Insurance Fraud Defense Attorney in Maine

Maine Insurance Fraud Defense Lawyer

In the state of Maine, insurance fraud is considered a serious violation, and can result in severe punishment. This article will discuss the following points in more detail:

  • The definition of insurance fraud
  • Common types of insurance fraud
  • Penalties for insurance fraud
  • The importance of enlisting the aid of an experienced fraud defense lawyer.

What is Insurance Fraud?

Insurance fraud is an illegal action on the part of either the buyer or the seller of an insurance policy. In Maine, a “fraudulent insurance act” includes your any of the following:

  • Submitting any information that contains false or misleading representations in order to benefit from an insurance policy payout, cause the insurance company to charge lower premiums, or otherwise take advantage of the insurer.
  • Aiding another individual to present or prepare such misleading or false information.
  • Soliciting or accepting insurance risks on behalf of an insurer by a person who knows that the insurer is insolvent.
  • Altering or eliminating the assets or records of an insurer.
  • Embezzling money or other assets from an insurer.
  • Initiating and/or completing an insurance transaction without the proper license or certification.
  • Attempting to commit such fraudulent acts, or aiding and abetting someone else in doing so.

Consumer insurance fraud typically involves filing false or exaggerated claims, or providing incomplete or deceptive information to insurers for the purpose of financial gain.

Common Types of Insurance Fraud

There are many different kinds of insurance fraud, both on the part of individual consumers as well as business entities. However, five of the most common types of insurance fraud committed by consumers include:

  • Auto insurance fraud. Some consumers commit fraud by falsely reporting their car stolen, when in fact they sold it or otherwise secretly disposed of it for financial gain. Another common type of auto insurance fraud is the fake car accident claim, in which two parties conspire together to stage a car accident and collect the payouts from their respective insurance carriers. Other consumers commit fraud by overstating the damage their car sustained in an accident. Some even deliberately inflict more damage on their vehicle, and then claim that the other driver caused it.
  • Homeowner’s insurance fraud. Many consumers will stage a fire in their own house to collect a payout from their home insurance policy. Others will take advantage of a major storm in the area, cause damage to their own house and then claim that the storm was responsible.
  • Renter’s insurance fraud. Some tenants will move their valuables out of their living space, and then file a claim to collect damages for”lost” possessions. Other renters will create an exhaustive list of their many possessions, along with each item’s financial value, and send such a list to their insurance carrier. They will then file a fraudulent claim in order to receive a payout from their policy.
  • Life insurance fraud. Some consumers take the extreme step of faking their own death to collect on a life insurance policy. They’ll wait for several months after the policy goes into effect, and then stage their own death with the purpose of deceiving the insurer into paying a conspirator (usually their spouse).
  • Health insurance fraud. Many doctors participate in a form of health insurance fraud. For example, they may order tests and procedures that are unnecessary, and then charge the patient’s insurance company.  Some physicians boldly file claims for in-office procedures that they don’t actually perform. Only the most vigilant of patients ever find out that their doctors are committing fraud.

In Maine, insurance carriers are required to report fraudulent insurance acts at least once a year, by March 1st. In some cases, an extension may be granted to an insurer, which would allow the company to report fraud at a later date.

Penalties for Insurance Fraud

Insurance fraud is associated with stiff penalties, both on a federal and state level. For example, the U. S. Code states that any fraud involving the FDIC may result in a fine of up to $1 million, imprisonment for up to 30 years, or both.

According to Maine’s law, in addition to incarceration, penalties for fraud may include fines between $500 and $5,000 per violation for individuals, and fines between $2,000 and $15,000 for each violation in the case of corporations or other entities. Other penalties may include:

  • Payments to the plaintiff for equitable relief and/or actual damages
  • Payments to the plaintiff for overcharges (e.g., a consumer repaying an insurance company the difference between the actual amount paid and the amount to which the insured was legally entitled)
  • Payments to cover the plaintiff’s cost of legal representation
  • Other restitution, as defined by the court

It is important to note that in many cases, state laws may not specifically cover cases of fraud. Under such circumstances, cases of fraud would be charged in federal court. Federal charges are often associated with harsher financial penalties, as well as longer prison sentences.

The Importance of Seeking Expert Legal Help for Your Fraud Defense

If you have been charged with fraud in the state of Maine, then you need to seek out professional legal help. A knowledgeable and experienced fraud defense attorney can help you to explore all of your options, and provide you with exceptional representation.

Richard Berne has been practicing law for over four decades, and is based in Portland, Maine. If you are need of help in your fraud defense case, reach out to the Law Offices of Richard Berne today to request a free consultation.