Since 1995, Pennsylvania has maintained units that specialize in the many types of crimes involving insurance fraud overseen by the Office of the Attorney General. Fraud occurs in auto, life, commercial liability, and other types of insurance. In 2017, there was a 34% increase in the reported incidents of automobile insurance fraud statewide. Motorists in Pennsylvania are reported to pay nearly an additional $300 in annual premiums attributed to fraud.
The annual losses from insurance fraud in the U.S. are estimated at $80 billion. The Delaware County District Attorney maintains an Insurance Fraud Unit that investigates such allegations. The prevalence of fraud has led to a rise in funding for enforcement and increased public awareness. Often those prosecuting potential violations act hastily and may rush to judgment without properly considering the rights of the accused. Those facing these allegations should consult with a defense attorney that is extremely familiar with this area of practice.
Defining Insurance Fraud
Acts of fraud associated with insurance may be made by those applying for insurance, policyholders, third-parties filing a claim, professional providers of good and services for claimants, and others. Some of the common actions of fraud involve “inflating” the value of a claim or falsifying or omitting information in the application process. Other examples include filing claims for injuries that do not exist or for products and services that were never provided or received.
One of the key elements in acts of insurance fraud is that it is committed with intent (knowingly). The Pennsylvania Code explains that it may involve filing information that is “false, incomplete, or misleading.” In addition to criminal actions, insurers may pursue damages through civil actions.
Pennsylvania: Types of Insurance Fraud[1]
|
Automobile |
Homeowners |
Workers Compensation |
Health |
Commercial |
Life |
Other |
|
57% |
13% |
10% |
9% |
7% |
2% |
2% |
Potential Penalties
Insurance fraud is generally a felony offense of the third degree that is punishable by up to seven years of incarceration and/or a fine of up to $15,000. Some related offenses may be misdemeanors of the first degree that carry a maximum sentence of five years of incarceration and/or a fine of up to $10,000. In addition to any of the penalties, the court may order those convicted to make restitution.
Importance of Seasoned Legal Representation
Insurance fraud is a serious felony charge that can result in harsh consequences. Those with a felony conviction may face long-term problems when subjected to a background check. This screening process is commonly used by employers that are considering a new hire, by landlords for prospective tenants, and by some agencies responsible for professional licensing. Your attorney may potentially challenge evidence, uncover errors in investigative procedure, and employ a host of other methods to aid your defense.
Experienced Delaware County Attorney for Defending Insurance Fraud Cases
Our Criminal Law Team has the experience necessary to effectively defend criminal allegations in the Pennsylvania court system. We will closely review the specific circumstances related to the allegations and create a comprehensive defense strategy. Make the call to 888-535-3686 today for a complimentary case evaluation.
[1] https://www.helpstopfraud.org/IFPA_2018Report-Final2.pdf
