Who Can Commit Insurance Fraud?

Insurance fraud is a serious matter, and many people in St. Petersburg worry about it affecting them. Both providers and policyholders are capable of cheating the system, and misunderstandings can lead to false accusations. Agents and adjusters that work for coverage providers are also capable of legal deception, so it’s important to be aware of this issue in order to stay protected.

Insurance Providers

Insurance companies are responsible for making sure their clients receive all the benefits they are due. Sometimes providers knowingly deny their benefactors the benefits to which they are entitled. Most often the motivation behind this is monetary gain, but improving financial figures can also be tempting. Other providers, like medical or health care, send false reports to companies in order to cash in. Billing for services not rendered, filing services not covered as ‘covered’, misrepresentation, and unnecessary issuance of drugs are all ways medical providers have attempted to commit perjury.

Claimants/Policyholders

It’s hard to believe that insurance fraud happens in St. Petersburg, but corruption can occur anywhere. With all the paperwork, middlemen, and statements necessary for filing claims, it’s easy to see how some things might slip by unnoticed. By enrolling in a policy program, policyholders agree to pay a recurring fee for the assurance that, should something happen, their provider will help them pay for damages. With so many different types of policies – life, health care, auto, and property, to name a few – some claimants may try to manipulate their provider. According to the FBI, common schemes include:

  • Premium diversion
  • Fee churning
  • Asset diversion
  • Worker’s compensation

These are typical ways people manipulate the system, but detectors have developed advanced methods to expose fraudulent activity. Anyone can be committed, and the consequences vary based on the type and level of extortion.

Hard vs Soft Fraud

St. Petersburg police are cracking down on insurance fraud, and the penalties can be severe. Fraud is categorized as either ‘hard’ or ‘soft’, depending of the level of severity.

  • ‘Hard’ describes deliberate, intentional loss created to cash in on damage payments.
  • ‘Soft’ involves lying about or exaggerating the extent of the damage to get more money.

Regardless of severity, this is a highly-punishable crime and should not be taken lightly. Criminals face significant fines, jail time, restitution, and more.

Have You Been Accused of Insurance Fraud In St. Petersburg?

If you or someone you know has been accused of having committed insurance fraud, consult an experienced defense lawyer in St. Petersburg right away. Flint Law has been helping clients since 1996 and can assist you with your case. Call today for a free consultation at (727) 483-8404.