Insurance Fraud

Insurance fraud consists of making false or misleading statements to an insurance company with the intent to obtain some financial benefit. Insurance fraud is illegal and, as of recently, is prosecuted aggressively by the State of Massachusetts. If you are facing allegations that you attempted to defraud an insurance company, reach out to the Law Office of Patrick J. Murphy. Attorney Murphy has the knowledge and experience you need to successfully defend against even the most complex white collar crimes.

The term insurance fraud broadly describes any type of fraud committed against an insurance company. There are many types of insurance fraud. Some of the most common types include automotive insurance fraud, homeowner’s insurance fraud, and healthcare fraud.

Insurance fraud can occur in one of two ways. In some situations, the party purchasing the insurance (the insured) creates a plan to file a false or manufactured claim. This is referred to as “hard” fraud. For example, the following are examples of hard insurance fraud:

Staged car accidents - The insured causes a car accident but arranges to have a “witness” say that another motorist caused the collision.

Arson schemes – The insured burns down their own home, claiming it was an accident or that someone else started the fire.

False healthcare claim – The insured files a claim for reimbursement under a health insurance policy for treatment they never received.

More commonly, however, insurance fraud is a crime of opportunity. Soft insurance fraud refers to misrepresenting facts in an otherwise legitimate insurance claim or lying in an application for insurance fraud. Examples of soft insurance fraud include:

Inflated damages – The insured includes losses that they did not sustain in an insurance claim, such as reporting that someone stole expensive items from their car or that pre-existing damage was caused by a car accident.

Late-bought policies – The insured purchases or modifies coverage after an accident or other loss and then files a claim under the new policy language.

Providing false information – The insured provides false information in an insurance application to obtain a cheaper premium rate.

If you face charges of insurance fraud in Boston, you should know a few things. First, the way the laws are phrased, anyone who lies to an insurance company may be on the hook for insurance fraud, regardless of whether they stand to benefit personally. Thus, if you agree to make a false statement on behalf of a friend or family member’s claim, the government can charge both you and the policyholder with fraud.

Second, insurance companies are almost certainly going to help law enforcement. Let’s face it, in many Boston criminal cases the alleged victim may not be on board. Maybe they don’t want to be bothered by coming to court or want to avoid being seen as a “rat.” This is rarely an issue in insurance fraud cases. Insurance companies have entire teams dedicated to investigating fraudulent claims and work closely with law enforcement and prosecutors to provide them with everything they need to bring a case.

Third, the rules of evidence can make proving an insurance fraud case tough. Fraud cases are some of the most challenging to prosecute due to the number of witnesses needed. Under the Confrontation Clause of the Sixth Amendment, you have the right to confront the witnesses against you. In most cases, this requires the prosecuting attorney to present live testimony from all necessary witnesses. However, in insurance fraud cases, inexperienced prosecutors may overlook certain witnesses. If a prosecutor brings a case without the necessary witnesses, and your lawyer objects, the court may have no choice but to throw out the case. In many cases, the burden of prosecuting an insurance fraud case also opens the door to the possibility of negotiating a favorable plea agreement.

Insurance fraud and white collar crimes such as embezzlement and credit card fraud are exceptionally complex and requires the assistance of a knowledgeable defense attorney with hands-on experience handling this particular type of case. Attorney Patrick J. Murphy is a veteran defense lawyer who has successfully handled countless insurance fraud cases for more than 25 years. He knows what the prosecution needs to prove and who they need to call to prove their case. If the prosecution shows up unprepared, Attorney Murphy won’t let them take any shortcuts. With his help, you can rest assured that your future is in good hands. To learn more, and to schedule a free consultation, call (617) 367-0450 today.