Insurance Fraud Lawyer | Insurance Fraud

Insurance fraud is a common white-collar crime that changes the intention of insurance from a risk protection plan to a money-making scheme.

If you have charges relating to insurance fraud, you need to take immediate steps to prevent strict punishment. Insurance fraud is a complex charge, and you need to hire a  professional insurance fraud lawyer to handle the case.

What is Insurance Fraud?

Insurance fraud is a process of intentionally breaking an insurance contract. The insurance provider or buyer can commit insurance fraud.

Insurance fraud happens on the providers’ part when they refuse to submit premiums, sell policies illegally, refuse to honor claims, and alter policies to make more profit or commissions.

On the buyer’s side, insurance fraud is when buyers use false information when buying policies, staging events that will pass as an accident, exaggerating claims, and using other means of getting money justly from issuers.

Examples of Insurance Frauds

Insurance fraud occurs in almost every field, although some insurance fields are more susceptible. Here are typical examples of insurance fraud: 

Health Insurance Fraud

Health insurance fraud is a prevalent example of the phenomenon because it cuts across almost all sectors, including automobile and property insurance. Health insurance fraud can happen in different forms. The healthcare facility may modify prices for treatment and include false or exaggerated medical reports to get more money. 

Insurance buyers or employees under an organization’s insurance coverage may also connive with health practitioners to falsify medical reports such as a workplace accident to gain more compensation.

Also, health insurance fraud may be inputting false information when filling application forms for medicare and other health insurance programs.

Workers Compensation Fraud

It happens when employers find a means to reduce compensation for their workers. They may do this while including their employees in their coverage by misinforming providers on the duties of their employees. Most times, they try to undermine the work risk to reduce compensation in the event of any occurrence.

Also, employees can be guilty of compensation fraud. They may fake accidents or work with health staff such as doctors to give fake diagnoses and exaggerate the extent of the injury.

Unemployment Insurance Fraud

Unemployment insurance fraud involves enjoying unemployment benefits from the government even when you are not eligible. Employers are guilty of this fraud when they try to evade tax for a particular employee account.

Claimants are also guilty of unemployment insurance fraud when they intentionally provide false information filling their employment status forms. They receive state benefits for unemployment when they are employed or are not eligible for unemployment insurance.

Auto Insurance Fraud

It is also widespread insurance fraud. There are different ways to commit auto insurance fraud. One way is by doing a fake registration. It may be false information about your address; you may fill in a low-risk location as your address to decrease the premium for your car coverage.

It can also be staging an accident or damage to your vehicle to receive excessive compensation. Car repairers may also give an overpriced estimate for car damage to receive more money from insurance providers.

Federal Insurance Laws

You have committed insurance fraud if you are guilty of these charges:

  • Intentional effort to break the insurance agreement.
  • Have completed the illegal process. For example, the offender has collected undue compensation.

Several federal bodies regulate insurance fraud, such as;

  • National Insurance Crime Bureau (NICB)
  • Coalition Against Insurance Fraud (CAIF)
  • National Association of Insurance Commissioners (NAIC)
  • Reputable insurance company
  • Federal Bureau Of Investigation (FBI)

Insurance Frauds Punishment

There are two significant categories of insurance fraud. The first category is soft fraud. Soft fraud occurs when an individual falsifies information to reduce the premium or increase compensation depending on the situation. It is also when insurance providers conduct processes that help them to gain more money.

Hard fraud occurs when an individual intentionally destroys a property or stages an accident to get compensation. Soft fabrication has less punishment. Individuals or organizations found guilty pay fines, short jail terms, probation, or community service.

Hard fraud has stricter punishment. The standard penalty is a long prison sentence. Insurance fraud punishment depends on the state you commit the crimes. 

Is Insurance Fraud a Felony?

Insurance fraud is a felony if it’s a hard fraud. The extent of damage is assessed; if there is massive property destruction or loss of lives, you can be charged with a felony. Also, if the compensation or money you have gained from insurance fraud is enormous, you can be charged with a felony.

How to Defend Yourself from Insurance Fraud Charges

Insurance fraud is a punishable offense under the law. Organizations or individuals involved in the act pay a considerable fine and, depending on the severity of the fraud, can face a prison term.

You need the help of an expert insurance fraud attorney. Zoukis Consulting Group offers professional attorneys that can represent you. Our attorneys can help to prevent or reduce the fines, years of imprisonment, and other punishments you may be vulnerable to when facing insurance fraud charges.

Schedule a free consultation with Zoukis Consulting Group today.