because he did not file the necessary
    and required documentation pursuant to the policy, including a proof of loss, in the
    requisite time period.” Mitchell, 
    2018 WL 6439502
    , at *12. The intermediate appellate
    court relied on the Policy’s technical requirements attendant upon filing a claim and
    concluded that “the defendant in this case did not meet the conditions precedent to filing
    a claim.” 
    Id. The majority
    reasoned,
    While the defendant made Allstate aware that there had been a fire, he did
    not file any documentation to support his filing of a claim for the initiation
    of a claim. Further, he did not comply with the requirements for filing a
    claim because he did not file a proof of loss. For the same reasons that
    Allstate could have denied the defendant coverage for not adequately filing
    a claim, we conclude that the evidence is insufficient to support that he
    fraudulently filed an insurance claim against Allstate.
    Mitchell, 
    2018 WL 6439502
    , at *12 (emphasis added). The majority dismissed the
    significance of the Advance Payment Agreement that the defendant signed and the
    $1,000 advance payment that Allstate made to the defendant thereunder on the basis that,
    “[b]y the plain language of the agreement[,] the $1,000 is an advance, and not part of the
    coverage pursuant to the policy.” 
    Id. Judge John
    Everett Williams dissented from the majority’s holding that the
    evidence was not sufficient to support the defendant’s conviction for presenting a false or
    fraudulent insurance claim, reasoning as follows:
    8
    The majority reasons that the defendant did not initiate a claim
    because he did not submit the documentation required to file a claim under
    the insurance policy, including a proof of loss, in the requisite time period.
    In my opinion, the language of Tennessee Code Annotated section 39-14-
    133, which criminalizes insurance fraud, is broad and does not limit a
    conviction for the offense to those instances in which a defendant has
    adhered to the provisions and niceties of the insurance policy. Under the
    majority’s analysis, an insurance company may determine what constitutes
    a criminal offense for filing a false insurance claim through its provisions in
    its insurance policies. Had the legislature intended for insurance companies
    to have such authority, the legislature would have stated so in the statute.
    Mitchell, 
    2018 WL 6439502
    , at *13 (Williams, P.J., concurring in part and dissenting in
    part). We agree with Judge Williams’ reasoning.
    Initially, we note that, as defined in our criminal code: “‘Fraud’ means as used in
    normal parlance and includes, but is not limited to, deceit, trickery, misrepresentation and
    subterfuge, and shall be broadly construed to accomplish the purposes of” the criminal
    code. Tenn. Code Ann. § 39-11-106(13) (2010).
    The false or fraudulent insurance claims statute does not define the word “claim.”
    However, when a statute does not define one of its terms, we may turn to other sources
    for guidance, including Black’s Law Dictionary. See, e.g., State v. Edmondson, 
    231 S.W.3d 925
    , 928 (Tenn. 2007) (“When the Legislature does not provide a specific
    definition for a statutory term, this Court may look to other sources, including Black’s
    Law Dictionary, for guidance.”); see also, e.g., State v. Fitz, 
    19 S.W.3d 213
    , 216 (Tenn.
    2000) (relying on Black’s Law Dictionary for guidance in construing the word “violence”
    as used in the robbery statutes). Black’s Law Dictionary defines “claim,” as apposite in
    this context, as “[t]he assertion of an existing right; any right to payment or to an
    equitable remedy, even if contingent or provisional.” Black’s Law Dictionary (11th ed.
    2019), available at Westlaw BLACKS. In addition, Black’s offers a subordinate
    definition of “insurance claim”: “A policyholder’s formal report to an insurance company
    about a loss with a request for a payment based on the insurance policy’s terms.” 
    Id. Significantly, the
    statute does not use the term “insurance claim.” Rather, it uses
    the much broader term, “claim.” Moreover, as Judge Williams recognized, the statute is
    drafted very broadly. The statute’s clear and unambiguous intent is to criminalize a
    person’s intentional efforts to obtain monies under an insurance contract through the
    presentation of false or fraudulent information to the insurer. The statute does not require
    any precise methodology that a person must follow in his efforts to convince an insurance
    company, through the provision of false or fraudulent information, to pay him money
    under an insurance policy.          The statute certainly does not criminalize some
    9
    methodologies and not others based on the technical requirements of different insurance
    policies.
    In this case, the Policy required the defendant to submit a written proof of loss
    within sixty days of the loss. Well within that time frame, however, Allstate concluded
    that the fire was not a covered loss. Therefore, any proof of loss subsequently submitted
    by the defendant would have been pointless. More importantly, within a few days of the
    fire, the defendant made sufficient verbal representations to Allstate to cause Allstate to
    assign a claim number to the alleged loss and to make an advance payment of $1,000 to
    the defendant, pending further investigation. The defendant accepted this payment and
    signed the Advance Payment Agreement, which refers repeatedly to “the claim.” The
    defendant’s words and actions represented to Allstate that the fire was a covered loss
    under the Policy, that is, a “sudden and accidental direct physical loss” to the defendant’s
    house and its contents. (Emphasis added). Thus, it can certainly be inferred that the
    defendant was claiming that the fire was accidental based on his conduct in this case.
    The defendant’s signature on the Advance Payment Agreement also indicated that
    he understood that the advance payment was provisional pending further investigation of
    his claim prior to an eventual payment under the Policy. The Court of Criminal Appeals’
    majority opinion emphasized that, because the $1,000 delivered to the defendant pursuant
    to this Agreement “shall not be considered payment under any portion of the policy,” the
    $1,000 was not payment of a claim under the Policy. This interpretation elevates form
    over substance. The common-sense construction of the Advance Payment Agreement is
    that it enabled Allstate to alleviate an insured’s immediate financial concerns resulting
    from an alleged covered loss while also allowing it to investigate the alleged loss and
    determine whether a covered loss had been established. If Allstate then determined that
    the alleged loss was not covered by the policy, Allstate was not obligated to pay any
    benefits under the policy. Indeed, in that event, the recipient of the advance payment was
    obligated to repay it to Allstate. The Court of Criminal Appeals erred in interpreting the
    advance payment, and the defendant’s acceptance thereof, as independent, separate, and
    distinct from the underlying Policy and the defendant’s apparent intent to recover under
    the Policy.
    We conclude that the defendant’s conduct satisfied the statute’s elements of
    intentionally presenting a false or fraudulent claim because, in making his verbal
    representations to Allstate representatives, signing the Advance Payment Agreement, and
    accepting the $1,000 advance payment, the defendant was clearly and unambiguously
    asserting a right to payment under his homeowner’s policy, even if that right was
    contingent or provisional insofar as Allstate had the contractual right to require further
    documentation, such as a written proof of loss, for final payment. The defendant’s words
    and conduct were fraudulent because they involved, at a minimum, “subterfuge” and led
    Allstate to consider, at least provisionally, that the fire was a covered loss. Because the
    Policy entitled the defendant to recover losses resulting from accidental direct physical
    10
    losses, and because the jury determined that the fire was not accidental but, rather, was
    set deliberately by the defendant, the jury was entitled to conclude that the defendant had
    violated the statute prohibiting the presentation of a false or fraudulent insurance claim.
    In short, the evidence in this case presented the jury with a textbook example of
    presenting a false or fraudulent insurance claim. The defendant intentionally informed
    Allstate that there had been a fire at his house. His description of the fire to Allstate and
    ELI clearly implied that the fire had been accidental. He subsequently accepted a
    payment and signed a document referring to his claim in conjunction with Allstate
    investigating his report. The defendant’s words and conduct clearly implied to Allstate
    that he considered the fire to be a covered loss under the Policy, i.e., accidental; however,
    the jury determined that he set the fire knowingly. Thus, the defendant’s words and
    conduct entitled the jury to conclude that the defendant intentionally presented a false or
    fraudulent claim for the payment of a loss or other benefit upon the Policy.
    Accordingly, we conclude that the proof was sufficient to support the jury’s
    conclusion that the defendant violated the false or fraudulent insurance claims statute.
    The Court of Criminal Appeals committed reversible error in concluding otherwise.
    IV. CONCLUSION
    We conclude that the proof was sufficient to support the defendant’s conviction of
    presenting a false or fraudulent insurance claim. Therefore, we reverse the decision of
    the Court of Criminal Appeals on this point and reinstate the defendant’s conviction of
    presenting a false or fraudulent insurance claim in the amount of $10,000 or more but less
    than $60,000.
    _______________________________
    JUSTICE ROGER A. PAGE
    11