Insurance fraud is not a victimless crime. It costs businesses exorbitant amounts of money every year and forces consumers to pay higher insurance premiums. Consequently, law enforcement agencies in New York spare no expense in investigating this, and prosecutors aggressively pursue cases against individuals charged with committing insurance fraud.
What is Insurance Fraud?
Insurance fraud is broadly defined as any actions undertaken with the intent of purposefully misleading an organization or individual in connection with an insurance policy, premium, or claim. The overall intent of New York’s insurance fraud criminal statute is to address the filing of a false insurance claim through the use of fraud, misrepresentations, or false statements. Prosecutors rarely bring insurance fraud as a standalone charge. Insurance fraud is frequently combined with other white-collar crimes, such as:
- Grand larceny
- Falsification of business records
- Forgery
- Identity theft
- Offering a false instrument for filing or enterprise corruption.
A “fraudulent insurance act” is committed by any person who knowingly and with intent to defraud presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, self-insurer, or purported insurer, or purported self-insurer, or any agent thereof any written statement as part of, or in support of, an application for the issuance of, or the rating of a commercial insurance policy, or certificate or evidence of self-insurance for commercial insurance or commercial self-insurance, or a claim for payment or other benefit pursuant to an insurance policy or self-insurance program for commercial or personal insurance that he or she knows to:
(a) contain materially false information concerning any fact material thereto; or
(b) conceal, for the purpose of misleading, information concerning any fact material thereto.
The definition of a “fraudulent health insurance act” is similar to that of a general fraudulent insurance act in that it addresses membership, enrollment, and coverage in a health care plan, and encompasses a fraudulent application for the issuance of a health insurance policy. In addition to health insurance fraud, cases may also involve:
- Automobile insurance fraud (including staging motor vehicle accidents)
- Life insurance fraud
- Homeowners or renters’ insurance fraud
- Mortgage fraud
- Disability Insurance Fraud
- Personal injury fraud
What is the Punishment in New York?
Article 176 of the New York Penal Code includes varying degrees of insurance fraud ranging from the first through the fourth. In each of these cases, a conviction carries extensive fines and lengthy prison sentences. A person is guilty of Fifth Degree insurance fraud, a Class A misdemeanor when he or she commits a fraudulent insurance act. This base-level offense is often incorporated into more serious felony crimes, like Grand Larceny, and is punishable by up to one year in jail.
Fourth Degree insurance fraud, a Class E felony, is committed when a person commits a fraudulent insurance act and thereby wrongfully takes, obtains, or withholds, or attempts to wrongfully take, obtain, or withhold property with a value over $1,000. Insurance fraud in the Fourth Degree is punishable by up to four years in prison.
Third-degree insurance fraud, a Class D felony, is committed when a person commits a fraudulent insurance act and thereby wrongfully takes, obtains, or withholds, or attempts to wrongfully take, obtain, or withhold property with a value over $3,000. Insurance fraud in the Third Degree is punishable by up to seven years in prison.
Second-degree insurance fraud, a Class C felony, occurs when a person commits a fraudulent insurance act and thereby wrongfully takes, obtains, or withholds, or attempts to wrongfully take, obtain, or withhold property with a value above $50,000. Insurance fraud in the Second Degree is punishable by up to 15 years in prison.
First-degree insurance fraud, a Class B felony, occurs when a person commits a fraudulent insurance act and thereby wrongfully takes, obtains, or withholds, or attempts to wrongfully take, obtain, or withhold property with a value over $1 million. Insurance fraud in the First Degree is punishable by up to 25 years in prison.
Aggravated insurance fraud in the fourth degree, a Class D felony, is committed when a person commits a fraudulent insurance act and has been previously convicted within the preceding five years of any offense, an essential element of which is the commission of a fraudulent insurance act.
Our Long Island & New York Insurance Fraud Attorney Can Help You
Like all white-collar crimes, this is considered a very serious offense. Given the complexities of these cases, only an experienced and knowledgeable New York criminal defense lawyer can properly advise a defendant accused of insurance fraud. If you have been charged with insurance fraud, securing legal representation as soon as possible is essential. Do not delay. Contact Michael A. Arbeit, P.C., Long Island’s leading criminal defense law firm, today to discuss your case.
Michael A. Arbeit, P.C. defends people who are facing insurance fraud charges throughout Long Island, Nassau County, Suffolk County, and New York City, including Queens, Brooklyn, Manhattan, Staten Island, and The Bronx.