If you’re accused of insurance fraud it’s essential to learn more about the charges against you, seek experienced legal advice, and start preparing a defense with your legal team.
The team at The Maine Criminal Defense Group can guide you through the legal hurdles and provide the help and support you need to minimize the impact on your future.
Call 207-571-8146 or contact us online to schedule a consult with one of our highly skilled OUI & criminal defense attorneys today.
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What is considered insurance fraud in Maine?
Insurance fraud is best described as an illegal action by either the buyer or seller of insurance policies.
Most people think of insurance fraud as an insured individual making incorrect or exaggerated claims to defraud an insurance company. For example, staging a fire to claim from a home insurance policy or filing an exaggerated claim for losses in a car accident could be found as insurance fraud.. They are misrepresentations made by the buyer to obtain an improper insurance payment. However, there are many other types of insurance fraud, such as the deceptive actions of insurance brokers.
Typically, in Maine, we see insurance fraud charges for the following types of activities from buyers/claimants:
- Submitting false or misleading information to benefit from an insurance policy payout.
- Submitting false or misleading information to cause the insurance company to charge lower premiums.
- Filing a false police report to support a claim.
- Aiding another individual to present or prepare misleading or false information for insurance purposes.
We also see cases of insurance fraud against the sellers or employees of insurance companies for the following types of activities:
- Soliciting or accepting insurance risks on behalf of an insurer by an individual who is aware that the insurer is insolvent.
- Altering the assets or records of an insurer.
- Approving insurance claims they know to be false.
- Embezzling money or other assets from an insurer.
- Initiating and/or completing an insurance transaction without the proper license or certification.
- Aiding and abetting someone else in performing these acts.
Common types of insurance fraud in Maine
It surprises many people to learn the full extent of insurance fraud in the U.S. The FBI estimates that the total cost of insurance fraud (non-health insurance) is over $40 billion per year.
In Maine, insurance carriers are required to report fraudulent insurance acts on an annual basis at the minimum. Carriers must detail all acts of fraud that they know of, or reasonably believe to have been committed during the previous calendar year.
Over 300 suspected fraudulent acts per year are reported or referred to law enforcement and other agencies.
Insurance fraud spans all types of policies and affects every area of the industry in Maine. From an insurance buyer’s perspective, the following types of insurance policies attract the most fraudulent activity:
Homeowner’s insurance fraud
Staging a fire in the home to collect a payout is an extreme (but relatively common) example of insurance fraud. Another example is taking advantage of a storm or other major weather incident to claim damage to a property.
Auto insurance fraud
Falsely reporting a car stolen or faking an accident (often involving more than one offender) are two of the most common types of auto insurance fraud. Even overstating the damage caused in a vehicle accident is considered insurance fraud and can be punished under Maine law.
Life insurance fraud
Another quite extreme example of insurance fraud is faking one’s death so that a partner (the conspirator in the scheme) can claim the life insurance payout as the beneficiary.
Health insurance fraud
Deceiving health insurance companies into making payouts can take many forms. This type of fraud often starts with medical professionals in hospitals or clinics ordering medical tests that are not required or have not been performed, and then billing the insurance company.
Renter’s insurance fraud
A relatively common example of renter’s insurance fraud includes staging a burglary, moving one’s belongings out, and filing a claim to collect damages. Inflating claims with possessions that were never owned by the claimant is also quite a common occurrence.
Call 207-571-8146 or contact us online to schedule a consult with one of our highly skilled OUI & criminal defense attorneys today.
Penalties for insurance fraud in Maine
The penalties for an insurance fraud conviction are severe, but the sentence will depend on multiple factors. Courts look at the level of fraudulent activity, whether the case is handled at the state or federal level, the criminal history of the offender, and the quality of legal representation available.
If charged at the federal level, the penalties are likely to be even more severe than at the state level. The U.S. Code states that any fraud involving the Federal Deposit Insurance Corporation (FDIC) can lead to a fine of up to $1 million, imprisonment for up to 30 years, or both.
Under Maine statutes, imprisonment is also a possible sentence for insurance fraud. Fraud penalties generally include fines ranging from $500 to $5,000 per violation for individuals, and $2,000 to $15,000 for each violation for corporations or other entities.
Other possible penalties include payments to the plaintiff for damages, equitable relief, or overcharges, or payments to cover the costs of their legal representation, as well as other types of restitution.
How can an insurance fraud lawyer help in Maine?
Although fraud is considered to be a “white-collar crime”, the potentially harsh punishments, reputational damage, and long-term consequences of a criminal record mean that you should do everything possible to fight the charge.
You are innocent until proven guilty and don’t need to go into battle alone. The first step is to seek professional legal help from an insurance fraud attorney experienced in these types of cases and accustomed to building powerful defenses.
If you have been arrested for insurance fraud in Maine, contact The Maine Criminal Defense Group directly online or call us at (207) 571-8146 to speak with an experienced criminal defense lawyer who can help you.
Call 207-571-8146 or contact us online to schedule a consult with one of our highly skilled OUI & criminal defense attorneys today.
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