Types of Insurance Fraud

Basically, fraud is an intentional deception regarding current facts which is designed to enrich the individual at the expense of another. More specifically, some common types of insurance fraud include:

  • Making False Claims: Staged car accidents, like the notorious “swoop and squat,” are the classic example. An unscrupulous motorist pulls out in front of another driver before braking suddenly and inducing a rear-end collision. Highly-exaggerated or outright false property damage claims are common as well. So are false Medicaid claims.
  • Filing Untrue Documents: Workers’ compensation insurance policies are a good example. Since risk usually determines premium amounts, many fraudsters lie about things like employee activities or payroll size in order to reduce their risk. Prosecutors must prove that the defendant lied about current facts on the form.
  • Lying to Adjusters: This final area is closely related to the first one. The defendant could be the person who filed a false or inflated claim. The defendant could also be a “witness” who says what someone else tells him/her to say. Frequently, the insurance company does not technically lose money in these situations.

In all these situations, the state must also prove that the defendant intentionally lied. The line between a lie and an error is often a very fine line. Prosecutors and Orlando federal insurance fraud lawyers have their own opinions about where this line is. But jurors have the final say in this area.

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What to Expect

What to Expect in a Federal Criminal Case

Thirty years ago, a significant number of federal criminal cases went to trial. The plea bargaining system in federal courts was convoluted at best. Today, less than 3 percent of federal criminal cases go to trial, mostly because of the federal sentencing guidelines. Lawmakers established these standards in 1987 and the Supreme Court endorsed them in 1991. Prosecutors and defendants can now make agreements free from political or other pressures.

Subsequent changes to the Federal Sentencing Act made these guidelines discretionary as opposed to mandatory. Therefore, neutral judges have more control over the process. That control usually means better deals for defendants, especially in fraud cases that have lots of moving parts or weak evidence.

Get the Legal Help Your Need Now.

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Reach Out to a Diligent Orange County Lawyer

Fraud accusations do not necessarily lead to fraud convictions. For a confidential consultation with an experienced federal insurance fraud attorney in Orlando, contact the O’Mara Law Group, Attorneys at Law. Convenient payment plans are available.

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