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New York Penal Code 176.15: Insurance fraud in the fourth degree

By Spodek Law Group | May 4, 2017
(Last Updated On: July 26, 2023)

Last Updated on: 26th July 2023, 08:56 pm

Insurance exists to compensate a person when they suffer an unexpected loss or injury. In some cases a person might try to get money from an insurance company when they haven’t suffered a loss. This is insurance fraud, and it’s against the law in the state of New York.

There are different types of insurance fraud

The crime of insurance fraud in New York is actually several different crimes. The state divides insurance crimes into different degrees. These degrees depend on the severity of the offense. Insurance fraud in the first degree is the most serious of the insurance fraud crimes.

Insurance fraud in the fourth degree is a violation of New York penal code § 176.15. It involves insurance fraud in the amount of at least $1,000 but less than $3,000. That means you must have committed insurance fraud in an attempt to get an amount of money in that range. If you tried to obtain more or less money, you can face insurance fraud charges of a greater or lesser degree.

What happens if you’re convicted

Insurance fraud in the fourth degree is a felony. It’s a class E felony, so you can spend up to four years in prison if you’re convicted. The court can also order you to pay a hefty fine in addition to paying restitution for the amount that you cheated the insurance company. You can serve as many as five years on probation for the offense. Talk to an NYC criminal lawyer at Spodek Law Group for more information about potential penalties for a charge of insurance fraud in the fourth degree.

Other similar charges

There are a few similar charges under New York law. One of them is health care fraud. Another is life settlement fraud. If you’re facing insurance fraud, you might face these related charges in addition to or instead of insurance fraud charges.

An example

One example of insurance fraud is a false worker’s compensation claim. For example, Nia gets hurt at work. She works in a department store, and a heavy piece of furniture falls on her foot. Nia files a worker’s compensation claim. She asks for payments because she can’t work.

Nia’s application for worker’s compensation asks if she works anywhere else. She says no. In fact, this isn’t true. Nia continues her other job as a bank teller. She decides not to report her second job because she doesn’t want the state to deny her worker’s compensation claim.

Nia eventually receives $2500 in worker’s compensation payments. She wouldn’t have received these payments if she had been honest about her employment. She purposefully chose not to tell the truth so that she could get payments that she didn’t really deserve. In this case, Nia comitted insurance fraud in the fourth degree.

Defenses to the charge

If you’re facing a charge of insurance fraud, you can evaluate each part of the charges to see what evidence the state has against you. For the state to prove insurance fraud, they have to prove that you tried to cheat the insurance company on purpose. If there’s an innocent explanation for what happened, the state might not be able to convince a jury that you’re guilty of the charge against you.

The state has to prove that you tried to get at least $1,000 using dishonest means. If the state can’t prove any part of the case against you, you might be not guilty of the offense. An experienced attorney can help you evaluate and defend the insurance fraud charges against you.

New York Penal Code 176.10: Insurance fraud in the fifth degree

When people are struggling financially, the temptation to find a short-cut or simple solution can be overwhelming. White collar crime such as insurance fraud has been on the rise over the years. It is important to understand what the New York Penal Code says about insurance fraud, examples of what insurance fraud could include, and defenses that your attorney might raise if you get charged with a white collar crime such as insurance fraud.

Insurance Fraud in the Fifth Degree
Every crime starts with a basic statue. Fraud in the fifth degree is the starting point and the base level for insurance fraud. Basically, this is defined as any insurance act that is fraudulent in nature. The statue itself is fairly vague so it is important to understand the key elements. There are 3 parts to proving insurance fraud.

1) Insurance fraud must involve a written statement as either part of an application or in support of an application for an insurance claim.

2) The person must know that the statement will be presented to an insurer with the intent to file an insurance claim.

3) The person must know that the statement has false or misleading information with the intent to conceal the truth.

Insurance fraud in the fifth degree is considered a class “A” misdemeanor and carries up to 1 year in jail. However, this is the base statue and is rarely the only charge that is filed. Additional charges could include theft if there is monetary gain. If there is more than 1 person involved, there could be additional charges related to organized crime.

Examples of Insurance Fraud
Insurance fraud covers a wide range of activities. Some of the more commonly seen crimes could include:

– Auto insurance fraud where people sell their cars and report it stolen to collect the insurance money

– Personal injury fraud where people fake an injury on the job to collect workman’s compensation

– Health insurance fraud where people falsify information on their health insurance applications or fail to disclose other health insurance coverage

– Personal insurance fraud where people claim their insured personal possessions were stolen or valued at a much higher amount than they are actually worth.

– Nuisance insurance claims where people fake injuries or plant foreign objects in their food to try to get insurance companies to settle to avoid the bad press or just get rid of the “nuisance” claim

There are defenses a good attorney can use to help protect you if you get charged with an insurance fraud crime. A good attorney will thoroughly investigate each claim looking for weak spots or holes in the prosecutor’s case. They can get illegal evidence thrown out of court. They can file motions to dismiss or drop certain charges if the prosecutors “overcharge” a case. They might be able to prove that there was no intent to defraud which could led to a complete dismissal.

White collar crime hurts everyone, and prosecutors and Assistant District Attorneys have been aggressively prosecuting claims of insurance fraud. In addition, judges have have been more willing to impose the maximum sentences to send a message and try to stem the rise of white collar crime such as insurance fraud. There are defenses if you get charged with insurance or healthcare insurance fraud in the New York area. The most important thing to do is hire a New York attorney that is experienced in these types of claims and can present a case that will you a chance to defend yourself.

Insurance fraud is illegal in the state of New York and covers a wide range of activities, such as auto and health insurance fraud. The state divides insurance crimes into different degrees depending on the severity of the offense, with insurance fraud in the first degree being the most serious. Insurance fraud in the fourth degree is a class E felony, which involves fraud in the amount between $1,000 and $3,000, and carries a potential prison sentence of up to four years, a hefty fine, and up to five years of probation. Defenses to insurance fraud can include proving that the defendant did not attempt to cheat the insurance company on purpose, or that the state cannot prove any part of the case against the defendant.

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