Best Insurance Fraud Lawyers in New York

About Insurance Fraud Law in New York, United States

Insurance fraud is a serious crime in New York, involving any act intended to defraud an insurance company or policyholder for financial gain. This can include providing false information on insurance applications, exaggerating claims, staging accidents, or submitting false documentation. The law applies to all types of insurance, such as health, auto, life, and property insurance. Insurance fraud can be committed by policyholders, insurance agents, medical providers, or organized crime rings. New York has some of the strictest laws in the country to deter and punish this type of crime, and penalties can be severe, including hefty fines and significant jail time.

Why You May Need a Lawyer

If you are accused of insurance fraud in New York, the consequences can be life-altering. A lawyer is vital in situations such as:

• You are under criminal investigation for suspected insurance fraud.
• You have been formally charged with insurance fraud.
• Your insurance claim has been denied due to suspected fraud.
• You have unintentionally submitted incorrect information or documents.
• An insurer or third party is pursuing civil action against you for alleged fraudulent behavior.
• You suspect that someone has committed insurance fraud against your policy.

Legal professionals can help protect your rights, navigate complex laws, provide guidance on compliance, and defend you in court if necessary.

Local Laws Overview

New York law defines insurance fraud under Article 176 of the New York Penal Law. There are several degrees of insurance fraud, ranging from the fifth degree (a misdemeanor) to the first degree (a class B felony), depending on the value involved and prior offenses. Key features of New York insurance fraud laws include:

• Making false statements or concealing material facts with the intent to defraud is criminalized.
• Specific statutes for workers' compensation fraud and healthcare fraud.
• The potential for both criminal and civil actions against offenders.
• Mandatory reporting by insurers of suspected fraud to state authorities.
• Penalties can include fines, restitution, probation, or imprisonment.
• Intent is a critical element in proving guilt, so honest mistakes are treated differently from deliberate deception.

Understanding local statutes is crucial, as penalties escalate with the amount of money involved and prior convictions.

Frequently Asked Questions

What is considered insurance fraud in New York?

Insurance fraud includes any intentional act of deceiving an insurance company for financial gain, such as submitting false claims, misrepresenting facts, or staging accidents.

What are the penalties for insurance fraud in New York?

Penalties vary based on the degree of the offense and can include fines, restitution, loss of professional licenses, and prison sentences ranging from one year to up to 25 years for the most serious offenses.

Can I be charged with insurance fraud for making a mistake on my claim?

Generally, honest mistakes are not prosecuted. Intentional deception or knowingly submitting false information is required for a fraud charge.

How do insurance companies detect fraud?

Insurers use special investigative units, data analysis, tips from the public, and cooperation with law enforcement to detect and investigate suspicious claims or activities.

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

Seek legal help immediately and avoid making statements to investigators or insurers before consulting with a qualified attorney.

Are both individuals and businesses subject to insurance fraud laws?

Yes, both individuals and businesses, including medical providers and insurance agents, can be investigated and prosecuted for insurance fraud.

Can someone go to jail for insurance fraud in New York?

Yes, depending on the severity and degree of the offense, individuals convicted of insurance fraud can receive jail or prison sentences.

Is it insurance fraud to exaggerate damages in a claim?

Yes, exaggerating or inflating damages can constitute insurance fraud and lead to criminal charges.

Can insurance fraud affect my ability to get insurance in the future?

A fraud conviction or documented attempt can make it extremely difficult or impossible to obtain insurance coverage in the future.

How does New York handle suspected insurance fraud?

New York mandates insurers report suspected fraud to the New York State Department of Financial Services, which investigates and coordinates with law enforcement for potential prosecution.

Additional Resources

If you need further information or assistance, the following organizations may be helpful:

• New York State Department of Financial Services - Insurance Frauds Bureau
• New York Attorney General's Office - Criminal Division
• National Insurance Crime Bureau
• New York State Bar Association - Lawyer Referral Service
• Local legal aid organizations for low-income individuals

Next Steps

If you are concerned about insurance fraud, follow these steps:

1. Document all relevant information and correspondence related to your insurance issue.
2. Avoid making statements to investigators, insurance companies, or law enforcement without consulting an attorney.
3. Contact a qualified criminal defense or insurance law attorney who has experience with New York insurance fraud cases.
4. Consider gathering character references and any supporting evidence that may help your case.
5. Stay informed about your rights and the legal process as your case proceeds.

Acting quickly and with the right legal guidance is crucial to protecting your rights and achieving the best possible outcome if you face an insurance fraud investigation or charges in New York.