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Looking into the Basics of Insurance Fraud


These days, there is almost nothing that cannot be covered by insurance. Whether it’s for a person, personal property, a business, or even for pets, there’s an insurance coverage program ready to keep the subject protected. It is safe to say that the insurance industry is a thriving business, and trusted insurers can easily get a steady income by having a substantial amount of clients. On the other hand, this also makes them vulnerable to so-called insurance fraud perpetrators.

Insurance fraud is considered as one of the most severe white collar offenses any person can make in Las Vegas. The city, as well as the State of Nevada in general, considers insurance fraud as a Category felony, making its penalties considerably harsh. Las Vegas criminal defense attorneys take particular care when defending clients accused of committing insurance fraud because of the possible legal repercussions.

Definition of Terms

Insurance fraud is defined as willingly and knowingly filing a false claim for an insurance policy that is either reserved for the defendant but only under certain circumstances that the defendant has not gotten into, reserved for somebody else, or reserved for a non-existent entity that the defendant created to gain insurance unscrupulously. It can be as simple as falsely declaring certain information or as elaborate as creating a fraudulent scheme to obtain the insurance benefits over a period of time.

Insurance fraud styles vary widely. In some cases, only one or two individuals may make false claims to an insurer to receive the monetary benefits of the coverage. In other cases, the main perpetrators can recruit one or several individuals as accomplices who will substantiate the insurance claims that they make. In other cases, a person even acts as the representative of an insurance firm to recruit prospective clients and use their credentials to gain the benefits in their place.

Not Quite Victimless

To some people, insurance fraud only works like a crime against a corporate entity or an insurance firm. The perpetrator funnels off a substantial portion of the firm’s money while the firm receives no compensation or return of interest as a result. If there is any entity suffering from the effects of a successful insurance fraud scheme, it will be the firm that provided the coverage in the first place.

Contrary to this belief, insurance fraud has far-reaching consequences and affects a large number of people. Compensation for the losses are usually passed on to the legitimate insurance clients, which means higher premiums and less benefits. Experts estimate around a $5,000 increase in premiums for each family per year. It also costs the state a whopping $100 billion annually for medical insurance fraud alone.

From the Defense’s Point of View

It may seem that insurance fraud is a crime that only a skilled forger can commit, but even an ordinary law-abiding citizen can unwittingly become a part of this scheme. Even the slightest mistake in filling up a form can become grounds for a charge. Those who sign up for a fraudulent insurance scheme may also be tagged as accomplices if they are not careful.

Defending against an insurance fraud charge focuses on proving that the defendant was not willingly filing a false claim for the insurance benefits. This may include proving that the defendant was tricked into signing documents for a falsified account, or that there were inconsistencies between the papers filed by the defendant and the papers currently in the insurance company’s records. Getting an acquittal for insurance fraud charges is difficult since it is a Category D felony, after all.

Insurance-related crimes are complicated and complex to handle. Their effects are almost all-encompassing, and they can affect a person even if they are not directly connected to it. Learning more about insurance fraud can help a long way in understanding how and why people commit it, and how a person can avoid being convicted falsely because of it.

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