In general, insurance fraud refers to any attempt to make a false claim to an insurance company, with the hope of illegally acquiring money or property. Although false arson claims are one of the most common insurance fraud attempts, there are also plenty of others. For instance, there have been cases where healthcare providers have attempted to bill insurance companies for services that were never rendered. Under the New York Penal Code though, insurance fraud in the second degree specifically refers to an attempt, whether successful or not, by someone to obtain property with a value of more than $50,000 and less than $1,000,000 from an insurance company.
Examples of Insurance Fraud
As previously mentioned, one of the most common examples of insurance fraud is arson. For example, if someone’s home is burned down, they might try to make a claim with an insurance company for the value of the house. If it is discovered that the person whose house burned down was the one responsible for the fire though, and intentionally committed the act in order to collect money from the insurance company, then they could be charged with insurance fraud. If the home’s value fell within the range between $50,000 and $1,000,000, then they would specifically be charged with insurance fraud in the second degree.
Defending Against Insurance Fraud Claims
In order to avoid being charged with insurance fraud in the second degree, a NYC criminal lawyer will normally try to prove that the value of the insurance money was less than the $50,000 minimum requirement. Of course, proving this does not absolve a defendant of guilt, but it does mean that the charge can at least be lowered to insurance fraud in the third, fourth, or fifth degree.
Aside from lowering the charges, the other primary defense against insurance fraud in the second degree is to prove that any wrongdoing was not actually intentional. For instance, if an insurance claim is found to be inaccurate, it could be argued that the defendant did not intentionally misrepresent their situation, and only made an inaccurate claim due to insufficient information. This is a common defense with regards to health insurance claims, where the circumstances surrounding a patient’s health can sometimes be difficult to determine, as well as the nature of any operations that they might require. Simply put, it is not enough for an insurance company to show that an error was made, they must also prove that the error was made intentionally.
Sentencing for Insurance Fraud
Insurance fraud in the second degree is treated as a class E felony, which means that anyone found guilty of it can be sentenced to up to 15 years in prison. In addition to serving time in prison, a guilty party can also be charged a fine or even sentenced to probation for up to five years. Finally, the judge can also order any money that was illegally obtained to be paid back to the insurance company.
Given the serious consequences associated with an insurance fraud case, it’s recommended that anyone suspected of having committed insurance fraud to immediately seek out an attorney. Since insurance fraud in the second degree can lead to prison time, as well as hefty fines, it’s important to have someone with expertise in the area to handle the case and ensure that the defendant has the best chance of avoiding punishment.
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