What is Insurance Fraud?

Insurance fraud is a criminal act that involves providing false information in order to receive insurance benefits. This can be done for an automobile accident, homeowners’ insurance, or even medical insurance. Participating in this crime can lead to a felony charge of the second or third degree and can have you facing a prison sentence of up to 30 years. Depending on the type of fraud you have committed can determine what your punishment may be. Any participating parties, like doctors, can also receive punishment for assisting you with this crime.

If a medical professional or a medical institution is found guilty of participating in insurance fraud, then they run the risk of losing their license. Fraud is not a victimless crime and it can affect more than just you. There are soft fraud crimes that can be done by exaggerating details of your injuries or damage to try and receive a higher financial compensation. There are also hard fraud crimes like staging a crime scene so you can receive money from your insurance. This is an illegal act and is a felony charge.

Insurance Fraud Orlando FL

Hire an attorney

Insurance fraud is a criminal offense and you would need to seek out a criminal defense attorney who has experience in handling insurance fraud cases. Do your research and hire an experienced attorney who has handled cases similar to yours. To find a lawyer you can use Google and Yelp to locate lawyers near year that are experienced with those cases. A conviction could lead to a felony charge and can have a sentence of up to 30 years in prison.

What you should know today about fraud and consumer protection?

The Bureau of Consumer Protection investigates claims that show red flags of possible fraud. Their role is to stop and prevent the act of fraudulent claims that are made by individuals or businesses. They will access databases to see if there are any patterns in their history that show the possibility of fraud being a factor. They can conduct investigations and sue companies and individuals who participate in insurance fraud.

Top 5 Most Common Types of Insurance Fraud

There are multiple ways to commit insurance fraud. The most common are car robbery, car accidents, car damage, health insurance billing, and unnecessary medical procedures. For car robbery, there are two ways this can be completed. The first way is to sell your car to be crushed and cut up then report it stolen. The second way is to sell your cars overseas and do the sale under the table with no documentation to back it up and then report it stolen. The second most common way is staging a car accident. If both vehicles are totaled, then the cost of the cars is inflated and the insurance payout is higher. Both parties might attempt to crash into each other so they can both collect the higher compensation.

The third common type is exaggerating car damages or using your compensation for pleasure instead of fixing your vehicle. The main reason for the compensation is to repair your vehicle and that’s what the money should be used for. The fourth and fifth most common type have to do with medical insurance. The fourth is health insurance billing fraud, meaning providing false billing to insurance companies for a higher payout. Your doctor could charge your insurance for surgery when in reality you just got a physical. The fifth common type is unneeded medical procedure. This is when your doctor issues you to run tests that are unnecessary for you to do. An example would be to make you go take a blood test when you just broke a toe.

If you or your loved one find themselves in a situation where you are being accused of Insurance Fraud, call us right away at 407-930-8912 to speak with a qualified legal professional or fill out the contact form on this page. We’re available 24/7, we offer free initial consultation and payment plans. In addition to our Orlando location, we have offices in the following cities across the state of Florida:

*Additional Orlando Florida & Orange County Legal Resources

Frequently Asked Questions

Insurance fraud is the act of providing false information or a false situation in order to receive insurance benefits. This can be done by putting down another person’s information, purposely damaging property to receive compensation, and lying to your insurance company about previous incidents. For example, putting down your sister’s information down for insurance because you look like her and know her insurance will cover your doctor’s visit is an example of insurance fraud.

Florida Statutes 817-234 is the statute that covers insurance fraud. The statute states that anyone who presents false information, orally presents, and presents written statements with false information in order to gain insurance benefits. It also states that if a hospital or medical office is involved insurance fraud then any evidence of participation in insurance fraud “shall be grounds for suspension or revocation of the license to operate the hospital or the imposition of an administrative penalty of up to $5,000 by the licensing agency, as set forth in chapter 395.”

To report insurance fraud, you could contact the National Insurance Crime Bureau. They can be reached by phone at (800) 835-6422, or you can submit an anonymous form online. Another way to report insurance fraud in Florida would be to contact the Florida Department of Financial Services by calling (800) 378-0445.

When an insurance claim shows potential for fraud then an insurance fraud investigator gets assigned to the case. They can deal with cases such as robberies, automobile accidents, arson, and medical. Their investigation might include interviews and surveilling involved parties, looking through computer databases to find any red flags on suspect, and examining property or accident scenes.

Insurance fraud is a serious offense that can lead to jail/prison time, probation, and fines. Depending on the type of insurance fraud was committed can determine how harsh your sentence will be. There is soft fraud and hard fraud. An example of soft fraud would be slightly exaggerating the damages your car received from an accident so you can receive a high compensation. This can be a misdemeanor charge and you can spend up to a year in jail or serve community service. An example of a hard fraud would be throwing a rock through his front doors window and mimics a robbery so you can claim insurance. This can lead to a felony charge with a prison sentence.

Looking for a insurance fraud lawyers in Florida?

Insurance fraud is a serious offense, even if the fraud was seen as soft or a harsh act you can still suffer a felony charge. These acts can be completed by an individual, business or a professional. Insurance fraud can be seen across all fields of insurance not just medical. Car insurance, homeowner insurance and medical insurance can fall victim to scammers who are just looking for compensation. No matter if it’s soft fraud or hard fraud, Fraud is not a victimless crime and there are multiple parties that can be affected.

At the Smith & Eulo Law Firm, we have criminal defense lawyers to represent you in your case. Call us today for a free consultation at 407-930-8912 or email at smithandeulo@gmail.com. We strive to always be available for you.