Insurance Fraud


SHORSTEIN, LASNETSKI, & GIHON
helps people defend against
Insurance Fraud
allegations.

People with little or no prior record sometimes find themselves accused of committing insurance fraud.   Whether it relates to an allegation that you lost or damaged your property before you obtained an insurance policy, an allegation that you damaged or got rid of the property in order to obtain insurance money, you participated in a staged auto accident, you made a false health insurance claim, or any other allegation that you committed fraud, SLG Law can help.  Call us today!
What is Insurance Fraud?

Insurance Fraud is defined in Florida Statute Section 817.234.  To prove the crime of Insurance Fraud, the State must prove:
  • You intended to injure, defraud, or deceive any insurer, and
(1)
  • You presented or caused to be presented any written or oral statement as part of, or in support of, a claim for payment or other benefit pursuant to an insurance policy or a health maintenance organization subscriber or provider contract, and
  • You knew that such statement contained any false, incomplete or misleading information concerning any fact or thing material to such claim, or
(2)
  • You prepared or made any written or oral statement that was intended to be presented to any insurer in connection with, or in support of, any claim fro payment or other benefit pursuant to an insurance policy or a health maintenance organization subscriber or provider contract, and
  • you knew that such statement contained any false, incomplete or misleading information concerning any fact or thing material to such claim, or
(3)
  • You knowingly presented, caused to be presented, or prepared or made with knowledge or belief that it would be presented
  • to any insurer, purported insurer, servicing corporation, insurance broker, or insurance agent, or any employee or agent thereof,
  • any false, incomplete or misleading information or written or oral statement
  •  as part of, or in support of, an application of the issuance of, or the rating of, any insurance policy, or health maintenance organization subscriber or provider contract, or
  • You knowingly concealed information concerning any fact material to such application; or

(4)

  • You knowingly presented, caused to be presented, or prepared or made with knowledge or belief that it would be presented
  • to any insurer a claim for payment or other benefit under a personal injury protection insurance policy
  • if the person knew that the payee knowingly submitted a false, misleading, or fraudulent application or other document
  • when applying for licensure as a health care clinic, seeking an exemption from licensure as a health care clinic or demonstrating compliance with part X of chapter 400. 

What if I'm charged with participating in a staged car accident?

Florida Statute Section 817.234(9) creates harsh penalties for anyone convicted of participating in a staged car accident for insurance money. 

The State must prove:
  • You organized, planned, or knowingly participated in an
  • intentional motor vehicle crash or a scheme to create documentation of a motor vehicle crash that did not occur
  • for the purpose of making motor vehicle tort claims or claims for personal injury protection benefits.  

Any person convicted of this statute is facing:

Sentence for Staged Motor Vehicle Crash

2 year minimum mandatory prison sentence up to 15 years in prison

$15,000 - $50,000 Fine


What is Burning to Defraud the Insurer?

Burning to Defraud an Insurer is a separate and distinct crime from Insurance Fraud.  Burning to Defraud an Insurer is defined in Florida Statute Section 817.233.  To prove the crime of Burning to Defraud an Insurer, the State must prove:
  • You set fire to, burned, attempted to set fire to, attempted to burn, caused to be burned, or aided, counseled or procured the burning of a building, structure, or personal property, and
  • the property belonged to a person, and
  • the property was insured against loss or damage by fire, and
  • you acted willfully and with a fully-formed, conscious intent to injure or defraud the insurer of the property. 
Burning to Defraud an Insurer is a Third Degree Felony punishable by up to 5 years in prison.

What are the potential sentences for Insurance Fraud?

There are different potential maximum sentences depending on the value of any property involved:

Less than $20,000
Up to 5 years in prison

$20,000 or more, but less than $100,000
Up to 15 years in prison

$100,000 or more
Up to 30 years in prison

FINES:
First Offense
Up to $5,000

Second Offense
Fine greater than $5,000 and up to $10,000

Third or Subsequent Offense
Fine greater than $10,000


What are the possible defenses to Insurance Fraud allegations?

The most common defense to insurance fraud allegations is that there was no fraudulent intent.  The State has to prove what was in your mind, which can be a difficult thing to do.  They will try to use documentation, timelines, standard practices, your own statements and other evidence to prove your intent.  Every case is different and there may be several defenses to your Insurance Fraud case.  Give us a call to discuss your unique set of facts.
If you or a loved one has been arrested for or accused of
Insurance Fraud,

Call Shorstein, Lasnetski & Gihon Now!

904-642-3332 (Jacksonville)
or
407-228-2019
(Orlando). 

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