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What you should know about insurance fraud

On Behalf of | May 3, 2017 | Financial Crimes, Fraud, Other Crimes, White Collar Crimes

Insurance fraud is a serious problem. The FBI reports that the annual cost of insurance fraud, non-health insurance, is about $40 billion per year. More law enforcement agencies are cracking down on potential perpetrators of insurance fraud. You should be aware that filing a false claim or attempting to get money from an insurance company under false pretenses is fraud. 

Under Ohio Code 2913.47, insurance fraud over an amount of $1,000 up to $7,500 is a felony of the fifth degree. Jail time is a possibility, but civil penalties are also probable. A person could lose his or her professional license and pay court-ordered fines and restitution. 

Insurance agents are at risk for prosecution for insurance fraud, but so are consumers, adjusters and providers, such as doctors, auto repair shops and contractors. Insurance fraud generally takes one of two forms: 

  • Soft insurance fraud is an unplanned occurrence of fraud, but it is very prevalent in the industry. You have a legitimate claim, but you exaggerate the loss to the insurance company. An example would be inflating your losses after a home burglary or claiming more severe injuries than you have. It is more difficult to get away with this type of fraud because insurance companies demand proof of injuries or loss.
  • Hard insurance fraud is premeditated and deliberate. A consumer might be charged with insurance fraud for slamming on the brakes to cause an accident to claim insurance money. An auto repair shop might collude with an adjuster to increase charges for repairs. An extreme example might be faking your death to get the insurance money. 

The consequences of insurance fraud are serious, but even allegations of insurance fraud can damage your reputation and business. If you are facing a white-collar crime, you want to deal with it quickly and avoid formal indictment if possible. An experienced criminal defense attorney is a good idea to help you fight the charges and protect your rights. 


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