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The Law Offices of Proetta & Oliver

Hudson County

Criminal Defense Lawyer

"We have successfully defended our clients against thousands of Criminal, DWI, and Municipal Court charges throughout Hudson County and New Jersey."

- William A. Proetta, Esq.

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Insurance Fraud 2C:21-4.6

NJ-Insurance-Fraud-Lawyers

New Jersey Insurance Fraud Lawyer

New Jersey has seen a trend in cracking down on insurance fraud related crimes, especially since Super Storm Sandy which saw countless fraudulent or over exaggerated insurance claims and contractor fraud. Most insurance companies have their own civil investigators who analyze and flag a claim if it appears to be fraud. However, if the level fraud appears to be serious enough, they will often forward these cases to the county prosecutor’s office or Attorney General’s Office for criminal investigation and prosecution. Prosecutors and law enforcement love going after insurance fraud cases because they always know the charges will be serious since insurance fraud is always at least a 3rd degree crime and can very quickly and easily be upgraded to 2nd degree crime, which carries a presumption of state prison from 5 – 10 years. The New Jersey fraud attorneys at Proetta & Oliver are experienced in handling insurance fraud cases and defending our clients against prison and even securing results such as Pre-Trial Intervention which can result in a complete dismissal of the case.

New Jersey Law on Insurance Fraud

2C:21-4.6. Crime of insurance fraud

  1. A person is guilty of the crime of insurance fraud if that person knowingly makes, or causes to be made, a false, fictitious, fraudulent, or misleading statement of material fact in, or omits a material fact from, or causes a material fact to be omitted from, any record, bill, claim or other document, in writing, electronically, orally or in any other form, that a person attempts to submit, submits, causes to be submitted, or attempts to cause to be submitted as part of, in support of or opposition to or in connection with: (1) a claim for payment, reimbursement or other benefit pursuant to an insurance policy, or from an insurance company or the Unsatisfied Claim and Judgment Fund Law, P.L.1952, c.174 (C.39:6-61 et seq.); (2) an application to obtain or renew an insurance policy; (3) any payment made or to be made in accordance with the terms of an insurance policy or premium finance transaction; or (4) an affidavit, certification, record or other document used in any insurance or premium finance transaction.
  2. Insurance fraud constitutes a crime of the second degree if the person knowingly commits five or more acts of insurance fraud, including acts of health care claims fraud pursuant to section 2 of P.L.1997, c.353 (C.2C:21-4.2) and if the aggregate value of property, services or other benefit wrongfully obtained or sought to be obtained is at least $1,000. Otherwise, insurance fraud is a crime of the third degree. Each act of insurance fraud shall constitute an additional, separate and distinct offense, except that five or more separate acts may be aggregated for the purpose of establishing liability pursuant to this subsection. Multiple acts of insurance fraud which are contained in a single record, bill, claim, application, payment, affidavit, certification or other document shall each constitute an additional, separate and distinct offense for purposes of this subsection.
  3. Proof that a person has signed or initialed an application, bill, claim, affidavit, certification, record or other document may give rise to an inference that the person has read and reviewed the application, bill, claim, affidavit, certification, record or other document.
  4. In order to promote the uniform enforcement of this act, the Attorney General shall develop insurance fraud prosecution guidelines and disseminate them to county prosecutors within 180 days of the effective date of this act.
  5. Nothing in this act shall preclude an indictment and conviction for any other offense defined by the laws of this State.
  6. Nothing in this act shall preclude an assignment judge from dismissing a prosecution of insurance fraud if the assignment judge determines, pursuant to N.J.S.2C:2-11, the conduct charged to be a de minimis infraction.

What Are The Penalties for Insurance Fraud?

Third Degree Insurance Fraud

Every crime of insurance fraud is at least a third degree crime punishable by 3 – 5 years in state prison, but there is a presumption against state prison for a first time offender. Moreover, each fraudulent document can have several misrepresentations on it and each counts as a separate account of insurance fraud. However, even a sentence of probation will result in a permanent felony record that can result in losing your job or diminished job opportunities in the future. Moreover, it is important to note that most insurance fraud cases are going involve restitution to pay back any money fraudulently collected.

Second Degree Insurance Fraud

If there are five (5) or more instances of fraud involving $1,000 or more in money or property then the charges of insurance fraud will be upgraded to a second degree crime which is punishable by 5 – 10 years in state prison. This sentence involves a presumption of incarceration even if it is a first offense. It is important to note that the five (5) or more instances of insurance could all be contained on a single claim, document or application. So even if you only submitted one fraudulent document to renew your car insurance you could be charged with a second degree crime.

Insurance Fraud Attorney in Hudson County, New Jersey

Insurance fraud comes in many shapes and sizes and can involve claims from a fake car accident, exaggerated property damage, Medicare or Medicaid fraud, as well as disability fraud. Our insurance fraud attorneys handle cases involving a simple situation of making misrepresentations of an insurance application to complex schemes involving a network of dozens of people. If you or a loved one has been charged with insurance fraud and are interested in learning more information about your charges and any possible defenses, then feel free to contact our office today for a consultation. All consultations, whether over the phone or in-person, are free and confidential.

Photo courtesy of the Office of the Insurance Fraud Prosecutor