Best Insurance Fraud Lawyers in Tennessee

About Insurance Fraud Law in Tennessee, United States

Insurance fraud in Tennessee occurs when a person knowingly submits false information, makes misrepresentations, or conceals facts in connection with any type of insurance policy in order to receive an illegitimate benefit or to cause someone else a loss. This can involve all kinds of insurance, including health, auto, homeowners, workers compensation, and more. Fraud affects both insurers and policyholders, leading to increased premiums and reduced trust in the system. Tennessee treats insurance fraud as a serious offense, with both civil and criminal penalties.

Why You May Need a Lawyer

Legal assistance is often necessary if you are being investigated for, accused of, or charged with insurance fraud in Tennessee. Whether you are an individual or a business owner, the following situations may require professional legal help:

• You have been contacted by an insurance company or law enforcement about a suspicious claim.
• You are being accused of submitting false information to an insurance company.
• Your insurance claim has been denied or delayed due to suspicion of fraud.
• You are facing criminal charges related to insurance fraud.
• You work in the insurance industry and are concerned about compliance with Tennessee law.
• You are a victim of insurance fraud and want to understand your rights and options.

Local Laws Overview

Tennessee law specifically addresses insurance fraud under Tennessee Code Annotated (TCA) Section 56-53-101 and following sections. Key aspects include:

• Insurance fraud may be prosecuted as a felony or misdemeanor, depending on the circumstances and value involved.
• It is illegal to make or assist with false statements, material misrepresentations, or concealments in connection with insurance policies or claims.
• Both individuals and businesses can be held liable for insurance fraud.
• The Tennessee Department of Commerce and Insurance (TDCI) investigates suspected insurance fraud through its Insurance Fraud Investigations Unit.
• Penalties can include imprisonment, fines, restitution to victims, and loss of insurance licenses or business credentials.
• There are separate provisions for health care insurance fraud and workers compensation fraud with specific guidelines and stricter penalties.

Frequently Asked Questions

What is considered insurance fraud in Tennessee?

Insurance fraud includes any deliberate act to deceive an insurance company for a financial benefit, such as lying on an application, staging an accident, inflating damage, or submitting false receipts.

Can I be charged with insurance fraud by mistake?

If you unintentionally made a mistake on your insurance paperwork, it is usually not considered fraud. Fraud requires intentional deception. However, investigations can be stressful and may still require legal assistance.

What are the possible penalties for insurance fraud in Tennessee?

Penalties range from fines and restitution to incarceration in jail or prison. The severity depends on the amount involved and whether the fraud is classified as a misdemeanor or felony.

How does the state investigate insurance fraud?

The Tennessee Department of Commerce and Insurance has a dedicated Insurance Fraud Investigations Unit that works alongside law enforcement and prosecutors to investigate and prosecute fraud cases.

Will a conviction affect my ability to get insurance in the future?

Yes, a conviction for insurance fraud can make it very difficult to obtain future insurance coverage, and it can also affect your employment prospects, especially in positions requiring trust or financial responsibility.

Does insurance fraud only apply to policyholders?

No, insurance fraud laws also apply to insurance agents, claims adjusters, and others who handle insurance matters. Anyone who knowingly helps commit fraud can be prosecuted.

Can I report suspected insurance fraud?

Yes, you can report suspected insurance fraud to your insurance company or directly to the Tennessee Department of Commerce and Insurance.

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

If you are accused of insurance fraud, do not make any statements or provide documents without first consulting a lawyer experienced in insurance fraud cases in Tennessee.

Does my intent matter in an insurance fraud investigation?

Intent is critical. Prosecutors must usually show that you intended to defraud the insurance company. Innocent mistakes or misunderstandings are not sufficient for a conviction.

How long will an insurance fraud investigation take?

The timeline for investigations can vary widely, from a few weeks to many months, depending on the complexity of the case and the amount of evidence involved.

Additional Resources

For those seeking more information or assistance regarding insurance fraud in Tennessee, consider the following resources:

• Tennessee Department of Commerce and Insurance (TDCI): Oversees insurance regulations and fraud investigations within the state.
• Tennessee Attorney General’s Office: Handles prosecution of criminal insurance fraud cases and provides public information.
• National Association of Insurance Commissioners (NAIC): Offers consumer information about insurance fraud and prevention tips.
• Local legal aid organizations: Provide free or low-cost legal assistance for individuals who qualify.

Next Steps

If you believe you need legal assistance regarding insurance fraud in Tennessee, start by gathering all related documents, correspondence, and any evidence involved in your situation. Avoid making statements to insurance investigators or law enforcement without first consulting a qualified attorney. Look for a lawyer who specializes in insurance law or criminal defense with experience in insurance fraud cases in Tennessee. Many attorneys offer an initial consultation to review your circumstances and outline your options. Taking swift and proactive steps can protect your rights and build the best possible case for your defense or claim.