In 2018, The Pennsylvania Attorney General Josh Shapiro announced a statewide sweep that resulted in 60 arrests of individuals for insurance fraud. Shapiro issued a statement explaining that insurance fraud ultimately burdens all consumers by increasing premiums. This sweep is part of a broad effort to prevent and prosecute those who seek to deceive insurance companies.
Recent Insurance Fraud Information
According to the National Insurance Crime Bureau, as many as an estimated 10% of insurance claims in the property-casualty sector are fraudulent. This type of unlawful activity is now the second leading “white-collar” crime in the U.S. behind tax evasion. The term white-collar crime is defined by Merriam Webster as one that involves “stealing money from a company” and one often committed by “white-collar workers.” These are crimes of deception that rarely involve direct use of force or create physical harm.
Understanding Insurance Fraud
Insurance fraud is a crime that is intentionally committed. It typically involves providing “false, incomplete or misleading” information to an insurance company. This false or inaccurate information may involve “any fact or thing material to the claim.” The crime is often committed by several individuals that “assists, abets, solicits” or otherwise conspires to commit fraud.
This crime may be committed when someone unlicensed or unauthorized acts as an agent or broker. Organizations that provide healthcare-related products or services may seek to defraud medical insurers.
Some Common Specific Examples
- “Staging” an automobile accident or falsely claiming a car was stolen
- A medical provider who orders and performs unnecessary testing or diagnostics to file a claim for reimbursement
- Intentionally creating a fire at a home or commercial property that is insured
- Claiming that valuable items that were insured have been stolen
- “Inflating” or otherwise misrepresenting the value of insured items that are damaged or stolen
Penalties and Level of Offense
Under Pennsylvania law, charges of insurance fraud may be either a first-degree misdemeanor or third-degree felony offense depending on the circumstances. In addition to fines and imprisonment, offenders are typically ordered to make restitution for the financial losses created.
|
Level of Offense |
Maximum Period of Incarceration |
Maximum Fine |
|
First-Degree Misdemeanor |
5 years |
$10,000 |
|
Third-Degree Felony |
7 years |
$15,000 |
Berks County Criminal System
Berks County has an established jail system that houses offenders in a secure environment. The Jail System Community Reentry Center (CRC) assists offenders with reentering the community in efforts to reduce recidivism. Berks County has an Adult Probation & Parole Office and Juvenile Probation Department that provide community supervision for offenders. There are also Treatment Court Programs offering specialized offender services including treatment for drug or alcohol dependency and those with mental health concerns.
Importance of Retaining Seasoned Legal Counsel
The Pennsylvania Attorney General's Office is committed to deterring crimes of insurance fraud. Prosecutors across the state are not viewing these offenses as “victimless crimes” and are imposing significant prison sentences. Those facing these types of allegations are strongly encouraged to seek experienced defense counsel.
Pennsylvania Criminal Law Team Defends Allegations of Insurance Fraud
The LLF Law Firm has spent many years representing clients accused of fraudulent activity. They employ a proactive approach that challenges the evidence and will ensure your rights are protected. Contact the office today at (888) 535-3686 for a consultation.
