Insurance Fraud Defense Lawyers

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Under 18 U.S.C. ยง 1347, certain types of Insurance Fraud are punishable by imprisonment of up to 10 years and up to 20 years if the fraud causes bodily injury.

According to the Federal Bureau of Investigation (FBI), insurance fraud costs insurance companies more than $40 billion each year. This does not include health insurance fraud, which by some estimates doubles the total cost to insurers. Unfortunately, these costs ultimately get passed on to premium-paying policyholders.

Equally unfortunate, in their efforts to combat insurance fraud, insurance companies and government investigators often get overzealous in accusing individuals and businesses of fraudulent conduct. The insurance companies have every incentive to deny claims, and they have teams whose sole job is to challenge claims on the basis of fraudulent conduct. When an insurance company alleges fraud, it can deny the policyholder’s claim, retroactively cancel their coverage, seek civil penalties, and then turn the case over for criminal prosecution.

At the The Criminal Defense Firm, we help our clients level the playing field. Our sole aim is on doing whatever it takes to have the charges against our clients dismissed. If you are facing criminal charges for insurance fraud, let us put our experience, dedication, and aggressive approach to criminal defense to work for you.

Put our highly experienced team on your side

Brian J. Kuester
Brian J. Kuester

Former U.S. Attorney

Former DA

Amanda Marshall
Amanda Marshall

Former U.S. Attorney

Local Counsel

Joe Brown
Joe Brown

Former U.S. Attorney
& Former District Attorney

Local Counsel

John W. Sellers
John W. Sellers

Former Senior Trial Attorney
U.S. Department of Justice

Local Counsel

John W. Sellers
Linda Julin McNamara

Former Chief, DOJ Appeals

Local Counsel

Joanne Fine DeLena
Joanne Fine DeLena

Former Assistant U.S. Attorney

Local Counsel

Aaron L. Wiley
Aaron L. Wiley

Former Federal Prosecutor

Local Counsel

Roger Bach
Roger Bach

Former Special Agent (OIG)

Chris Quick
Chris Quick

Former Special Agent (FBI & IRS-CI)

Kevin M. Sheridan
Kevin M. Sheridan

Former Special Agent (FBI)

Ray Yuen
Ray Yuen

Former Supervisory Special Agent (FBI)

Dennis A. Wichern
Dennis A. Wichern

Former Special Agent-in-Charge (DEA)

Insurance Fraud Explained

Applicants and Policyholders

Most insurance fraud claims are brought against applicants and policyholders. In these cases, insurance fraud involves providing false information to an insurance company or intentionally damaging property in order to receive payments that are not properly owed. Minor offenses may be charged as misdemeanors; however, serious fraud crimes may be charged as felonies.

Insurance Agents and Insurance Companies

We also represent insurance agents and insurance companies that have been accused of insurance fraud. We handle cases involving:

  • Embezzlement of insurance premiums (premium diversion)
  • Use of “reinsurance agreements” to deplete policyholders premiums (fee churning)
  • Theft of insurance company assets (asset diversion)
  • Fraudulent denial of policyholders claims

Contractors

Contractors can face charges of insurance fraud as well. Some of the most common situations involve accusations of bid rigging and requiring up-front payment and then failing to perform the contracted repairs.

Health care fraud is a concern of epidemic proportions in the United States. From Medicare fraud to schemes by practitioners to overbill patient’s insurance companies, health care fraud encompasses a wide range of costly and illegal practices. Our attorneys have vast experience representing both individuals and corporate clients accused of health care fraud nationwide.

Defending Against Insurance Fraud Claims

In order to obtain a conviction for insurance fraud, the prosecution must prove beyond a reasonable doubt that you (i) made a false statement, (ii) knew the statement was false, and (iii) made the statement in connection with a claim or payment under an insurance policy. The government must also prove that your false statement caused the insurance company to make a payment it otherwise wouldn’t have on a claim.

In defending clients against allegations of insurance fraud, we seek to attack each individual element of the prosecution’s case. We will raise questions about the inaccuracy of your statements. Even assuming your statements were inaccurate, we will challenge that you knew it at the time they were made. We can also call into question whether the insurance company relied on your statements, or if they would have paid (or been obligated to pay) even in the absence of the alleged fraud.

Of course, each case is different, and the facts in your case may dictate a specific approach. But, generally speaking, these are some of the primary defenses to insurance fraud charges under state and federal law.

Penalties for Insurance Fraud Charges

Charges for felony insurance fraud can carry penalties of up to 10 years in federal prison and up to 20 years in cases involving bodily injury. Some of the most common charges involve:

  • Making false statements on an insurance application
  • Faking accidents or injuries
  • Exaggerating the extent of an accident or injury
  • Filing a false theft report
  • Misclassifying the cause of damage in order to obtain coverage
  • Arson
  • Other methods of intentional destruction of property

Read more about facing investigations and defending allegations of health care fraud.

Schedule Your Free Insurance Fraud Case Evaluation

Our experienced criminal defense lawyers and former federal prosecutors provide vigorous and experienced representation for clients accused of insurance fraud. If you are under investigation or facing state or federal charges, we can help you protect your assets, your family, and your future. To schedule a free case evaluation, call 866-603-4540 or contact The Criminal Defense Firm online today.

The Criminal Defense Firm represents clients nationwide.

Last Updated:

Dallas 214-817-2053
Houston 713-454-7814
Detroit 313-634-0925
Baton Rouge 225-269-8749
New York 332-239-7345
Winter Park 407-890-0460
Miami 786-751-3247
Portland 207-222-7742
Nationwide 866-603-4540