Last Updated on: 27th July 2023, 04:34 pm

Joseph Potashnik and Associates PC has some of the most experience NYC Insurance Fraud lawyers in New York City. In this blog,  we’ll talk about insurance fraud; we will look at a brief definition of terms, and then we’ll get into what exactly constitutes the crime of insurance fraud. Let’s get started.

Insurance fraud; definition of terms.

• By insurance policy, we mean an insurance contract that includes reinsurance contracts, purported insurance policies, as well as reinsurance contracts.
• By statement we mean a notice, proof of loss, invoice, bill for any services, or any other evidence of loss.
• A person means any individual or type of firm.
• Personal insurance is an insurance policy that insures someone against loss of or damage to property, loss of or damage to property that isn’t used in conducting a business, losses or liabilities coming from ownership or use of a vehicle, other liabilities for loss of or damage to people or property, or death, including death by personal injury. A policy of insurance that insures any of these contingencies will be personal insurance if that portion of the premium exceeds the portion that can be attributed to other contingencies.
• Lastly, commercial insurance means any insurance other than personal insurance, and also includes any and all disability benefits.

Insurance fraud; defined.

Now that we’ve defined some of the terms involved, let’s get into what exactly a fraudulent insurance act is. This is an act committed by someone who, with the intention to defraud, presents a written statement as part of an application for the issuance of a claim that contains materially false information,or if they conceal any written statement or other type of physical evidence as part of an application for the issuance of a health insurance policy, or a claim that they know contains materially false information, or they conceal any information about this.
Such a policy will include those that were issued in relation to any plan for health coverage, or services authorized in relation to public health law. For the purposes of this part, an application for a health insurance policy won’t include an application for a health insurance policy or a contract that’s been approved by the superintendent of financial services.

Insurance fraud in the fifth degree.

Now that we have all of those definitions out of the way, let’s get into the charges. For insurance fraud in the fifth degree, you’re guilty of this when you commit a fraudulent insurance act. This is punished as a class A misdemeanor.

Insurance fraud in the fourth degree.

Same thing here, but with the addition that you’ve wrongfully taken property with a value that’s greater than $1,000. This charge is a class E felony.

Insurance fraud in the third degree.

Same thing here, but the property is of a value of $3,000. This one is a class D felony.

Insurance fraud in the second degree.

For this charge, it relates to property that exceeds $50,000, and it’s a class C felony.

Insurance fraud in the first degree.

For the final charge of insurance fraud, this relates to taking property that has a value of more than a million dollars, and this is a class B felony.

Aggravated insurance fraud.

Aggravated insurance fraud is when you commit a fraudulent insurance act and have previously been convicted within the last five years for any offense. This charge is a class D felony.

Fraudulent life settlement act; defined.

A fraudulent life settlement act is when, with the intent to defraud, you present a claim for payment or other benefit under a life settlement contract, which you know contains false information about a material fact, or if you try to conceal information that concerns any fact.

Life settlement fraud in the fifth degree.

Life settlement fraud in the fifth degree is when you commit a fraudulent life settlement act. Life settlement fraud in the fifth degree is a class A misdemeanor.

Life settlement fraud in the fourth degree.

This charge is if you commit life settlement fraud with property that’s worth more than $25,000. This is considered a class E felony.

Life settlement fraud in the third degree.

Same thing here, but the overall value is $50,000. This charge is a class D felony.

Life settlement fraud in the second degree.

For the second degree charge, it involves property with a value greater than $100,000, and it’s a class C felony.

Life settlement fraud in the first degree.

For life settlement fraud in the first degree, you’re guilty if the property you’ve taken exceeds in value of one million dollars. This is considered a class B felony.

Aggravated life settlement fraud.

Finally we come to aggravated life settlement fraud. You’re guilty of this when you commit a fraudulent life settlement act and have been previously convicted within the last five years of any offense. This charge is a class D felony.

Insurance fraud is a crime committed when someone intentionally presents false information or conceals information in an application for an insurance policy or claim. Charges for insurance fraud range from the fifth degree, which is considered a class A misdemeanor, to first degree felony charges, which involve fraudulent acts related to property valued at over $1 million. In addition to property insurance fraud, there are also charges for fraudulent life settlement acts, which involve presenting false information or concealing material facts in a claim for payment or other benefits under a life settlement contract. The charges for life settlement fraud range from a class A misdemeanor to a class B felony.