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What is insurance fraud, and could you be guilty of it?

On Behalf of | Jul 29, 2019 | Firm News |

There are many kinds of fraud and they are classified as a white collar crime.

One example of this sort of criminal activity is insurance fraud, which is on the rise in South Carolina. What exactly is insurance fraud? Could a judge find you guilty of such a crime?

Insurance fraud defined

Insurance fraud refers to the misrepresentation or false statement on an insurance claim. It could be a sophisticated system of submitting false medical claims to a health care insurer such as Medicare. On the other hand, it could involve the padding of an insurance claim by just one person almost as a gesture in retaliation for premiums paid throughout the years when there was never a claim. In addition to health care insurance, people may pad claims for disability, auto and life insurance, among others. Some people are tolerant of the padding practice believing that it is hurting no one. However, the law does not regard fraud as a victimless crime. It affects the premiums everybody pays for insurance coverage.

Reporting fraud in South Carolina

If you are under investigation for insurance fraud, you may wonder how you became a target. Here in South Carolina, one possibility is the Insurance Fraud Hotline. The state has established a mandatory reporting act, which, in part states that anyone who believes that someone else has made a misrepresentation or false statement on an insurance claim must notify the Insurance Fraud Division of the Office of the Attorney General. The reporting act resulted from the steady rise in insurance fraud: In 2018, the Attorney General received 2,957 complaints that required the appropriate personnel to follow up.

Being proactive

An investigation into suspected fraudulent activity usually takes a considerable amount of time, and if you are the suspect, you may not have any idea it is underway. If a charge of insurance fraud is eventually filed against you, explore your legal options without delay. You want to seek protection of your rights so that if you go before a judge, you have a chance for the best outcome possible for your case.