Have you been accused of committing insurance fraud?
Understanding insurance fraud
New Jersey defines insurance fraud as knowingly deceiving an insurance company. This deception can take many forms, including verbally, in writing, and through electronic communication.
Regardless of the method, anyone who intentionally leaves out important facts, embellishes the truth, or lies about an insurance claim, policy, or application is committing fraud. It’s generally considered a serious crime. But in situations where a defendant accidentally provided wrong information, there may be opportunities for greater leniency.
Are you facing insurance fraud charges and unsure how to protect your rights? Contact Dughi, Hewit & Domalewski to begin building a proactive defense today.
Types of insurance fraud
The circumstances under which insurance fraud occurs are diverse. However, insurance crime usually falls under two categories: hard and soft. Understanding the type of insurance fraud you have been accused of is essential to building your defense and navigating the legal process effectively.
Hard insurance fraud
Hard insurance fraud occurs when an individual deliberately causes or entirely fabricates a fraudulent insurance claim. It is often premeditated and executed carefully.
Examples of this include:
- Faking a home burglary to claim reimbursement for “stolen” property
- Using someone else’s health insurance card to avoid paying full price for a lab test
- Hiring someone to “steal” and/or crash a vehicle to submit a property casualty claim
- Deliberately staging a workplace injury to obtain workers’ compensation funds
- Faking one’s own death to collect life insurance funds
- A doctor conducting unnecessary medical procedures, or billing for procedures that were not completed, to collect higher payouts from Medicaid or private medical insurance companies
It’s worth noting that insurance providers are not always the victims in hard insurance fraud cases. In some cases, the roles are reversed. Illegitimate companies and dishonest agents or brokers may also commit insurance fraud against consumers by collecting premiums for insurance policies they have no intention or ability to pay claims on.
Soft insurance fraud
Soft insurance fraud occurs when a person exaggerates a legitimate insurance claim or “stretches” the truth to obtain coverage.
Although people may consider soft fraud to be less “serious” than hard fraud, it is still a crime that can lead to serious consequences. Examples include:
- Providing misleading information about pre-existing health conditions to secure a lower health insurance premium
- Exaggerating the injuries sustained in a car accident to obtain a larger payment
- Overstating the value of belongings covered by a renter’s or home insurance policy
- A doctor inflating the severity of real injuries in medical records or medical tests completed to obtain a larger payout from Medicaid or a private health insurance company
- Lying on an insurance application or using something else’s personal information to fraudulently obtain insurance coverage
- “Padding” a property casualty insurance claim by including items that were not damaged
The consequences of insurance fraud
New Jersey has strict penalties for people who are convicted of insurance fraud. If you have been accused of fraud, contact an experienced criminal defense attorney as soon as possible.
The severity of fraud charges—and penalties—depends on the amount of money involved, the number of victims, and the overall impact of the suspected fraud. The consequences could face include:
- Fines
- Imprisonment
- Restitution (paying back money)
- Loss of professional licenses
- Damage to your reputation and career
Less serious fraud schemes are sometimes charged as disorderly persons offenses, which carry a maximum penalty of six months in jail and a fine of up to $1,000. On the other hand, hard fraud charges can be punishable by several years in prison and fines ranging from $15,000 to $150,000.
In addition to fines imposed by the state, you may also be required to pay back the money you allegedly obtained by committing fraud.
A conviction of criminal insurance fraud can also affect your employment and housing opportunities, as many employers or landlords may view fraud charges as a sign of poor moral character.
Above all, remember—you have the right to an attorney, and exercising that right doesn’t imply that you’re guilty. In fact, seeking legal counsel is the best thing you can do to minimize the negative impact of fraud allegations.
Don’t attempt to fight fraud charges on your own. Protect your reputation and future by contacting an attorney you can trust.
Dealing with insurance fraud? Consult with an attorney
You need a strong defense—and an attorney you can trust.
Unraveling accusations of insurance fraud can feel frustrating, especially if you do not believe you’re guilty of committing a crime in the first place. At Dughi, Hewit & Domalewski, we take pride in acting as our clients’ advocates during this challenging time.
Our team of dedicated attorneys has extensive experience fighting for clients accused of insurance fraud. We have the skills to navigate the complexities of insurance fraud cases efficiently and compassionately and with the least damaging results.
Take the first step toward defending insurance fraud allegations by contacting us now to schedule your consultation with our team and learn more about your options.
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