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Last Updated on: 28th July 2023, 07:17 pm
Insurance fraud is considered a form of white collar crime. White collar crime is defined as a criminal act, usually some type of fraud, performed by someone with a higher than normal social standing or level of education. These types of cases can be prosecuted on either the federal level or the state level, depending on the type of fraud committed, who the victims are, the total dollar amount involved, and more. In some cases, both the US Attorney and the New York State District Attorney could both prosecute. The laws behind insurance fraud can get very complex.
New York penal code 176.30 Broken Down
New York Penal Code 176.30 deals with insurance fraud where the property involved has a value in excess of $1 million. People can be charged with insurance fraud when they knowingly give false information to an insurance company with the intent to receive money they are not entitled to receive. Penal code 176.30 deals with insurance fraud in the first degree, which is the most serious insurance fraud crime due to the high dollar amount involved. This is a class “B” felony. Sentences for class B felonies can be quite stiff, with prison terms of up to 25 years plus probation, fines, and restitution.
Examples of Class B Felony, First Degree Insurance Fraud
To qualify under Penal Code 176.30, the total dollar amount must exceed $1 million. One example might be when someone fakes a robbery of a valuable collection just so they can file an insurance claim. Another example might be if someone sets fire to their home to get out from under a mortgage and collect on the homeowner’s insurance. These would both fall under the Penal Code 176.30 if the total value was greater than $1 million. There could be additional charges in both these events in addition to an insurance fraud charge.
There are other instances of insurance fraud where the total amount involved could exceed $1 million. Life insurance fraud and healthcare claims fraud are two such examples. However, these types of insurance fraud are covered under a different Penal Code.
Defenses Against a Charge of First Degree Insurance Fraud
There are many different defense strategies that a good experienced criminal defense attorney can utilize. The first test is always intent. If you didn’t intent to defraud the insurance company or didn’t realize that you were filing a claim with false information, you wouldn’t be guilty of fraud. For example, if a family member removed a piece of valuable property and you thought it was stolen, then that wouldn’t be considered insurance fraud because you didn’t know and didn’t willfully intend to deceive the insurance company. Similarly, if you filed a claim and unknowingly made false statements, that would not be considered fraud. The key is intent. In addition, if the total value of the insurance claim is less than $1 million, than Penal Code 176.3 would not apply and the charges should be reduced.
New York Penal Code 176.30 is a very serious charge that carries substantial fines and potential prison time of up to 25 years. There are defenses that a good experienced New York criminal attorney can utilize to help minimize the sentence, reduce the charges, or even get the case dropped altogether. The most important thing is to contact a good attorney as soon as possible when these type of charges are levied against you. A good defense attorney will examine all the fact and be able to present the best possible defense.
New York Penal Code 176.25: Insurance fraud in the second degree
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 ,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.
New York Penal Code 176.20: Insurance fraud in the third degree
Insurance fraud occurs when a person uses dishonesty or a material misrepresentation in order to get a payment from an insurance company that they don’t really deserve. People can try to use any type of insurance to commit fraud. Consumers can submit false claims on homeowner’s insurance, automobile insurance and medical insurance, to name just a few.
Even public insurance programs like medicaid and Medicare are subject to fraud. Insurance fraud costs honest consumers because it raises the premium rates for everyone. This is why courts take insurance fraud seriously.
Examples of insurance fraud
Fraud can occur on a homeowner’s insurance policy when a person commits arson. After the arson, they make a claim for the value of their home, even though the insurance policy excludes arson from their coverage. Another homeowner’s insurance fraud occurs when a person claims that a thief stole items when the items aren’t really stolen.
In automobile insurance, fraud can occur when a person claims that damage occurred in a crash when the damage really occurred at a different time. A person might also claim damages for physical injuries when the person didn’t really suffer the injuries in the automobile crash. A person might even claim that a crash occurred when it really didn’t even happen.
Types of insurance fraud
New York law aims to punish people more severely if their insurance fraud involves greater amounts of money as opposed to lesser amounts of money. For this reason, there are several different degrees of insurance fraud under New York law. You might face a charge of insurance fraud in the third degree if you attempt to cheat an insurance company out of more than $3,000 but less than $50,000.
Insurance fraud in the third degree
Insurance fraud in the third degree is a violation of New York penal code 176.20. It is a class D felony. A conviction can send you to up to seven years in prison. You also face a potential term of probation of up to five years. You have to pay restitution in the amount of the fraud.
All felony charges are serious, so it’s crucial that you speak with an NYC criminal attorney if you’re facing this type of charge. The attorneys at Spodek Law Group have years of experience defending clients from insurance fraud claims. An attorney can help you evaluate potential defenses. If it’s appropriate, they can help you approach the state’s attorney with your defenses. Your attorney might be able to get your charges dismissed before trial or help you reach a non-trial resolution that works for you.
If you’re charged with insurance fraud in the third degree, the state has to be able to prove that you intended to cheat someone else. In some cases, the state might not be able to prove your intent. It’s possible that you didn’t plan to cheat the insurance company at all. You might have had honest misconceptions about a situation, or it might be a situation where reasonable minds can differ. Any misunderstanding of this nature can serve as a defense to the charges against you.
You can also attack the amount of the fraud. Although it might seem technical, insurance fraud is charged by degrees. It might be worth your while to argue that the alleged fraud didn’t amount to $3,000. Because it’s an element of the charge, the amount of the fraud is something that the state has to prove. If the state can’t prove the amount, it can serve as a viable defense to the charges.
While white collar crimes may not paint the same dire picture as violent offenses, many people fail to recognize that insurance fraud, a common form of white collar crime, comes with its own set of complex nuances and hefty penalties. Prosecutions may take place on both federal and state levels, entangling defendants in a web of legal complications. In response to the intricacies of insurance fraud, it’s crucial to understand the numerous aspects of relevant legislation, such as New York Penal Code 176.30, and the potential defenses available.
Insurance fraud not only involves white lies but also places defendants at risk of being charged with a class “B” felony if the property in question has a value of over $1 million. Crucially, defendants face up to a staggering 25 years in prison plus probation, fines, and restitution when charged under Penal Code 176.30 categorizing this as first-degree insurance fraud.
|Examples of Class B Felony||Other Instances of Insurance Fraud|
| A person fakes a robbery of a valuable collection to file an insurance claim.|| Life insurance fraud|
| Someone sets fire to their home to escape a mortgage and collect homeowner’s insurance.|| Healthcare claims fraud|
Despite the potential severity of insurance fraud charges, a skilled and experienced criminal defense attorney can employ multiple defense strategies. The crucial factor in insurance fraud cases hinges on intent. If a defendant did not knowingly submit false information or had no intent to deceive the insurance company, they may not be found guilty of fraud.
For Example, if a family member took a valuable property and the defendant believed it was stolen, this would not be considered insurance fraud. Similarly, if the defendant unknowingly makes a false statement during a claim, that incident would not be classified as fraud. It’s worth remembering that if the total value of the claim falls below $1 million, Penal Code 176.3 wouldn’t apply, and the charges would be reduced.
Insurance fraud isn’t confined to first-degree charges; individuals may also face charges for insurance fraud in the second degree if they attempt to obtain property valued between $50,000 and $1,000,000 from an insurance company. This type of fraud, classified as a class E felony, carries severe penalties including up to 15 years in prison, hefty fines, and possible probation for up to five years.
|Popular Defense Against Insurance Fraud||Alternative Defenses|
| Establishing the insurance money’s value is less than $50,000, lowering the charge to third, fourth, or fifth-degree insurance fraud.|| Showing that any wrongdoing was not intentional, such as insufficient information or unclear circumstances.|
New York’s third-degree insurance fraud, defined as a class D felony, occurs when individuals attempt to cheat insurance companies out of more than $3,000, but less than $50,000. Convictions of this nature can result in up to seven years in prison and a potential term of probation up to five years, as well as restitution.
Regardless of the severity of the insurance fraud charge, effective defenses can be employed by skilled attorneys. For third-degree insurance fraud, defendants’ intentions to deceive can be challenged. A lack of intent to cheat, honest misconceptions about a situation, or differing reasonable opinions can serve as valid defenses against such charges. Additionally, disputing the amount of the alleged fraud may prove advantageous since this element of the charge must be proven by the state.
Ultimately, the best course of action for individuals facing insurance fraud charges, especially high-stakes first-degree insurance fraud under Penal Code 176.30, is to seek reliable legal representation. With the complex landscape of insurance fraud offenses and penalties, enlisting the help of an experienced New York criminal attorney can be a game-changer for defendants.
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