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What is insurance fraud and how is it perpetrated?

An arrest on charges of insurance fraud can shatter your life. Florida residents must take this situation seriously and understand the particulars of the offense.

What is insurance fraud?

Insurance fraud is a white-collar crime that occurs when a person deliberately defrauds an insurance company for their own gain. It could involve a monetary gain, and it often occurs when a person includes false information on an insurance application.

The crime costs the country billions of dollars each year, according to the Coalition Against Insurance Fraud. Consumers are the ones who pay for it the most due to insurance companies charging higher premiums to cover their losses.

What are the elements of insurance fraud?

In order to find a person guilty of insurance fraud, the prosecution is required to prove that the elements of the crime are in place. Those elements include the following:

  • The defendant made a deliberately false or misleading statement.
  • The statement made by the defendant was in support or connection with a claim or payment related to an insurance policy.
  • The defendant’s statement is material, affecting the outcome of the claim or insurance application.

If the statement was material, it means that it was something that was deliberately false. A false statement made as an honest mistake wouldn’t be considered material.

What are the most common types of insurance fraud?

Insurance fraud can involve many types of insurance. However, they frequently involve health insurance with someone deliberately defrauding an insurance company. For example, a person exaggerates their financial situation to obtain free insurance instead of paying for it.

Life insurance fraud is also common. A person might fake the death of a family member to obtain a payout on their life insurance policy.

Getting help and fighting back should be your top priority if you face insurance fraud charges.