Giving false information to an insurance company in Florida to obtain undeserved benefits can lead to serious criminal charges. Insurance fraud can involve auto, life, homeowner’s, worker’s compensation, or health insurance, and any other insurance covering damages to people or property.

In Florida, insurance fraud rates continue to rise, with thousands of insurance fraud claims being investigated or charged by authorities each year. Florida’s Chief Financial Officer has recently warned that Florida communities are “under attack” by insurance fraudsters, and further action must be taken to curb the problem. Costs of insurance fraud schemes are passed down to innocent consumers in the form of increased premiums.

Examples of acts that could constitute insurance fraud include:

  • Staged car accidents
  • Intentional destruction or concealing of property
  • Arson
  • Falsified injury claims
  • Claiming Medicaid or Medicare benefits for services never received
  • Operating an unauthorized insurance entity, or selling insurance without a proper license

A common act of insurance fraud is also “inflated” claims in auto accident or injury insurance cases. This typically involves adding on pre-existing damages to a new insurance claim, or exaggerating the actual costs or damages incurred by the claimant. Sometimes, regular people do these things by mistake, without intent to commit fraud against their insurer.

Insurance Fraud Elements Under Florida Law

Florida Statutes Sec. 817.234 spells out a number of different ways insurance fraud can be committed. Notably absent from the statute, Florida courts have observed, is any requirement that an insurer relied upon the misrepresentation when processing a claim. Simply making the false or misleading statement is enough in most cases. Under the statute, generally, a person commits insurance fraud in Florida when they present false, incomplete, or misleading information to an insurer that is material to the insurance claim. To constitute fraud, the person involved must have known they were providing false, misleading, or incomplete information.

Penalties for Insurance Fraud in Florida

The punishments for an insurance fraud conviction can be severe, depending on the amount of money involved. Fraud less than $20,000 can be charged as a third degree felony, with jail time up to 5 years. If the amount fraudulently taken was between $20,000 and $99,999, it is likely a second degree felony with penalties up to 15 years in prison. Over $100,000 and a defendant faces first degree felony charges and up to 30 years in prison.

Any of these charges also include statutory fines in the thousands, court costs, restitution, and the prospect of civil lawsuits to recover money damages.

Professionals such as health care workers, accountants, and lawyers can also face suspension or revocation of their professional licenses for participation in any insurance fraud scheme. 

Defending Against Insurance Fraud Claims in Florida 

Given the serious and sometimes drastic penalties imposed on those accused of insurance fraud, preparing a strong and viable defense is of utmost importance. Consulting with an experienced Florida fraud defense attorney is the best way to get started, no matter what you think the outcome of your case may be. Because Federal, State, and local law enforcement agencies cast a wide net to catch purported insurance fraudsters, people can get dragged into an investigation based on a simple mistake or miscalculation they made. When this happens, you need to put your best foot forward and know all available legal options.

The Tampa Criminal Defense Attorneys at Trombley & Hanes Can Help You Defend Against an Insurance Fraud Claim 

Insurance fraud is a serious allegation with damaging consequences if convicted.

At Trombley & Hanes, we have handled many varieties of fraud defense cases such as these and can help you build a smart and vigorous defense to your case. Getting your side of the story out while navigating the legal process is challenging, but can be done with the right team at your side. Contact our Tampa white collar crime lawyers today for help.