People who travel for business or for personal reasons know the benefit of securing travel insurance. This type of coverage can help with the losses incurred due to delays, lost luggage, unexpected medical situations, and a number of other events. Like other forms of coverage, travel insurance providers may be the victims of fraud. Understanding how this can come about and what sort of repercussions can result can help anyone facing an accusation of fraud to understand what is happening and how legal counsel can aid in dealing with the charge.
What Forms Can Travel Insurance Fraud Take?
Most of the fraudulent attempts to make use of travel insurance revolve around filing claims that are not legitimate. The details of the claim may be completely false or they may be some basis in fact with certain bits of information omitted or others added. With any approach, the goal is to successfully file a false claim that results in a payout to the insured party. Depending on who is involved with the attempt, others may also benefit by receiving a portion of the benefits or payments from the insurance company.
One of the more classic examples of travel insurance fraud has to do with obtaining medical treatment while on a trip. The patient may go to a local clinic or other medical facility and actually see a doctor. When the time comes to submit a claim for the services rendered, the claim is sweetened or embellished in some manner. Most often, the scope of the treatment is claimed to be more comprehensive and complicated than what the patient actually received. The result is that the insurance company provides a greater payment to the medical facility or the insured party, depending on who submitted the claim.
Another example has to do with claiming that luggage was lost when in fact it arrived on time and was not damaged. Depending on the terms of the coverage and how those terms relate to the contents of the luggage, the payout can be significant. When the attempt to defraud the insurance company is successful, the traveler still has possession of all the belongings plus the money for what was purportedly damaged property.
Claiming theft of property is another common approach with travel insurance fraud. In this scenario, the claim is that something of value was stolen from the luggage, a hotel room, or possibly during a robbery attempt such as a mugging. This type of fraudulent activity can become even more involved, since it usually means filing a report with the local police as well as contacting the insurance provider.
What Sort of Penalties Result from Travel Insurance Fraud?
If the fraud is detected at any point, the perpetrator will have to deal with less than pleasant circumstances. The best case scenario is that the fraud is detected during the evaluation of the claim and before any funds are disbursed. That will often lead to a rejection of the claim and a cancellation of the coverage. The individual will find it difficult to receive coverage from that same provider again.
When a payout has already taken place, investigators will work closely with the local authorities to confirm that fraud was committed. This can lead to criminal charges that involve repaying the amount received, probation, and possibly time in jail. Assuming the individual is found guilty, there is also the possibility of a civil suit along with the criminal action.
Accusations When the Claims are Legitimate
While there is no doubt that travel insurance fraud does take place, not every allegation has a basis in fact. The allegation may arise from the fact that the claim was incomplete in some manner, but free of any attempt to defraud. In these situations, identifying the cause for the allegation and seeking to resolve the issue makes it possible to move forward with the claim evaluation.
Being accused of filing a claim with the intent to commit fraud is nothing to take lightly. Along with the immediate legal troubles, a conviction could also make it impossible to obtain the same type of coverage from any other carrier. There is also the matter of the conviction showing up on background checks and preventing the individual from being able to secure employment.
Never take accusations of this type lightly. Seek out legal counsel and listen closely to the advice of the travel fraud lawyer. Under the best possible circumstances, whatever led to the allegation can be defused and the matter settled without anyone having to go to court.