Monmouth County Insurance Fraud Lawyers

Insurance fraud is committed in New Jersey when someone purposefully makes a misleading statement or omits facts from bills, claims, or other electronic, oral, or otherwise written documents. The submission or attempted submission of claims for payment, reimbursement, or additional benefit obtained from an insurance policy. It is also a fraudulent application to renew or get an insurance policy. If any payment is made or an affidavit, certification, or other document is submitted fraudulently, these are all considered acts of insurance fraud.

In addition, insurance fraud can come in many forms. It generally happens when a person knowingly distorts a material fact or lies to an insurance company. If the insurance company discovers the duplicity during the investigation, law enforcement will be notified. When someone is investigated and subsequently charged with insurance fraud, this is a serious offense in New Jersey and the consequences can be severe. If found guilty, the offender may face up to ten years in prison and substantial fines. That being said, misunderstandings can exist. If you have been charged with insurance fraud involving any kind of insurance in New Jersey, you need an outstanding lawyer to help defend your case.

Contact the attorneys at Chamlin, Uliano, & Walsh to thoroughly discuss the insurance fraud allegations you are facing and find out how we can help you. Our dedicated, client-centered law firm has spent over 50 years providing exceptional defense representation to clients accused of health, car, bank, and other forms of insurance fraud throughout Monmouth County and surrounding communities in Southern New Jersey. You can request a consultation online or by calling our West Long Branch office at (732) 440-3950 today.

Criminal Penalties for Insurance Fraud Violations of N.J.S.A. 2C:21-4.6

The New Jersey Code of Criminal Justice criminalizes and explains the acts that may lead to prosecution under this section in N.J.S.A. 2C:21-4.6. In New Jersey, insurance fraud isn’t just one or two specific situations. It is where someone misleads or lies to an insurance company, which of course, can include various types of insurances that companies may provide, such as auto insurance, as well as applications and claims for other benefits, such as disability, unemployment, or workers’ compensation.

As it is not a violent crime, it may be a disorderly person offense, for which a defendant could be sentenced to a maximum jail term of 6 months and a fine of $1,000. If insurance fraud is a a fourth degree offense, it has a $10,000 fine and a prison term of up to 18 months attached. A third degree criminal offense for insurance fraud can carry a 3 to 5-year sentence and up to $15,000 in fines. If the defendant engages in 5 or more separate attempts to deceive the insurance company, or if the value of the deception is more than $1,000, second degree charges may be applied. Second degree charges carry 5 to 10 years in prison and fines of up to $150,000.

Elements Required to Convict Someone of Insurance Fraud in New Jersey

Whenever criminal charges are discussed, there are core elements of the crime that must be proven beyond a reasonable doubt to obtain a guilty verdict. Some of the features found in insurance fraud charges are when the accused makes a misleading statement with forethought to deceive if that false statement was made associated with an application, claim, or payment and if the incorrect information influenced an application or claim’s resolution.

Not all false statements are material (spoken with a motive to cheat the insurance company). For example, Mrs. Adler’s dishwasher, which was three years old, leaked all over her kitchen. Her handyman, Stanley, helped her report it to the insurance company. When she got her new dishwasher, she realized she had given the insurance company the wrong serial number. This mistake was not intended and, therefore, not material. However, had she reported to the insurance company that the appliance was fresh off the factory shelf and a much fancier model than what she owned, there would be a significant monetary gain from the exchange; her statements would be material in committing a crime.

The New Jersey Insurance Fraud Protection Act

The NJ Insurance Fraud Protection Act focuses on detecting and eliminating insurance fraud while requiring restitution to reimburse the state for the costs affiliated with their investigations. There are six types of conduct that violate the law.

Types of Conduct that Constitute Insurance Fraud in New Jersey

Suppose one makes untrue statements for a claim or application to receive benefits or conceals an event that affects an individual’s right to payment; that is against the Creating or distributing certificates of insurance that contain misleading information or planning to do so is another kind of conduct. Additionally, anyone who conceals or hides an occurrence of an event that influences someone’s insurance benefit or payment (whole or partial) has committed fraud. If one creates any written or oral statement to an insurance company with the motive to obtain an insurance policy for a vehicle in New Jersey as the principal residence, but the owner’s home is not in New Jersey, fraud has been committed. Lastly, if one fails to disclose or knowingly covers evidence that may be relevant to a finding from the above situation, this is considered a violation of the insurance fraud laws of the state as well.

Take the following example. When a car owner is from a state other than New Jersey, but they reside in New Jersey, and their car insurance is from their home state, it is considered fraud. They would have had to lie to someone to get their insurance or their home state’s insurance company by telling them they reside in that state or by the New Jersey authorities telling them they do not live in New Jersey. You don’t even have to drive your car to be charged with fraud. You can be set if your vehicle is in a car park or garage. The only exception to this situation is attendance at a university or school.

Important Tips to Build a Strong Defense with Your Insurance Fraud Lawyer

The New Jersey Office of the Insurance Fraud Prosecutor has many resources for investigating and prosecuting potential cases. However, a prosecutor may not be able to convince a judge or jury to find you guilty beyond a reasonable doubt in criminal court. Your top-notch lawyer from Chamlin, Uliano, & Walsh knows what to do to make your defense rock-solid. Some of the things that will build a strong defense are to consult with insurance experts who can say that your claim was by no means fraudulent while incorrect in its handling. Your lawyer may attempt to show that it was a mistake of fact that caused your confusion and that you never intended to defraud anyone. Additionally, they may explain that the false statement wasn’t material (untrue when spoken). Or, perhaps they will argue that the quantity of insurance fraud acts you are being charged with is overly inflated and unrepresentative of the reality. Finally, your lawyer may argue that the prosecution’s incomplete case doesn’t have enough evidence to convict you of insurance fraud.

Expected Actions if You are Aware of Insurance Fraud in NJ

Insurance fraud costs the state 80 billion dollars per year. It is a severe crime and affects many people. If you are contacted or know someone who has committed insurance fraud, the state of New Jersey has a web page designed specifically to explain insurance fraud and related information. The New Jersey Office of the Insurance Fraud Prosecutor also provides a direct way to report insurance fraud. You can fill out a report online, via email, or by U.S. mail. If your tip leads to an arrest and conviction, you could be eligible for a reward.

Get in Touch with our Insurance Fraud Defense Lawyers to Work on Your Defense in Red Bank NJ

If you are under investigation or have already been charged with insurance fraud, it is essential that you retain a skilled criminal defense lawyer to zealously represent you. An experienced defense lawyer may be able to find weaknesses in the prosecution’s case and decrease the chances of an escalating legal process against you. Hiring the right lawyer to provide a solid legal defense against health, car, bank, home, or other types of insurance fraud accusations is critical to obtaining the best possible outcome.

Chamlin, Uliano, & Walsh is a firm with years of experience and a passion for helping clients. Reliability, determination, and focus on your needs are all a part of what makes us an excellent choice for your defense. Our lawyers are ready to review all of the facts and evidence, assist with the investigation process, protect you during questioning, and craft the strategy that most readily confronts insurance fraud prosecution involving you or a loved one in Freehold, Rumson, Middletown, Holmdel, Asbury Park, Long Branch, Wall, Neptune, and other Monmouth County areas.

Contact our firm’s local office in West Long Branch at (732) 440-3950 or look for us online to make your appointment or request a confidential consultation. Let our experience pave the way to a better legal horizon for you.