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Insurance fraud is the second most costly white-collar crime behind tax evasion in the U.S. Insurance fraud costs the American insurance industry up 150 billion dollars every year, thus increasing the average household insurance cost by up to $5,000 per year.
Insurance fraud occurs when an insured entity or individual gives false information to obtain an advantage or a benefit to which they aren’t entitled. Insurance fraud can also be committed against customers when they are denied a benefit to which they are entitled. Depending on the circumstances involved, an insurance fraud case may be handled by the Fraud division as a criminal matter or as an administrative action by the Department of Insurance.
Insurance Fraud: Basics
Any deceitful act performed by either an individual or entity with the intent of obtaining undeserved payment from an insurer constitutes to insurance fraud. Surprisingly, insurance fraud offenses are not only committed by people in the insurance industry, but also by individuals from all walks of life. Over the years, law enforcement officials in Bucks County have prosecuted insurance agents, doctors, chiropractors, car salespeople, lawyers and other people in positions of trust for these offenses.
Classifications of insurance fraud
Insurance fraud falls into two categories- soft fraud and hard fraud.
• Hard fraud occurs when an insured individual deliberately fakes an injury, accident, arson, stolen automobile or any other loss to obtain money from the insurance provider. In most cases, hard fraud is executed by organized crime rings.
• Soft insurance fraud is more common than hard fraud. It is also known as opportunistic fraud. Soft fraud occurs when usually honest individuals tell little ‘white lies’ to their insurance provider to inflate an already legitimate claim. For instance, soft insurance fraud can occur when an insured person is involved in an automobile accident and claims more money than they are entitled to by lying to the insurance company. Soft fraud can also occur at the start of an insurance policy when an individual lie about their car’s mileage to obtain a lower premium.
Insurance fraud is a real problem not only in Bucks County, but the whole of U.S. Insurance fraud also includes other cases such as:
• Using a false identity to obtain healthcare benefits
• False disability claims
• Falsifying slip and fall claims
• Inflated billing by healthcare providers and billing for services that were not provided
• False workers compensation claims
Penalties for insurance fraud in Bucks County
The details surrounding your case and the state legal directives are the two main determinants of the sentence you are likely to receive for the alleged offense. The two factors will also determine whether the alleged offense is a felony or misdemeanor. As highlighted earlier, government agencies and insurance companies may be part of the investigating team in such cases.
What to do if you are entangled in an insurance fraud case
It is possible to be a victim of insurance fraud. In most cases, the offenders target the elderly by selling policies that they may not need or possibly use. Some rogue insurance agents may fail to remit your premiums to the insurance company while others will sell fake insurance policies. If you realize that you have been a victim of insurance fraud in Bucks County, contacting an experienced insurance fraud lawyer can help in getting things back the way they should be.
On the other hand, if unfortunately, you have been accused of being part of an insurance fraud case, it’s in your best interest to contact an experienced insurance fraud attorney in Bucks County. Fraud claims usually attract lengthy prison sentences and hefty fines depending on the amount of money involved and the circumstances surrounding your case. In such a case, the advice of an experienced insurance fraud lawyer is invaluable.
While any lawyer can handle your case, not all lawyers have the current knowledge and experience of insurance law to handle your case effectively. Choosing a lawyer who specializes in insurance fraud will give you the best chance of arguing your case to avoid the hefty fines and a possible jail term.