client and attorney shaking hands

Resources, Education, & News Blog

When can people be charged with insurance fraud?

Unexpected events occur in people’s lives in South Carolina. Many of these unexpected events can be very costly as well. This could be a car accident resulting in damage to vehicles and injuries. There could be a hurricane or other weather event that damages people’s homes. People can also develop diseases or other medical conditions that result in the need for extensive medical treatment.

People often do not have the money available to pay for these unexpected costs and that is why it is important that people have the appropriate insurance policies in place. Insurance can be very valuable for people who need it, but it can also be very valuable for the companies, medical professionals and others who are paid with insurance payments. In some situations contractors, doctors or individuals may try to take advantage of the system to receive extra money, which is considered insurance fraud.

Ways insurance fraud occurs

People may stage car accidents to receive money for new vehicles or report injuries that may have not resulted from the car accident. Contractors and individual homeowners may try to get extra money after a storm by falsely reporting damages or stating that repairs were needed that were never completed simply to obtain insurance money. This can happen especially in major disasters affecting large areas. Workers may be able to falsely report workers’ compensation claims.

Finally, one of the major ones that can be involved in the other types of insurance fraud as well is medical providers reporting procedures that were never actually completed or upcoding for legitimate procedures to obtain more money from insurance companies.

People who do these types of activities could be charged with insurance fraud crimes. If convicted of the crimes, people could face serious consequences depending on the extent of the alleged fraud. However, like any other type of crime people have defenses available to them and may have legitimate reasons for the claims made to insurance companies.

Insurance companies invest in trying to prevent insurance fraud from occurring in South Carolina. There are times when it may appear fraud occurred when there was in fact no fraud though. Simply being charged with insurance fraud crimes does not mean that people will be convicted. Everyone is innocent until proven guilty and it is important to understand the law and the potential defenses. Experienced attorneys understand the potential defenses and may be able to help protect people’s rights.