Defending an individual who is accused of insurance fraud can be a challenge. However, with 30 years of combined experience, the lawyers at Raiser & Kenniff understand the ins and outs of an insurance fraud charges, and we are eager to use our years of experience in defense of our clients. Our lawyers win tough insurance fraud cases because of our ability to pay close attention to the law. We understand the insurance policies that are involved, and we are experts at narrowing down the issues before the case begins. Solid investigation and detailed research can often keep claims of insurance fraud out of court.
Defining Insurance Fraud
Insurance fraud is defined as an unscrupulous act committed by an individual whose intent is to fraudulently obtain entitlements that they otherwise would not have been authorized to collect. On the other side of the coin, the term insurance fraud can refer to denying benefits to someone who has the right to receive those entitlements.
The most common form of insurance fraud is filing fraudulent insurance claims. The goal of these insurance claims is to defraud an insurance provider. Insurance fraud has plagued the insurance industry ever since its inception. On an annual basis insurance companies lose billions of dollars as a result of fraud. These losses are then passed on to their customers in the form of higher premiums. There is no insurance industry that is free from some form of fraud. Fraud affects automobile insurance, life insurance, Workmen’s Comp. insurance, healthcare insurance as well as general liability insurance. Individuals who perpetrate insurance fraud will engage in activities that range from exaggerated insurance claims all the way down to committing homicide.
The Challenge of Defending Insurance Fraud Cases
The outcome of most insurance fraud cases are determined by a jury. This makes insurance litigation challenging because of the preconceived ideas that people have both about insurance companies and about individuals accused of fraud. In many cases, even though the jurors are no friends of insurance companies, they automatically assume that the individual accused of insurance fraud was motivated by greed and therefore committed the crime. So, while the law stipulates that it is the insurance company that must prove fraud existed, it is often the defendant who is forced to prove that no fraud existed. Our experienced attorneys understand the makeup of the juries we deal with. We present our case in a clear and concise manner, helping the jury to overcome any preconceived notions and focus on the laws pertaining to insurance fraud. In this way we are able to provide a defense that protects the legal rights of our clients.
Defending against Charges of Conspiracy to Commit Insurance Fraud
It is possible for a single individual to commit insurance fraud. However, the vast majority of insurance fraud schemes involve multiple people acting in concert. An example of this could be where one friend promises to steal another friend’s car, or one friend promises to burn down a friend’s bankrupt business. Another example could be a patient who signs a doctor’s fraudulent medical bill to Medicaid.
Because of the nature of the conspiracy laws associated with insurance fraud, it is very easy for a person who is innocent to get wrapped up in an insurance fraud investigation. When this happens with our clients, our lawyers provide a comprehensive defense that puts in doubt the prosecutions circumstantial evidence, focuses on the facts, and undermines the prosecution’s case against you.
Some of the strategies that our law firm uses to defend our clients who are accused of insurance fraud is to highlight any lack of evidence that exists. According to the law, it is the insurer who has the responsibility to prove that fraud was committed. Our number one priority is to explain this to a jury and put the burden of proof on the prosecution and the insurance company.
Second, we work to help the jury see the difference between a mistake and intent to deceive. For example, accidentally grabbing your roommate’s medical insurance card is not fraud. Whereas intentionally taking your roommate’s insurance card and using it and pretending to be him is fraud. The difference is intent. If intent cannot be proven, most insurance fraud cases are thrown out.
Many who have been accused of insurance fraud worry that there is no defense that will work for them. This simply is just not the case. The best way to determine how effective a defense will be in your case is to sit down and talk to our insurance fraud attorneys. Let us use our experience to help you get the best outcome in court.