According to the Pennsylvania Insurance Fraud Prevention Authority, all types of insurance are adversely impacted by acts of fraud. It is most prevalent in the realm of property and casualty insurance. Fraudulent activity increases the premium costs for everyone who purchases insurance.
Since 1996, the Lehigh County District Attorney has been the leading local agency that investigates and prosecutes cases of insurance fraud. More than $420,000 in grant funding was obtained specifically for this purpose by the agency in 2018. Statewide, the total amount of grant funding provided for insurance fraud exceeded $14 million.
Insurance Fraud (§4117)
Pennsylvania's Code contains clearly defined provisions that explain how insurance fraud may be committed. It commonly involves submitting some information that is “false, incomplete, or misleading” in efforts to defraud an insurer. Often, policyholders will commit the crime by falsely increasing the actual value of insured items that were lost, stolen or damaged. Fraud does occur in all realms of the insurance market such as automobile, homeowners, health, and workers compensation.
Penalties That May Be Imposed
Insurance fraud is usually charged as a third-degree felony offense punishable by up to seven years in prison and/or a fine of up to $15,000. Some less severe offenses may be charged as first-degree misdemeanors punishable by a maximum sentence of five years and/or a fine of up to $10,000. The courts are also likely to order those convicted to make restitution.
Fraud in Workers Compensation Insurance
One way that workers compensation fraud occurs is when an insured party makes false or incomplete statements during the claims process. Health care providers may also be involved in acts of insurance fraud. This may be committed by allowing for fraudulent insurance billing practices to occur on their premises. An injured worker may unlawfully begin working elsewhere to earn wages while they are receiving total disability benefits.
Fraud in Homeowner Insurance
Fraud may be committed by falsely claiming to have been a victim of theft to receive insurance compensation. An insured party who was actually a victim of theft may falsely “inflate” the value of a stolen item.
Fraud in Automobile Insurance
Automobile insurers are among the most likely to encounter fraud. A policyholder may “stage” an accident for purposes of fraudulently obtaining insurance compensation. An insured party may falsely claim that their vehicle was stolen.
How Can a Defense Attorney Help My Case?
Having experienced legal representation when you are facing serious criminal charges should be a top priority. Your attorney may be able to assist you in various ways such as:
- Ensuring that your rights were protected when you were arrested
- Identifying evidence that was not improperly obtained
- Proving that the prosecution has not satisfied all the key elements of an offense i.e. the acts were knowingly committed
- Entering into negotiations on your behalf that could result in reduced charges with lesser penalties
Experienced Pennsylvania Criminal Defense Attorney
Joseph D. Lento has spent many years providing aggressive representation for clients in the Lehigh County court system. He uses this experience to create favorable outcomes in difficult situations. Contact the office today at (888) 535-3686 for a case evaluation.