Best Insurance Fraud Lawyers in New Mexico

About Insurance Fraud Law in New Mexico, United States

Insurance fraud in New Mexico occurs when an individual or business intentionally deceives an insurance company or agent with the intent to receive benefits, payments, or other advantages that they are not entitled to. This type of fraud can involve many forms of insurance, including health, auto, homeowner, and workers’ compensation policies. Both individuals making fraudulent claims and those helping to execute or file such claims can be prosecuted under New Mexico law. Insurance fraud is a serious criminal offense that can lead to heavy fines, restitution, and imprisonment.

Why You May Need a Lawyer

Legal complexities surrounding insurance fraud can make it challenging for individuals to navigate the process alone. Some common situations where legal assistance is crucial include:

• If you are accused of submitting a false insurance claim or are under investigation.
• If your insurance company has accused you of misrepresentation, arson, or staged accidents.
• If you are an insurance professional or agent facing allegations of fraud in your practice.
• If you are denied payment of a legitimate claim and accused of acting fraudulently.
• If you suspect your provider or agents are involved in fraudulent activities impacting your coverage or benefits.

Engaging a knowledgeable lawyer can help protect your rights, advise on the legal process, and potentially minimize the consequences of a fraud accusation.

Local Laws Overview

Insurance fraud in New Mexico is addressed under state statutes, specifically Section 59A-16C of the New Mexico Insurance Code. The law makes it illegal to knowingly and willfully execute, or attempt to execute, a scheme to defraud any insurance provider or agency. This includes providing false information, omissions, or fabricating evidence related to an insurance policy. The penalties for insurance fraud in New Mexico range from misdemeanor to felony charges, depending on the amount involved and the nature of the offense. Beyond criminal penalties, violators can also face civil liability for damages caused to the insurer. Additionally, insurance companies in New Mexico are required to report suspected fraud, and the state has an established Insurance Fraud Bureau to investigate and prosecute these crimes.

Frequently Asked Questions

What types of actions constitute insurance fraud in New Mexico?

Insurance fraud includes submitting false claims, inflating the value of losses, staging accidents, falsifying information on insurance applications, and submitting claims for non-existent or pre-existing damages.

Is insurance fraud a felony or misdemeanor in New Mexico?

The classification depends on the value of the fraudulent claim. Higher value frauds can be charged as felonies, while lesser value offenses may be treated as misdemeanors.

What are potential penalties for committing insurance fraud in this state?

Penalties can include significant fines, restitution to the victim insurance carrier, probation, and prison time. Felony convictions can carry multi-year sentences.

Who investigates insurance fraud in New Mexico?

The New Mexico Office of Superintendent of Insurance operates an Insurance Fraud Bureau dedicated to investigating and prosecuting insurance fraud cases.

Can I be prosecuted for making a mistake on an insurance application?

Honest mistakes are generally not prosecuted as fraud. However, deliberately providing false information with intent to deceive can result in criminal charges.

What should I do if I am accused of insurance fraud?

Contact an experienced insurance fraud attorney immediately to discuss your case, protect your rights, and respond appropriately during any investigation or legal proceedings.

Are insurance companies required to report suspected fraud?

Yes, New Mexico law obligates insurance companies to report any suspicious activity or suspected fraud to the authorities.

What defenses are available against insurance fraud charges?

Common defenses include lack of intent, insufficient evidence, misunderstanding, or proving the claim was legitimate. An attorney can help assess which defenses apply to your situation.

Can insurance fraud charges be settled or negotiated out of court?

In some cases, it may be possible to resolve insurance fraud allegations through negotiations, restitution, or plea agreements, depending on the circumstances and the prosecutor’s discretion.

If I witness insurance fraud, how can I report it?

You can report suspected insurance fraud to the New Mexico Office of Superintendent of Insurance or directly to your insurance provider’s fraud department for investigation.

Additional Resources

If you need further information or wish to report insurance fraud, consider reaching out to these organizations and resources:

• New Mexico Office of Superintendent of Insurance - Insurance Fraud Bureau
• New Mexico Attorney General’s Office
• New Mexico State Bar Association for referrals to specialized attorneys
• National Insurance Crime Bureau (NICB)
• Legal aid organizations in New Mexico

Next Steps

If you are facing insurance fraud allegations or believe you need legal guidance, it is advisable to:

• Document all relevant communications and evidence related to your insurance policy and claims.
• Contact a qualified attorney with experience in insurance fraud cases in New Mexico.
• Do not discuss your case with investigators, insurance companies, or third parties without legal counsel.
• Cooperate with your lawyer to build a strong defense or response to the accusations.
• If you suspect fraud by others, report it to the appropriate authorities or organizations.

Timely legal guidance is crucial to protecting your rights and achieving the best possible outcome in insurance fraud cases in New Mexico.