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Michael A. Gottlieb, P.A.
“Out of the Box” Defense Strategy
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Is fibbing on an insurance claim fraud?

Insurance fraud is a type of fraud that occurs when a person makes exaggerated or false claims to an insurance provider. The individual seeks compensation for losses or injuries that weren't suffered, which takes advantage of the insurance company's policy.

A good example of insurance fraud would be if you wrecked your vehicle intentionally but claim it was a hit-and-run crash. You may also claim that you have injuries, like whiplash or ongoing headaches, that make it hard to work -- even though you don't. The insurance company would likely offer a settlement believing that the crash was an accident, when in fact, it should not cover the incident at all.

Faking an accident is a type of hard fraud. Comparatively, soft frauds are situations in which normally honest people tell small "white" lies. For instance, they may round up a hospital bill to maximize a claim, even though that's not the amount they need.

To be convicted of fraud, a prosecutor must show that the individual made a false or misleading statement intentionally. The claim must be in relationship to a payment or claim, and the statement must affect the outcome of the claim.

If the prosecution can't prove one of those factors, then you can win your case. Fortunately, the burden of proof lies on the prosecution, so if the attorney can't find enough evidence, the court is likely to rule in your favor. Your attorney can help you prepare if you have to go to trial, so you know what to do to help yourself and protect your reputation.

Source: FindLaw, "Insurance Fraud," accessed Oct. 17, 2017

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