Insurance Fraud

Insurance fraud occurs when someone uses deceptive practices to recover from an insurance company. It is classified as the second largest economic crime in America, costing taxpayers $90 billion a year. Claims of insurance fraud are handled by the Insurance Fraud Bureau of Massachusetts (IFB) and covered by penal law. Insurance fraud is classified as a felony fraud and can result in up to five years in prison, 2 ½ years in jail, and fines up to $10,000. There may be other civil penalties such as the revocation of a business license.

Insurance fraud can be a result of exaggerating otherwise legitimate insurance claims, or fabricating or causing damage solely for the purpose of recovering. Either way, these crimes are taken extremely seriously in the state of Massachusetts. If charged, call one of our experienced insurance fraud attorneys to take over your case.

Common Insurance Fraud Schemes

  • Automobile fraud. Automobile fraud is by and large the most common insurance fraud scheme. This may include staged auto accidents, exaggerated injury or damage claims, or claims for pre-existing damage.
  • Homeowner’s insurance fraud. This is the type when an individual burns down an insured property for the purpose of defrauding the insurance company. This is taken extremely seriously because of the likelihood of serious injury or death.
  • Healthcare fraud and Medicaid fraud. This can be committed by both a patient and a healthcare facility. This may include billing for care that never took place, for unnecessary treatments or unnecessary medications, upcoding, and double billing for the same treatment. Allowing others to use your health insurance also falls into this category. Healthcare fraud is a federal offense and may result in up to 10 years in prison.
  • Insurance application fraud. This is when an individual misrepresents something on their health insurance application. For this to amount to fraud it must go beyond a simple mistake, it must be an actual lie and this will have to be proven in court.

There are countless ways to commit insurance fraud beyond the list above including disability benefits fraud, unemployment insurance fraud, and workers compensation fraud. In these cases, the prosecution will have to prove beyond a reasonable doubt that the defendant misled the insurance company or federal government, and that they had the intent to do so. The intent element can be difficult to prove, and one of our experienced attorneys can help you fight your charges in court.

Note that insurance fraud can also be propagated by the insurance company itself by denying otherwise valid claims. There are also schemes that operate around selling phony insurance policies. Contact us for more detail on suits for this type of insurance fraud.

Insurance fraud may seem straightforward, but these cases have a way of getting complicated when they are actually being litigated. Often in these cases, the prosecution will offer the defendant a deal if they choose to cooperate. This can be beneficial and result in lower sentences and fines but can also lead to self-incrimination in cases that may have otherwise been dismissed. These difficult decisions arise with any case, and many defendants make mistakes that effect them for years to come. Avoid the downfalls that are all too common in insurance fraud cases by hiring one of our experienced insurance fraud attorneys. We have an experienced team of attorneys that specialize in these cases.

To schedule your free case evaluation with Altman & Altman LLP, call 617.492.3000 or 800.481.6199 (toll free) or contact us online. Our Boston, Massachusetts criminal defense lawyers represent clients that are under investigation, have been charged with, or have already been convicted for insurance fraud. We are known for our ability to secure the best outcomes for our clients’ cases.

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