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New York Insurance Fraud

New York Penal Law 176.00 et seq describes the definition of New York insurance fraud and its various gradations. Penalties for insurance fraud can be severe depending on the amount that is alleged to be in controversy. Insurance fraud can range anywhere from a class A misdemeanor to a class B felony, with maximum penalties of 1 through 25 years of incarceration. Additionally, if a person commits insurance fraud more than once within a 5 year period, regardless of the amount in controversy, a charge of aggravated insurance fraud may be imposed as well. Aggravated insurance fraud is a class D felony that carries with it the maximum penalty of 7 years in prison.

If you have been accused of insurance fraud call our experienced New York Criminal Attorneys today for a free consultation.

Generally speaking, Insurance fraud is committed when a person with knowledge and intent to defraud causes materially false information to be entered into an application or claim for commercial insurance. Additionally, insurance fraud is also committed when a person enters materially false information into a health insurance or personal insurance application or claim.

Passing a specific law to deal with insurance fraud, apart from other forms of fraud was premised upon New York’s legislature’s attempt to protect insurance companies from fraudulent arson, car theft, and staged accident no-fault claims. This problem was particularly severe in Bronx county in the late 70s and early 80s.

Nearly every prosecutors’ office in the state has investigated such conduct. According to insurance companies, insurance fraud schemes have become a moneymaking criminal scam allegedly driving up the costs of insurance of all types. Insurance companies would have the public believe that there is a vast anti insurance conspiracy against insurers and the tendrils of that conspiracy reach everyone from attorneys, doctors, police on the take, professional plaintiffs, fake property management companies, corrupt nurses, fake accident victims, paid witnesses, and many other illicit professions intent on making money off insurance companies.

On the other hand, there are many honest and hard working health care providers, business owners, and car drivers who file absolutely legitimate claims on a daily basis, that are aggressively pursued by insurance company “Special Investigative Units” or SIU units, generally made up of former military personnel, private investigators, and off duty, or retired police. These SIU units often bully and intimidate people and corporations into withdrawing legitimate claims merely because the claim would be expensive for the insurance company to pay or because the insurance company paid out a large claim to that party before. Furthermore, these SIU units can cause claimants to accidentally admit to what may be evidence of insurance fraud. This may trigger further investigation by district attorney’s offices that are specially devoted to one thing, prosecuting insurance fraud.

One may ask what the distinction between insurance fraud and larceny is, since essentially, the final goal of both crimes is to steal. The major distinction between the two crimes is that the crime of insurance fraud is completed upon its attempt, the execution of the documents, rather than the theft actually taking place while larceny actually requires the victim to be dispossessed of their property. The fraudulent applications or claims do not need to actually be paid, and the amount that the prosecution believes the defendant sought to fraudulently extract from the insurance company is what is used to determine the severity of the charges.

If you or someone you know is being investigated or prosecuted for insurance fraud call our team of experienced New York Criminal Attorneys. We may be able to help get your charges dismissed or reduced. Call us today for a free consultation.

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