There are many forms of fraud, including identity theft, forgery, tax fraud, mail fraud and insurance fraud. In a 2017 sweep operation, the Pennsylvania attorney general charged 29 people with felonies based on instances of insurance fraud.
In the state of Pennsylvania, insurance fraud is a third-degree felony with penalties that include up to $15,000 in fines and imprisonment of not more than seven years. Fraud is a defensible crime, however. A strong defense strategy may make a significant difference in the outcome.
Here are three real-life examples of insurance fraud.
Theft by deception and conspiracy
A Philadelphia woman filed an insurance claim for $14,000, stating that this sum represented the value of items stolen from her home, including a handbag worth $3,600. Her friend claimed to have purchased the handbag for her at Neiman-Marcus. However, another woman actually bought the handbag: The other two got a hold of her receipt and fraudulently submitted it to the insurance company.
Both women subsequently faced charges of theft by deception and conspiracy.
Health care insurance fraud
A resident of Saltsburg was seriously injured and treated at a hospital after he crashed his motorcycle. Instead of reporting the accident factually, he filed a claim stating that his injuries resulted from a fall off a stranger’s pickup truck.
The charge in this incident was insurance fraud.
Workers’ compensation fraud
A middle school employee received almost $3,000 as a workers’ compensation disability benefit. He stated on a Pennsylvania Department of Labor and Industry document that he had not been employed during the time that he was receiving the payment when, in fact, he was still working and receiving wages.
He received a charge of workers’ compensation fraud.