Best Insurance Fraud Lawyers in Wisconsin

About Insurance Fraud Law in Wisconsin, United States

Insurance fraud is a serious criminal offense in Wisconsin and throughout the United States. It generally involves an individual or organization intentionally deceiving an insurance company or policyholder for financial gain. This can include filing false insurance claims, exaggerating damages, staging accidents, or providing false information on an insurance application. In Wisconsin, insurance fraud is prosecuted under both state criminal statutes and, in some cases, federal laws. Law enforcement and insurance agencies actively investigate and prosecute suspected cases of fraud to protect consumers and maintain the integrity of the insurance system.

Why You May Need a Lawyer

There are several scenarios where someone might require legal assistance related to insurance fraud in Wisconsin. You may need a lawyer if:

• You have been accused or charged with insurance fraud, whether as a policyholder, health care provider, or business.
• You are under investigation by an insurance company or law enforcement agency regarding a suspicious claim.
• You suspect someone else has committed insurance fraud against you or your business.
• Your insurance company is attempting to deny or delay your valid claim by suggesting potential fraud.
• You are unsure about the legality of your claims or documentation provided to an insurer.

A legal professional can help you understand your rights, defend you against criminal allegations, and guide you through complex insurance and legal processes.

Local Laws Overview

In Wisconsin, insurance fraud is governed by criminal statutes found in Chapter 943 of the Wisconsin Statutes, particularly section 943.395, which addresses fraudulent insurance claims. Key aspects of Wisconsin insurance fraud law include:

• It is illegal to present false information with the intent to defraud an insurer with respect to any material fact in support of an insurance claim.
• Both individuals and businesses can be prosecuted for insurance fraud.
• Penalties for conviction may include fines, restitution, and imprisonment, depending on the value of the fraud and the circumstances of the offense.
• Convictions can also result in long-term consequences such as loss of professional licenses or increased insurance costs.
• Insurance companies are required to report suspected cases to the Wisconsin Office of the Commissioner of Insurance (OCI).

Because insurance fraud cases can be prosecuted as felonies in Wisconsin, the stakes are high for anyone accused of violating these laws.

Frequently Asked Questions

What actions are considered insurance fraud in Wisconsin?

Insurance fraud can include false claims about losses, exaggerating injuries, staging accidents, submitting fictional bills, or providing misleading information on insurance applications.

What are the penalties for insurance fraud in Wisconsin?

Penalties vary based on the value of the fraudulent claim and the charges brought. They can range from misdemeanor to felony convictions, with possible jail or prison time, fines, and mandated restitution.

Can insurance fraud be both a criminal and civil matter?

Yes. In addition to criminal prosecution, insurance companies or other affected parties may pursue civil lawsuits to recover losses associated with fraudulent claims.

If I made a mistake on my insurance claim, is it still considered fraud?

Not necessarily. Fraud requires intent. Honest mistakes or misunderstandings are not usually prosecuted as fraud, but corrected information should be provided as soon as possible.

How do insurance companies investigate suspected fraud?

Insurance companies may use investigators, interviews, document review, surveillance, and collaboration with law enforcement to detect and investigate fraud.

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

Contact a qualified criminal defense attorney immediately. Do not speak to investigators or insurance representatives until you have secured legal counsel.

Who prosecutes insurance fraud in Wisconsin?

Insurance fraud cases may be prosecuted by local district attorneys, the Wisconsin Department of Justice, or federal authorities if federal laws are implicated.

Can I report suspected insurance fraud?

Yes. Suspected fraud can be reported to the Wisconsin Office of the Commissioner of Insurance or local law enforcement agencies.

What is the statute of limitations for insurance fraud in Wisconsin?

Generally, for felonies, the statute of limitations in Wisconsin is six years from the date of the alleged fraud. However, timing can vary depending on the case specifics.

If I am convicted, can I appeal a decision in an insurance fraud case?

Yes, you have the right to appeal a conviction. A lawyer can advise you on your options based on the details of your case.

Additional Resources

There are several helpful resources available regarding insurance fraud in Wisconsin:

• Wisconsin Office of the Commissioner of Insurance (OCI) - Oversees insurance regulation and consumer protection.
• Wisconsin Department of Justice - Criminal investigations and prosecution, including insurance fraud cases.
• Wisconsin State Bar Association - Legal resources and lawyer referral services.
• National Insurance Crime Bureau (NICB) - Information on combating insurance fraud.
• Local law enforcement agencies - For filing police reports or seeking assistance.

Next Steps

If you need legal assistance regarding insurance fraud in Wisconsin, consider the following steps:

• Gather all relevant documents, such as insurance policies, claim forms, correspondence with insurers, and any notices or allegations received.
• Do not make any statements to investigators or insurance companies without first consulting a lawyer.
• Contact a qualified attorney with experience in insurance fraud defense or insurance law. Many offer free initial consultations.
• File any necessary reports or complaints with the appropriate authorities if you are a victim of insurance fraud.
• Stay informed about your rights and responsibilities throughout the legal process to ensure proper defense or resolution of your case.

Navigating insurance fraud allegations or investigations can be complex and stressful. Professional legal advice can make a significant difference in protecting your interests and achieving a favorable outcome.