nsurance Fraud

Who commits Insurance Fraud?

Perhaps no other crime attracts such a wide variety of perpetrators as insurance fraud. As indicated by the files of the Office of Insurance Fraud Prosecutor, insurance fraud is committed by people from all classes and is not limited to any one occupation.

Types of Insurance Fraud

  • Staged automobile accidents.
  • Over billing for services rendered by health care practitioners.
  • Billing for services not rendered by health care practitioners.
  • Receiving treatment for nonexistent injuries.
  • Manufacturing or selling counterfeit motor vehicle insurance cards.
  • Submitting a false claim in order to be paid for services that were not received or provided. (Punishable by 5-10 years in prison if claim is submitted by any licensed professional)
  • Falsifying statements in order to obtain insurance.
  • Receiving any kickbacks or compensation in connection with the furnishing of items or services covered by Medicaid.
  • Receiving Medicaid benefits to which you are not entitled.
  • Receiving disability benefits if you are not disabled and really are capable of performing your job.

The Penalty for Insurance Fraud

  • Any licensed professional convicted of health care claims fraud can be punished by 5-10 years in prison and can be required to pay a fine of up to $150,000 or up to five times the amount of the claim.
  • Any person who is not a licensed professional and is convicted of health care claims fraud may be punished by 3-5 years in prison in addition to a fine. (For filing just one fraudulent claim!)
  • Any person who manufactures or sells a counterfeit motor vehicle insurance card may be punished by up to 18 months in jail and a $10,000 fine. Additionally, any person convicted of this offense will be required to perform 30 days of community service.
  • Any person convicted of Medicaid fraud may be punished by up to 3 years in prison and a $10,000 fine.

What can you do to combat insurance fraud?

If you have specific information or suspect that individuals or entities may be committing insurance fraud, please contact the Hunterdon County Prosecutor's Office at 1-866-Fraud-no (1-866-372-8366) or contact the New Jersey Office of Insurance Fraud Prosecutor at (877) 533-7283. For additional information on insurance fraud, please visit http://www.njinsurancefraud.org.