Insurance Fraud

If you collected insurance payments you were not entitled to, it may have been a one-time mistake you regretted deeply. But insurance companies will be relentless in tracking you down and seeing you are prosecuted.

If you are arrested for insurance fraud, you can face harsh repercussions that include prison and having to pay restitution. If you are questioned by the police or charged, you will need to retain an experienced defense attorney.

What You Need To Know About Insurance Fraud

In Pennsylvania, you can be up against insurance fraud charges if you:

• Knowingly and with intent to defraud, provide an insurer with false or misleading statements about a claim.
• Knowingly and with intent to defraud, provide an insurer with documents that have false or misleading information that would cause them to approve or disapprove motor vehicle insurance rates or actions.
• Knowingly and with intent to defraud, help or conspire with someone else to present false or misleading claims to an insurer. This includes information that you falsely create to support an amount that is in excess of the actual loss sustained by the claimant.
• Hire someone to defraud an insurer.
• Use someone else’s insurance identification card to present a fraudulent insurance claim.

For example, if your home is flooded and you turn in a claim to your homeowner’s insurance company to be reimbursed for the loss of expensive furniture, art and electronics you never actually owned, you risk being convicted of insurance fraud.

You can also face insurance fraud charges if you are the owner, administrator or employee of a health care facility and you knowingly allow that facility to be used in an insurance fraud scheme.

If you are arrested for insurance fraud, you are at risk of a third degree felony conviction. The court may also order you to make restitution.

You are also likely to face civil action by the insurance company.

What To Do If You Are Charged

If you are charged with insurance fraud, do not anger the arresting officer unnecessarily. At this stage, do not discuss what happened with the police or claim your innocence.

• As with most criminal charges, you should not talk to the police or prosecutors without your attorney by your side. What you say can be taken out of context and used against you.
• If the police question you, tell them you want a lawyer and politely refuse to answer their questions.

What Your Lawyer Can Do

Your attorney will carefully review every aspect of your case to determine if there is evidence for all you have been accused of.

• Your lawyer will make every effort to discredit any evidence not in your favor.
• Much of what your lawyer can do to help you will depend on the exact circumstances of your case.
• You may have acted without criminal intent. If so, your lawyer will gather the evidence or witnesses to prove it.

Your lawyer will be looking at every avenue that can help you, so it’s important that you give them all of the information that can support your case.

How A Lawyer Will Help

When you are up against an insurance fraud charge, even before your first hearing you will be facing a determined prosecutor. You need an attorney who will stand by you every step of the way, work hard to discredit any evidence – and work with you to determine your best course of action.

Pennsylvania Insurance Fraud Law

Insurance fraud is described and defined under The Pennsylvania Criminal Code under Title 18, Chapter 41. Read the code here.