Complex Civil Litigation, Criminal Defense & Insurance Claims

  1. Home
  2.  » 
  3. White Collar Crimes
  4.  » When insurance fraud can be considered a crime.

When insurance fraud can be considered a crime.

On Behalf of | Feb 15, 2019 | White Collar Crimes |

Insurance contracts are basically private contracts between the insurer or the insurance company and the insured. People in Baton Rouge, Louisiana who are contemplating a scam on an insurance company should be aware that this may be a criminal offense. It is generally considered a white collar crime, but this has no effect on penalties involved.

Insurance fraud is normally set forth in the penal code of a jurisdiction. It may be in a more general fraud statute or it may be a specific crime related to insurance contracts. In most penal codes, the crime consists of an intentional misrepresentation of a material fact. All elements must be present for a conviction.

A prosecutor must show that a misrepresentation occurred, that the misrepresentation was purposeful and that it was related to a material fact. A fact may be material if it causes payment of an improper claim, provides coverage when it would not have been given or leads to a lower premium on the contract.

Insurance fraud normally occurs in two areas. It may occur by providing false information on an application for insurance and in a claim for benefits. Most forms of insurance are under the umbrella of insurance fraud such as life, health, homeowner or vehicle insurance.

Often when applying for insurance or submitting a claim, benefit forms may be submitted through the US mail or interstate phone lines. In these cases, other crimes may come into play. The fraudulent act can then be considered mail fraud or fraud involving interstate commerce. These are federal offenses.

A person charged with insurance fraud should seek the assistance of a criminal defense attorney at the first instance. The attorney challenge that a misrepresentation, if any, is not material or may not have been intentionally given. There might be other areas in the case for the attorney to challenge the charges.