What to Know About Insurance Fraud

You may have been hearing more about insurance fraud lately. So what exactly is it?

This crime can be committed in various ways by various parties, including consumers and insurance providers themselves. 

Essentially, if someone seeks to game the system for their own benefit, they may face serious consequences as a result.

Here’s what to know about insurance fraud, including some examples of what it looks like.

What is insurance fraud?

Insurance fraud is when someone makes a false or exaggerated insurance claim in order to seek unwarranted payment from their provider. It also describes instances where insurance companies sell bogus claims to consumers.

These types of crimes exist on a spectrum: hard fraud, such as faking a total loss or injury to make a claim, and soft fraud, which is changing the details of a specific incident to refile a claim or seek more benefits. Both instances are illegal, though consequences may vary.

Some common examples of insurance fraud include:

  • Staging an accident or injury
  • Making a false disability claim
  • Falsely reporting the location or other details of an incident
  • Billing for services not provided
  • Overstating the value of items stolen in a home robbery

What are the repercussions?

Insurance fraud can be charged as either a misdemeanor or a felony depending on the details of the crime and the amount of the claim. In both cases, repercussions can include both prison time and a steep fine.

Defenses that can be made during trial include lack of intent to defraud as well as an expiration on the statute of limitations.

Qualified legal counsel is key in cases of insurance fraud. If you need assistance — or if you just have a question — reach out today at (330) 394-1587.

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