Insurance fraud is a serious criminal offense that involves deliberately deceiving an insurance company for financial gain. It happens when someone provides false information to an insurer to obtain benefits or money they are not entitled to receive for non-existent or exaggerated losses.
Submitting any type of false insurance claim is a felony in the state of Florida. Conviction can lead to jail time, fines, and financial restitution.
If you are under investigation or been charged with it, the defense attorneys at Farkas & Crowley are experienced in white-collar criminal cases and have considerable experience in both state and federal courts in Florida.
There are two major categories of insurance fraud:
• Hard Fraud, where someone intentionally destroys property for the sole purpose of collecting an insurance payout
• Soft Fraud, where someone files a legitimate claim and exaggerates the degree of losses suffered. Alternatively, a person applies for an insurance policy and gives misleading or incorrect information about medical conditions or other circumstances to ensure a lower premium.
The most common types include:
• Auto insurance fraud:
o Filing false or inflated theft repair claims
o Staging accidents
o Falsifying accident dates or circumstances to obtain coverage
• Homeowner insurance fraud:
o Submitting false or inflated property damage claims
o Filing falsified burglary reports
o Committing arson for insurance payouts
• Health insurance fraud:
o Billing for services not provided
o Overcharging for services
o Providing unnecessary treatments
• Life and disability insurance fraud:
o Filing fake death claims
o Submitting falsified beneficiary claims
o Making fraudulent disability claims
• Workers’ compensation fraud:
o Working while collecting benefits
o Acting injured
o Claiming non-work-related injuries as work-related
The impact of insurance fraud is estimated at $40 billion every year in the US for non-health insurance fraud alone. Therefore, the penalties can be severe.
Florida Statutes 817.234 details the conditions and criminal penalties for insurance fraud in The Sunshine State, which is based on the amount of money involved:
• For less than $20,000, a third-degree felony, up to five years in prison
• Between $20,000 and $99,999, a second-degree felony, up to fifteen years in prison
• For $100,000 or over, a first-degree felony, up to thirty years in prison
Other criminal charges may be included, such as conspiracy, or federal charges such as money laundering, tax fraud, and wire fraud.
A conviction may also lead to civil penalties, including:
• A $5,000 fine for a first-time offense
• Fines of $5,000 to $10,000 for a second offense
• Fines of $10,000 to $15,000 for a third (or subsequent) offense
• Fines of $15,000 to $50,000 for staging an intentional motor vehicle accident or falsifying documents for a non-existent motor vehicle accident to wrongfully file a tort claim or file a claim for personal injury protection (PIP) funds.
Doctors, hospitals, and other facilities that participate in such fraud can lose their licensing and accreditation. Additionally, the other parties that are affected may also file their separate claim for civil action separate from the criminal and civil cases.
A defense specific to your case will depend on its circumstances. The priority is to disprove the element of fraud through:
• The lack of intent
• The lack of evidence
• Mistake of fact by the policyholder, the evidence used was not fraudulent
• Unintentional misrepresentation, where the policyholder believed the damage to be as extensive as they claimed and had no intention to defraud the insurer
• The value of the property
• Proof that the insurer did not suffer a loss
Because every case is different, we will examine the facts to find the best defense for you.
Investigations take time before a person is charged. It is crucial to seek legal advice from an attorney who specializes in insurance fraud and criminal defense as soon as possible. Do not speak with law enforcement or any other authority until you speak with us first. Our experienced defense lawyers can help you navigate the complexities of the investigation and provide guidance on how to proceed.
Gather up the documents and information involved in the claim that’s being investigated as fraudulent. Include all relevant documents, such as insurance policies, correspondence with the insurance company, and any other paperwork that could support your case. Keep detailed records of all interactions and communications related to the insurance claim in question so you can relay the information to your attorney as needed.
If you do discover that you’re the target of an insurance fraud investigation, contact our office immediately so we can begin building your defense.
Insurance fraud includes harsh consequences if you’re convicted. Get ahead of the case by seeking representation to protect your rights before you are arrested and/or charged. You need a strong criminal defense attorney who can represent you in both state and federal court for the defense.
These nonviolent crimes can still lead to harsh penalties. If you are facing insurance fraud charges in West Palm Beach, contact Farkas and Crowley P.A. immediately. We are available 24/7, whenever you need us. Call (561)-444-9529 or contact us online to schedule your consultation.
Looking for a criminal law firm? Farkas & Crowley, P.A. are the attorneys for you. They are extremely knowledgeable of the law and go the extra mile for their clients. Their expertise and impeccable work ethic are hard to beat. Available 24/7. Highly recommended.
-Marla Newman
500 S. Australian Ave.
6th Floor
West Palm Beach, FL 33401
(561) - 444 - 9529
Mon - Fri: 9 am – 5 pm
The information on this website is for general information purposes only. Nothing on this site should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing does not constitute an attorney-client relationship. No content on this site may be reused in any fashion without written permission from criminal defense attorneys at Law Office of Farkas & Crowley, P.A.
The information on this website is for general information purposes only. Nothing on this site should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship. No content on this site may be reused in any fashion without written permission from criminal defense attorneys at Law Office of Farkas & Crowley, P.A.
