Some insurance companies try to play hardball after a claimant makes a claim against them and threatens to charge them with insurance fraud. Insurance fraud is a serious offense that can lead to felony charges in some cases. If you were accused of any type of insurance fraud, it is vital you contact an experienced insurance fraud lawyer who can explain the charges against you and how to dispute a false insurance claim.
What Is Insurance Fraud?
Insurance fraud occurs when someone lies to obtain a benefit or advantage to which they are not entitled. Some common acts that often lead to a prosecution of insurance fraud include:
- False claims – A false claim occurs when someone fabricates a claim, such as reporting an accident that did not occur or a medical office billing insurance for services it never provided. Examples of false claims include faking an injury at work, auto collision claims where an uninsured driver is concealed, intentionally damaging property, such as a home to make a claim, and a medical professional or mechanic billing for services not performed.
- Exaggerated estimates – Exaggerated estimates may be sent to an insurance company for payment. For example, a person may try to get old vehicle damage covered under a current auto insurance claim.
- Underreporting – A policyholder may underreport information to save money on insurance premiums, such as an employer underreporting the number of workers they want to be covered.
- Misreported damages – A claimant may report damages that did not occur, along with damages that did occur, such as listing items that were not stolen in a homeowner’s insurance claim for burglary.
What Kinds of Insurance Fraud Are There?
There are many different kinds of insurance fraud. Insurance fraud can be committed by individuals, employers, businesses, insurance companies, and others. Insurance fraud can apply to any type of insurance product, including:
- Auto insurance fraud
- Health insurance fraud
- Home insurance fraud
- Life insurance fraud
- Medicaid fraud
- Medicare fraud
- Property insurance and casualty fraud
- Workers’ compensation fraud
The California Department of Insurance has identified more than 60 distinct types of insurance fraud.
What Are the Consequences of Insurance Fraud?
A conviction for insurance fraud can range from probation to five years imprisonment, fines, community service, and restitution.
Insurance fraud punishment in California depends on the type of alleged insurance fraud and the value of ill-gotten gains, as described below:
- Felony insurance fraud – Up to five years imprisonment and a fine of $50,000 or double the amount of the fraud
- Misdemeanor health care benefits fraud – For fraud less than $950, up to six months in county jail and a $1,000 fine; for fraud more than $950, up to one year in county jail and a $10,000 fine
- Felony health care benefits fraud – Two, three, or five years imprisonment and a fine of $50,000 or double the amount of the fraud
- Destruction of insured property – Two, three, or five years imprisonment and a fine of $50,000
Additionally, you will likely be ordered to pay restitution.
The penalties described above can be stricter when the defendant has previous convictions of insurance fraud, or someone suffers serious bodily injury in a case involving vehicle fraud.
Get Help from Our Attorneys at Lamano Law
The stakes are high, so it’s vital that you take prompt action to protect your legal rights and freedom. Contact an experienced insurance fraud attorney from Lamano Law to begin mounting a solid defense.
