Insurance fraud generally involves making fraudulent claims to an insurance company. This can include auto insurance, property insurance, health insurance, or any other type of insurance. Insurance fraud in Virginia can be a felony, depending on the value of alleged fraud involved.
Unfortunately, innocent people can be charged with insurance fraud because of a misunderstanding or making a mistake on a form. If you were accused of insurance fraud in Charlottesville, talk to an experienced criminal defense lawyer to understand your rights and defenses.
Insurance Fraud Laws in Virginia
Under Virginia Code § 52-36, insurance fraud is obtaining money or signature by false pretense related to insurance. Obtaining money, signature, or other property by false pretense and with the intent to defraud can be a felony in Virginia.
Types of Insurance Fraud
There are as many types of insurance fraud as there are types of insurance, including:
- Auto insurance fraud,
- Rental insurance fraud,
- Home insurance fraud,
- Life insurance fraud,
- Workers' compensation fraud,
- Unemployment insurance fraud, and
- Health insurance fraud.
Insurance fraud generally involves filing a false claim to obtain money from the insurance company. This could include overestimating the value of lost items, using insurance to cover another person who does not have insurance, or causing damage to get money from an insurance claim.
Examples of Insurance Fraud
Sam takes out a $100,000 insurance policy on his business. Sam pays someone to burn down the business and make it look like an accident. Sam then attempts to claim the insurance money after the business is burned down.
Erin crashes her car in a drunk driving accident. Erin leaves the scene of the accident and later reports that her car was stolen. Erin makes a claim to the insurance company for repair or replacement of the vehicle caused by the accident.
Simon gets into a car accident and goes to the doctor to get checked out. The doctor and Simon agree to claim Simon suffered a more serious injury so Simon can file a disability claim and the doctor will get money for treating Simon even though there is no medical treatment.
Teresa's car is broken into and a phone and a pair of expensive sunglasses were stolen. Teresa files a claim for the stolen items as well as jewelry, a laptop computer, clothing, and a tablet, even though these items were never taken from the car.
Oslo does not have medical insurance and feels a serious stomach pain. Oslo uses his brother's insurance information and claims to be the brother when going to the doctor for treatment. If the brother is aware that Oslo was using his name and information, the brother may also be implicated in the fraud.
Penalties for Virginia Insurance Fraud
The penalties for insurance fraud may depend on the specific criminal charges. Insurance fraud may involve multiple criminal offenses including:
- Identity Theft
- Obtaining Money by False Pretense
Larceny, or theft, of $500 or more is classified as grand larceny. A conviction for grand larceny fraud can include up to 20 years in jail. In addition to criminal sentencing, the defendant may also be ordered to reimburse any fraudulently obtained money or property.
Using another person's identifying information to commit insurance fraud without their knowledge may be considered identity theft. Identity theft can be a Class 6 felony if the theft results in a financial loss of $500 or more. The penalties for identity theft include up to 5 years in prison.
Insurance Fraud Investigations
Insurance fraud is taken very seriously in Virginia and there is even an Insurance Fraud Investigation Unit established under the state police to conduct insurance fraud investigations. In addition to law enforcement, insurance companies may also conduct audits and investigations and report suspected fraud to the police for prosecution.
In many cases, individuals are reported by estranged family members, former business associates, or disgruntled employees. There may also be a reward offered for information used to procure a conviction for insurance fraud.
The time to contact an experienced insurance fraud defense attorney is as soon as the individual becomes aware of an insurance fraud investigation or accusation. The insurance company or other business may investigate the alleged fraud before law enforcement gets involved. Anyone accused of fraud should consider having an attorney represent their interests in questioning by the insurance company.
Red Flags That Can Start Insurance Fraud Insurance Fraud Investigations
There are a number of signals or red flags that can alert insurance companies to potential fraud. Unfortunately, an innocent policyholder can be flagged for an investigation because of these situations, even if the policyholder did not intend fraud. Examples of insurance fraud red flags can include:
- Getting insurance shortly before filing a claim;
- Increasing insurance coverage shortly before filing a claim;
- Policyholder is in financial trouble or debt;
- Policyholder has a history of reporting similar claims;
- No witnesses of an accident or injury; or
- Willingness to take a fast but smaller settlement.
Charlottesville Insurance Fraud Defense Attorney
A conviction for insurance fraud can lead to costly fines, restitution, and jail time. A criminal record involving fraud can also harm your future job prospects and professional opportunities. If you are accused of insurance fraud in Charlottesville, talk to an experienced criminal defense attorney about how to fight criminal charges and avoid a criminal record. Contact me today for a free consultation.