Insurance Fraud Lawyers

Responding to Insurance Fraud Accusations: A Comprehensive Guide

If an insurance company or law enforcement agency has recently accused you of committing insurance fraud, you must respond right away so that you can protect yourself, your future, and your reputation from irreversible damage. Judges and prosecutors take these charges seriously and will do everything in their power to bring you to justice. The worst part is that they can even target innocent people who have made honest mistakes.

Seek Legal Assistance Immediately

No matter if you are a medical professional or a policyholder, you could face allegations when you least expect it. Moving forward without help is unwise and will probably destroy your chance of reaching a fair outcome. When you want to keep yourself out of harm’s way, turn to a trusted insurance fraud defense attorney as soon as you can. Doing so will reduce your odds of being convicted and provide you with the best possible results.

Understanding Insurance Fraud

Types of Insurance Fraud

You will need to learn as much as you can about insurance fraud and how it works, which will give you a better understanding of the charges you are facing. Insurance fraud is the process of lying on an insurance claim to collect benefits to which you would otherwise not have access. In cases of soft fraud, patients will exaggerate the nature or impact of a legitimate claim to increase the amount of compensation they can collect.

Hard fraud occurs when people invent claims or stage accidents so that they can collect compensation, and this type is much easier for insurance companies and law enforcement to detect and prosecute. If you work in the medical field, law enforcement agencies can accuse you of filing a claim for services that you did not provide. Insurance fraud also covers cases in which medical professionals overcharge or lie about the type of treatment that they offered. If you are under investigation and don’t want to face unneeded problems, ask an insurance fraud lawyer for advice on what you should do next.

Potential Penalties

When they are first accused of committing insurance fraud, most people ask about the type of penalties they could face if they lose in court, which is understandable. Prosecutors will usually seek a misdemeanor conviction when they suspect that someone has committed soft fraud, and you can face up to one year in jail and a fine of up to $15,000. If you commit hard fraud or are a medical expert and commit billing fraud, you will likely face felony charges, steep fines and up to five years in prison.

Navigating Your Case

Progress of Your Case

At this point, you might want to know how your case will move forward so that you can prepare yourself for the future. Fraud cases normally begin when an insurance company detects red flags that trigger an internal investigation. The insurance company will look into your past claims to detect a pattern of unusual behavior, but it can also conduct an audit and utilize private investigators. Since it does not want to give you time to cover your tracks, the insurance company is unlikely to notify you of the investigation at this point.

Legal Proceedings

If your insurance company believes that it has enough evidence to pursue charges, it will hand the case over to a relevant law enforcement agency. Depending on what evidence they use against you, the police can obtain an arrest warrant and place you in jail. If you can afford your bail, you can get out from behind bars until the conclusion of your case. Your case will likely end with a plea deal if you are like other defendants. You can take your case to court if you are not pleased with the deal offered by the prosecution, and a jury will decide your fate.

Defense Strategies

Defending Yourself

When you are at risk for going to prison and being forced to pay fines, you must put in the effort to learn about your possible defenses. You can earn a verdict of not guilty if you can prove that the evidence against you is false, but that is only one approach. Since nobody is perfect, the errors on your claim could be the result of an honest mistake. Your insurance fraud attorney will look at the details of your case and help you form an effective defense.

Role of an Insurance Fraud Attorney

When you are facing insurance fraud allegations and enlist the support and guidance of a criminal defense attorney, your legal expert will learn about your case, review the evidence, and help you understand the situation. Your attorney will tell you about the possible outcomes and what you can do to protect yourself and reduce the damage. A qualified and caring lawyer will search for holes in the prosecutor’s case to create reasonable doubt.

When you have a fraud defense attorney on your side, you will gain a fair deal from the prosecutor’s office, but you will also have the opportunity to challenge the accusations if you are not happy with the terms. If you decide to fight, your attorney will defend your name, reputation, and future in front of a judge and jury.