Insurance Fraud

Herman Law discusses one of the most common white collar crimes: insurance fraud.

White-collar crime refers to a financial crime that involves things like deception or misappropriation of funds. While you may see CEOs and wealthy entrepreneurs facing white collar crime charges such as embezzlement or tax evasion, among other things, anyone can be involved in white-collar crime and face white collar crime charges.  One of the most commonly charged white collar crimes is insurance fraud. In fact, insurance fraud has overtaken tax evasion as one of the more commonly charged white collar crimes in recent years.

Insurance Fraud: One of the Most Common White Collar Crimes

Generally speaking, insurance fraud involves any fraudulent act that is committed with the intent to receive improper payment from an insurer. While insurance fraud falls under the white-collar crime category, it is a category in and of itself that includes a range of different types of fraud involving insurance. For instance, the following are examples of insurance fraud:

  • Government benefit fraud (including Medicare fraud)
  • Healthcare fraud
  • Driver’s insurance fraud

Government benefit fraud may also include things like receiving unemployment benefits or welfare to which you are not entitled. Driver’s insurance fraud may include things like faking an accident injury to recover insurance benefits you are not really entitled to. One of the most common ways that driver’s insurance fraud occurs is when a person recovers insurance proceeds to fix damage to their vehicles and, instead of using the money to get the car fixed, keeps it or spends it on something else. There are also instances where a person will claim that his or her vehicle was stolen when in fact it wasn’t. The person actually sells the car and then recoups the insurance money.

Health care providers can face charges for health care fraud if they have done something like proceed with unnecessary medical procedures on a patient in order to get paid by health insurance. There are also instances of health care providers billing for services that were not actually provided or inflating a bill so that health insurance is charged for more than they should be.

In order for a prosecutor to succeed in bringing an insurance fraud case against a defendant, he or she must prove, beyond a reasonable doubt that:

  • The defendant knowingly made a false or misleading statement;
  • The statement was made in connection with an insurance claim or payment; and
  • The statement was material to the outcome of the claim.

Trusted Insurance Fraud Defense Counsel

Insurance fraud may be charged at the state or federal level. In either instance, serious penalties await those convicted. Furthermore, if any other crime was involved in the perpetration or covering up of the insurance fraud, additional criminal charges are likely to follow as well. The consequences to your personal, professional, and financial life are steep and you may never be able to recover what you have lost because of an insurance fraud conviction. Don’t go up against the system alone. Contact Herman Law, P.A. today.