Insurance Fraud Charges

A person will be charged with insurance fraud if suspected to have committed any set of actions that lead to an insured individual fraudulently benefitting or getting paid by their insurer. These criminal charges can take many forms and can occur in any scenario involving an insurance policy.

Insurance fraud is a serious offence, especially given that insurance companies are typically very large, with the resources to push for hefty fines and stiff penalties for accused persons. If you are facing these charges, you need to get an experienced criminal defense attorney with proper mastery of insurance law and trial advocacy. Contact the Law Office of Stephan Jacob Siegel, Esq. as soon as possible after you suspect you’re under investigation or have been arrested.

Types of Insurance Fraud

Insurance fraud is more than just assigning blame to another person in the event of an accident so that the insurance can cover the costs. There are many types of insurance frauds covered by NY law as there are schemes, insured parties and employees. The following are just a few examples:

  • Health insurance fraud – by policyholders or care providers
  • Auto/car insurance fraud – vehicle dumping, staged accidents, exaggerated injury following accidents, fake repairs, false addresses, etc.
  • Life insurance fraud – stealing premiums, fraudulent up sales, annuity frauds, buying seniors’ policies, etc.
  • Dental insurance fraud
  • Employment insurance fraud
  • Disability insurance fraud
  • Medicare insurance fraud
  • Travel insurance fraud
  • Home insurance fraud
  • Mortgage insurance fraud
  • Title insurance fraud
  • Arson insurance fraud
  • Renter’s insurance fraud
  • Jewelry insurance fraud
  • Phone insurance fraud

The burden rests with the prosecution to prove that the accused party offered misleading statements or false information about material facts to an insurance company so as to gain some benefit/value.

Insurance Fraud

Insurance Fraud Laws

Most fraud cases are prosecuted at state level. There are specific sections of law to cover insurance fraud – in New York this is found in the NY Code, Article 176. These charges can be brought in the first to the fifth degree according to the value of the funds/benefits fraudulently obtained.

Fifth degree insurance fraud is a Class A misdemeanor and covers crimes not exceeding $1,000. However, all other degrees are at felony level. Fraud related to government-initiated programs, however, is prosecuted as a federal charge.

Jail Time for Insurance Fraud

The law exerts very stiff penalties on persons found guilty of insurance fraud offenses, especially if the fraud was perpetrated in connection with a government-initiated program like Medicare/Medicaid. The following are just a few examples of this.

  • Up to $10,000 civil if guilty of making false claims to get health service payments
  • Up to five years’ imprisonment for falsifying or misrepresenting material facts to get unlawful payments from federal insurers
  • Up to 10 years in jail for defrauding health care programs in any way

Given that there are many insurance fraud offenses, it’s important to speak with a knowledgeable and experienced attorney in the area of NY insurance law. This way, you can be sure about the exact nature of the charge being brought against you, as well as the penalties you may be facing on conviction.

For instance, communicating with an insurer through post, mail or wire is a charge that can attract up to 20 years’ imprisonment on conviction. Contact the Law Office of Stephan Jacob Siegel, Esq. if you’re facing this kind of charge, and let our knowledge and experience work to your best advantage.

Insurance Fraud Criminal Charges