New York Insurance Fraud Defense Lawyer

Insurance companies run investigations to verify the validity of all insurance claims. If they find evidence suggesting the claim is fraudulent, they report it to law enforcement. This report may lead to criminal charges of insurance fraud, and suddenly, people find themselves under a lot of pressure about where to turn for help.

But you don’t have to face this alone. The Law Offices of Mehdi Essmidi are here to help. Attorney Mehdi Essmidi is a former New York City Prosecutor who has turned his focus to aggressive criminal defense. He uses his experience as a former prosecutor to anticipate and counter the strategies that might be used against you. Contact us today for a free consultation.

Insurance Fraud Charges

Under NY Penal Law § 176, it’s illegal to plan and carry out a scheme to deceive an insurance company into giving you money or property by making false claims.

The degree of the charge depends on the value of the claim. The law outlines five degrees of insurance fraud, with the first degree being the most serious:

Fifth Degree: Claims not exceeding $1,000.

Fourth Degree: Claims exceeding $1,000 but not exceeding $3,000.

Third Degree: Claims exceeding $3,000 but not exceeding $50,000.

Second Degree: Claims exceeding $50,000 but not exceeding $1 million.

First Degree: Claims exceeding $1 million.

If you’re facing any fraud charges, hiring an experienced criminal defense attorney who can build a strong defense and fight for your rights is essential.

Insurers’ Investigations

Insurance companies use many methods to gather evidence against you. This can include surveillance, interviews with witnesses, and a diligent examination of documents related to your claim.

These investigations can be invasive and stressful. If you’re under investigation for insurance fraud, it’s important that you do not speak with investigators without legal representation present.

The Fraudulent Insurance Act

The Fraudulent Insurance Act is a piece of legislation in New York that penalizes deceptive practices within the insurance industry.

Under this act, any individual who knowingly engages in a scheme to defraud an insurance company by presenting materially false information, submitting fraudulent claims, or concealing important facts is subject to legal action.

Violations of the Fraudulent Insurance Act can result in fines, restitution, and imprisonment, depending on the degree of the offense.

The prosecution carries the burden of proof in all insurance fraud cases. They must convincingly demonstrate that fraudulent activity occurred and that you knowingly and intentionally engaged in it.

Insurance Fraud Related Charges

Insurance fraud often involves other offenses that, while distinct in their own right, can be committed while executing insurance fraud and, thus, fall under its umbrella. Below are some crimes commonly linked to insurance fraud.

Personal Injury Fraud

Personal injury fraud is a form of insurance fraud where individuals fabricate or exaggerate injuries to claim compensation from insurance companies. This type of fraud can involve staging accidents, providing false medical records, or exaggerating the severity of an injury to receive a larger settlement.

Auto Insurance Fraud

This is a common type of insurance fraud where the insured deliberately causes a road accident, intending to claim fabricated damages and injuries.

Home Insurance Fraud

Home insurance involves any act committed to obtain payment from an insurer. This could include inflating the value of stolen items, deliberately damaging property to claim for repairs, or even staging a burglary or fire.

Health Insurance Fraud

Health insurance fraud convictions often result in felony charges under New York penal law. These involve false claims to obtain unauthorized benefits from health insurance providers. This type of fraud can include submitting false claims, exaggerating medical conditions, or billing for services not rendered.

Identity Theft

This involves using another person’s identifying information, usually for financial gain. In the context of insurance fraud, a person might use someone else’s identity to file a fraudulent insurance claim.

Forgery

This crime involves creating, altering, or using a forged document intending to defraud. For instance, a person might forge a doctor’s signature on a medical document to support a fraudulent insurance claim.

Money Laundering

This is the process of making illegal proceeds appear legal. A person committing insurance fraud might launder the money received from a fraudulent claim to make it seem as if it was obtained legally.

Racketeering

This involves operating an illegal business or scheme for profit. Concerning insurance fraud, a person or group might run a racketeering operation, staging accidents and filing fraudulent insurance claims.

Consequences of Insurance Fraud Convictions

As a type of white collar crime, insurance fraud can lead to fines, restitution, imprisonment, probation, and a permanent criminal record. The specific penalties depend on the degree of the charge:

• Fifth Degree: Up to 1 year in jail
• Fourth Degree: Up to 4 years in prison
• Third Degree: Up to 7 years in prison
• Second Degree: Up to 15 years in prison
• First Degree: Up to 25 years in prison

Possible Insurance Fraud Defenses

Every case is unique, and the best defense strategies should be tailored to your circumstances. Some possible defenses that attorney Mehdi Essmidi has used against insurance fraud charges include:

Lack of intent

The prosecution must prove that you intentionally committed fraud. This could be a strong defense if misrepresentations were accidental or due to a misunderstanding.

Insufficient evidence

The prosecution must prove beyond a reasonable doubt that you committed insurance fraud. If the evidence against you is weak or circumstantial, its sufficiency may be challenged.

Violation of rights

Any evidence obtained could be suppressed if law enforcement violated your rights during the investigation or arrest.

Contact Our Insurance Fraud Attorneys Today

At The Law Offices of Mehdi Essmidi, we have worked day and night to develop the best possible defenses for hundreds of fraud cases in New York. Choosing the right attorney can make all the difference in your case.

As a former prosecutor, attorney Mehdi Essmidi provides insight into how the other side thinks and operates, allowing him to anticipate their strategies and build a strong defense on your behalf.

Whether you have been charged with insurance fraud or other white collar crimes, we stand ready to defend you. Contact us today for a free consultation.

Frequently Asked Questions About Insurance Fraud Defense

How are insurance fraud offenses classified in New York?

Insurance fraud charges in New York are classified by degrees. Insurance fraud in the fifth degree is a class A misdemeanor, while insurance fraud in the fourth degree is a class E felony, and insurance fraud in the third degree is a class D felony. For more serious cases, insurance fraud in the second degree is a class C felony, and first-degree offenses constitute a class B felony. The degree depends on the fraudulently obtained or attempted benefit amount, with higher degrees corresponding to larger sums.

What penalties might I face for auto insurance fraud in New York?

Auto insurance fraud penalties vary based on the offense. A class E felony conviction may result in probation or up to three years’ imprisonment. Class D felony convictions can carry up to seven years, while Class C felony and Class B felony charges carry even longer sentences. Additionally, most insurance fraud convictions require payment of restitution. Even a misdemeanor conviction is punishable by up to one year in jail and significant fines.

Is submitting a false health insurance claim considered a serious offense?

Yes, health insurance fraud is treated as a serious criminal offense in New York. Submitting false claims to a health insurance provider can result in felony charges under New York penal law. This includes misrepresenting services received, billing for services never rendered, or providing false patient information. Prosecutors often pursue these cases aggressively. A New York insurance fraud attorney can help determine available legal strategies to fight these charges.

How does the prosecution prove insurance fraud cases?

To prove insurance fraud cases, prosecutors must establish that you knowingly presented materially false information in an insurance claim or application. Evidence typically includes insurance claims documentation, written statements, business records, altered medical reports, or witness testimony.

Do I need an attorney for an insurance company investigation that hasn’t led to criminal charges?

Hiring a York insurance fraud lawyer during an insurance company investigation is advisable even before criminal charges. Many fraud investigations begin with the insurer before transitioning to law enforcement. Early legal representation can sometimes prevent criminal charges entirely. Most insurance fraud lawyers offer a free consultation to evaluate your situation and explain potential risks, making it worthwhile to seek advice at the earliest sign of investigation.

Can I face criminal charges and civil penalties for the same insurance fraud charges?

Yes, insurance fraud allegations can lead to both criminal prosecution and civil liability. While the state pursues criminal charges under the fraudulent insurance act, the affected insurance company may simultaneously sue for damages. These proceedings run under different standards of proof and may result in separate penalties. An experienced New York insurance fraud defense lawyer may coordinate strategy across both cases to minimize your overall exposure to penalties.