Insurance Fraud

Insurance fraud offenses generally involve false insurance claims or the fraudulent receipt of insurance benefits. An example of false insurance claims that may result in a fraudulent receipt of insurance benefits is staging accidents. Both federal and Florida law include heavy fines and severe criminal penalties, including potential mandatory/minimum sentences of up to 25 years and maximum potential sentences of up to LIFE. Mr. Petruzzi has represented numerous individuals charged with, or under investigation for, insurance fraud offenses by both federal and state authorities. His experience and knowledge serve as an invaluable asset to his clients.

To arrange for a free and confidential consultation with respect to any federal or state insurance fraud offense, contact our office at 305-330-1774. For complete details about Mr. Petruzzi’s background, expertise and experience, click here.

Federal insurance fraud offenses are investigated and prosecuted by various agencies, including the FBI, IRS, and the Department of Justice. Some common federal statutes criminalizing insurance fraud include:

18 USC Sec. 1033 –

(a) (1) Whoever is engaged in the business of insurance whose activities affect interstate commerce and knowingly, with the intent to deceive, makes any false material statement or report or willfully and materially overvalues any land, property or security –

(A) in connection with any financial reports or documents presented to any insurance regulatory official or agency or an agent or examiner appointed by such official or agency to examine the affairs of such person, and (B) for the purpose of influencing the actions of such official or agency or such an appointed agent or examiner, shall be punished as provided in paragraph (2).

(2) The punishment for an offense under paragraph (1) is a fine as established under this title or imprisonment for not more than 10 years, or both, except that the term of imprisonment shall be not more than 15 years if the statement or report or overvaluing of land, property, or security jeopardized the safety and soundness of an insurer and was a significant cause of such insurer being placed in conservation, rehabilitation, or liquidation by an appropriate court.

Florida insurance fraud offenses are investigated and prosecuted by various state and local law enforcement agencies. Some common Florida statutes criminalizing insurance fraud include:

817.234 False and fraudulent insurance claims.—

(1) (a) A person commits insurance fraud punishable as provided in subsection (11) if that person, with the intent to injure, defraud, or deceive any insurer:

1. Presents or causes to be presented any written or oral statement as part of, or in support of, a claim for payment or other benefit pursuant to an insurance policy or a health maintenance organization subscriber or provider contract, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim;

2. Prepares or makes any written or oral statement that is intended to be presented to any insurer in connection with, or in support of, any claim for payment or other benefit pursuant to an insurance policy or a health maintenance organization subscriber or provider contract, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim; or

3. a. Knowingly presents, causes to be presented, or prepares or makes with knowledge or belief that it will be presented to any insurer, purported insurer, servicing corporation, insurance broker, or insurance agent, or any employee or agent thereof, any false, incomplete, or misleading information or written or oral statement as part of, or in support of, an application for the issuance of, or the rating of, any insurance policy, or a health maintenance organization subscriber or provider contract; or

b. Who knowingly conceals information concerning any fact material to such application.