Insurance plays a vital role in protecting Floridians from losses that arise as a result of automobile theft, car accidents, or property damage from fires, floods, and hurricanes. Life insurance is also crucial for providing needed financial resources to families after a loved one’s death. Because of the vast sums of money that are available for claims, insurance fraud has become increasingly common.

Herman Law, P.A routinely defends clients against insurance fraud charges in Ft. Lauderdale, West Palm Beach and throughout the South Florida area. If you have been accused of insurance fraud, our experienced white collar crime defense attorneys will aggressively fight for your rights.

What is insurance fraud?

Generally, insurance fraud occurs when individuals or businesses intentionally deceive insurance companies to receive money to which they are not entitled. This is not a victimless crime because insurance fraud costs insurance companies billions of dollars each year, costs that are ultimately borne by consumers in the form of higher premiums. For this reason, the state vigorously prosecutes insurance fraud.

This crime can involve a wide range of activities, including:

  • Knowingly presenting a false claim to an insurer for payment
  • Providing false, incomplete or misleading information to an insurer concerning a claim
  • Presenting a false application to an insurer to obtain an insurance policy
  • Concealing information regarding an insurance application or claim

In any case, insurance fraud in Florida is charged as a felony. Depending on the circumstances, civil or criminal charges may apply. A criminal conviction can lead to a lengthy prison sentence, significant fines and a permanent criminal record. In a civil case, those accused typically face fines and other penalties and may be ordered to pay restitution.

Common Insurance Fraud Schemes

There are a wide range of insurance schemes that are common throughout the South Florida area, such as:

  • Stolen Car -This crime generally occurs in two ways. First, a car owner will sell his or her car to a body shop (or “chop shop”) to be cut up for parts, and then report the car stolen. Another scheme involves an owner selling a car overseas without any paperwork and then reporting it stolen.
  • Staged Car Accident -In this scenario, a driver and an accident “victim” stage an collision so that they can recover money for the auto damages. At times, the driver, the victim, bystanders and insurance investigators are all involved in the scheme to recover a payoff for the totaled vehicles.
  • Staged Home Fire – A  common form of fraud involves staged home fires or acts of vandalism that occur when the homeowner is not home. Individuals are hired to set fire to the home or break in and vandalize it, to make it appear as if the homeowner was victimized.
  • Storm Fraud – Given that South Florida has seen catastrophic hurricanes and flooding over the years, some homeowner’s have taken advantage of major storms by enhancing the storm damage to their homes to get a higher settlement or submit claims for damage that did not occur.
  • Faked Death -This form of insurance fraud is not a mere plot of a crime story. In fact, it is not uncommon for individuals to take out life insurance policies, name their spouses as beneficiaries, and then fake their death so that the spouse is paid the death benefit.

Elements of Insurance Fraud

Under Florida law, in order to prove insurance fraud, investigator’s must be able to demonstrate the following three elements:

  1. The accused knowingly made a false or misleading statement in an insurance claim
  2. The false statement was made or intended to be made in connection with a claim or a payment made
  3. The statement was material to the case

Types of Insurance Fraud

Insurance fraud is generally classified in two categories: soft fraud and hard fraud.

  • Soft Fraud – This form of fraud occurs when an individual submits a claim that overestimates the damages to maximize the value of a claim. For example, claiming a car was totaled in a minor fender bender.  Soft fraud is considered a felony, punishable by up to one year in prison and a fine up to $5,000.
  • Hard Fraud –  Involves someone fabricating a loss from an accident, injury, theft, or arson with the intent to defraud an insurance company. Depending on the value of the payments made, hard fraud can be charged as a first-degree felony, punishable by up to 30 years in prison and up to $50,000 in fines.

South Florida Insurance Fraud Defense Attorney

Herman Law, P.A. has extensive experience defending clients against insurance fraud charges. We are well versed in the state’s insurance fraud laws and the tactics investigators rely on when pursuing these cases. Ultimately, they must be able to show that there was intent to defraud, which is a high threshold. We will design a strategy to refute their claims and work diligently to protect your rights. Because insurance fraud is a serious crime, the penalties can be harsh. We will provide an aggressive defense in order to protect your freedom and your future. If you are facing insurance fraud charges, call our office today for a free consultation.

Herman Law, P.A. serves clients in Ft, Lauderdale, West Palm Beach, Martin, Okeechobee and Palm Beach Counties and throughout South Florida