What You Should Know About Insurance Fraud in New Jersey

You may not know it, but insurance fraud affects both the innocent and guilty in the Garden State. Investigating an insurance fraud claim can be a time-consuming and expensive effort. If you see that your insurance company is hiking up their rates for some unexplained reason, it could be a sign that your insurer spent a lot of time and money prosecuting false insurance claims.

New Jersey has some of the toughest laws when it comes to insurance fraud. If you are being charged with defrauding an insurance company, then you should know that you will most likely be investigated very aggressively. Our state even has its own office that handles insurance fraud issues – the Office of the Insurance Fraud Prosecutor.

Defining Insurance Fraud

According to N.J.S.A. 2C:21-4.6b:

“A person is guilty of the crime of insurance fraud if that person knowingly makes, or causes to be made, a false, fictitious, fraudulent, or misleading statement of material fact in, or omits a material fact from, or causes a material fact to be omitted from, any record, bill, claim or other document, in writing, electronically, orally or in any other form, that a person attempts to submit, submits, causes to be submitted, or attempts to cause to be submitted as part of, in support of or opposition to or in connection with: (1) a claim for payment, reimbursement or other benefit pursuant to an insurance policy, or from an insurance company or the “Unsatisfied Claim and Judgment Fund Law,” P.L.1952, c.174 (C.39:6-61 et seq.); (2) an application to obtain or renew an insurance policy; (3) any payment made or to be made in accordance with the terms of an insurance policy or premium finance transaction; or (4) an affidavit, certification, record or other document used in any insurance or premium finance transaction.”

To simplify this legal definition, insurance fraud occurs when a person admits a material fact or makes a false or misleading statement to an insurance company. This crime is considered a third-degree felony in New Jersey, but depending on what the crime was, it could be bumped up to a second-degree offense.

A third-degree felony for insurance fraud can carry a prison sentence of up to five years. Depending on the circumstances of your case, it could be possible to avoid a prison sentence altogether. When charged with a second-degree offense for insurance fraud, you are pretty much guaranteed a prison sentence for several years.

Types of Insurance Fraud in New Jersey

Any type of insurance (auto, health, life, etc.) can ultimately lead to insurance fraud. We have compiled a list of different examples of fraud we tend to see here at our Jersey City office:

• False workers’ comp claims
• Misleading property loss claims
• Staged auto accidents for insurance settlements
• Healthcare claims fraud
• Stolen vehicle scams
• Obtaining unemployment insurance benefits while you’re working
• Home repair fraud
• Arson for profit
• Medical procedures that aren’t needed

Not everyone who takes part in insurance fraud has malice intentions. For many, it is an attempt to save money on premium costs. For others, the mistakes can be innocent.

Contact the Law Offices of Anthony Carbone

At the Law Office of Anthony Carbone, we have thirty years of experience dealing with insurance companies in New Jersey. Do you believe you are a victim of insurance fraud? Are you concerned that you may be unwittingly committing this type of fraud? Contact our offices at 201-733-2230 for the proper legal advice. The consultation is free.