Insurance Fraud is a Felony!

Any person who willfully makes a false statement or misrepresentation of a material fact for the purpose of obtaining or denying any benefit or payment or assisting another to obtain or deny any benefit or payment can be charged with a felony. If you then are able to obtain the insurance payment or benefits based on those false statements or misrepresentations, you have now obtained property by false pretenses, which can also be a felony charge.
Most insurance customers are honest and do not set out to commit fraud. Nevertheless, fraud can be committed by consumers who do not necessarily know what they are doing is fraudulent. For example, they may see exaggeration of an otherwise genuine claim as just part of the negotiating process. Others may feel lying to an insurance company is “fair game” because they just want something in return for their premiums. Committing fraud may be tempting for some, but rest assured, trained invesigators are always watching!
But is it really FRAUD?
How fraud is detected
The Cost of Fraud
Insurance fraud hurts more than just yourself and an insurance company. Fraudsters can face multiple felony charges, restitution and jail time. Remember, not only could you be jailed for committing fraud, you could also have to pay back all of the money fraudulently obtained and pay various fines.
At the end of the day, society as a whole pays the costs of insurance fraud through increased premiums. Be honest and save time, money, your freedom and reputation.
Real Examples of Insurance Fraud Cases from Actual Department of Insurance Press Releases (names have been changed)
“John Smith, 27, of Fayetteville. Smith was charged with insurance fraud, a felony. According to the arrest warrant, Smith filed a claim with Progressive Premier Insurance for damage to his vehicle and another man’s vehicle, claiming that the damage occurred after he took out the insurance policy when it occurred before he took out the policy.”
“James Robert, 42, of Hickory, was charged with insurance fraud, a felony. Special agents with the Department of Insurance’s Criminal Investigations Division accuse Robert of providing a $28,995 repair estimate from a business that does not exist in support of an automobile insurance policy claim with Geico.”
“Jane Green, 31, of Carrboro, was charged with insurance fraud and attempting to obtain property by false pretense, both felonies. Special agents with the Department of Insurance’s Criminal Investigations Division accuse Green of attempting to obtain $3,000 from USAA Insurance Co. by filing a fraudulent renters’ policy claim for damage to a ninth-generation MacBook Pro laptop that she did not possess, purchase or own”
“Sam Black, 65, of Wilmington, was charged with insurance fraud and obtaining property by false pretense, both felonies. Special agents with the Department of Insurance’s Criminal Investigations Division accuse Black of obtaining $6,000 from Aflac Insurance in short-term disability insurance funds that he was not entitled to receive. According to the criminal summons, Black told AFLAC that he could no longer work when he was still employed and working.”
“Andrew Davis, 32, of Whitakers, was charged with four counts of insurance fraud and four counts of obtaining property by false pretense, all felonies. Special agents with the Department of Insurance’s Criminal Investigations Division accuse Davis of pursuing automobile insurance claims with State Farm Mutual Automobile Insurance Co. for a vehicle he did not own that was involved in staged crashes. According to the arrest warrants, Davis obtained payments totaling $13,642.42 as a result of the claims.”
“David Howards, 52, of Charlotte, was charged with insurance fraud, a felony, and a misdemeanor charge of making a false statement on an insurance application. Special agents with the Department of Insurance’s Criminal Investigations Division accuse Howards of listing four men’s mink coats, valued at $20,000, on a report of stolen property with State Farm Fire & Casualty Co. when the coats were not actually stolen.”
Share this page: