Insurance Fraud

Insurance fraud is a blanket term that covers a wide variety of fraudulent activity. Generally, it involves false reporting or filing a false insurance claim to obtain benefits to which the accused is not entitled. This may include seeking benefits from the insurance provider or from government agencies. Insurance fraud can occur at the state, local or international level, and involve any type of insurance.

Insurance fraud is a serious crime with severe penalties. If you or someone you know becomes the target of an insurance investigation or receives a subpoena in relation to an insurance claim, it is critical to enlist the services of experienced legal counsel. At Dhar Law, LLP, our committed attorneys can help you make the difficult decisions regarding your next steps.

How Insurance Fraud Is Detected

Certain types of claims have a higher rate of fraud, and insurance companies will use computer models to identify suspicious claims. In other cases, the public may provide information to law enforcement regarding possible fraud. Often, there are "red flags" that alert insurance companies, such as multiple claims by the same policyholder; losses occurring shortly after coverage takes effect; or the insured pushes for a fast settlement of their claim.

Insurance fraud is widespread and can take a variety of forms, including:

  • Auto insurance fraud
  • Workers' compensation fraud
  • Property insurance fraud
  • Medical or health care insurance fraud
  • Life insurance fraud
  • Unemployment fraud

The Penalties Are Severe | Your Legal Defense Must Be Assertive

Penalties for insurance fraud will depend on the facts of the individual case. Under Massachusetts law, filing a false insurance claim or using false information to deceive claims representatives is considered a felony. It is punishable by up to five years in prison and a fine of up to $10,000. There are also a number of federal laws that can be used to prosecute insurance fraud, usually treated as a felony depending on the specific crime. In addition, restitution may have to be paid.

There are a number of possible defense strategies for someone charged with insurance fraud. In many cases, there will not be enough evidence for the prosecutor to prove the case beyond a reasonable doubt. In other cases, the person charged may have mistakenly acted fraudulently, but they did not have the intent to commit a crime.

Whether or not to cooperate with the government or insurance company is a critical decision, which could end in a beneficial resolution or, alternatively, could expose the accused to criminal and civil liability. Often, individuals are given the opportunity to cooperate with investigators to reduce any potential penalties. Our knowledgeable insurance fraud defense lawyers can advise you on these options and other potential risks.

We Will Bring Clarity To Your Insurance Fraud Case

Insurance fraud defense can be complicated because of the number of activities, laws and agencies involved in fraud investigations. At Dhar Law, LLP, a knowledgeable lawyer experienced in defending those charged with insurance fraud can assess the facts of your case and recommend an effective course of action. Call 617-391-0592 or use our online contact form to schedule a consultation.