Insurance Fraud in Florida

It’s important to know what happens and what consequences one may face when being accused of insurance fraud in Florida. Although insurance fraud doesn’t seem as heinous as murder or burglary, it is still a crime that can result in a prison sentence of quite a few years. Insurance fraud is not a rare crime either. According to the Division of Insurance Fraud’s annual report, there was a total of 17,392 suspected fraud referrals and the court ordered a total of $51,203,744.42 in restitution in the 2014-2015 fiscal year; that includes health, vehicle, PIP and home insurance fraud, just to name a few. How exactly does insurance fraud affect others? I mean, if you didn’t do the crime, then you have no worries, right? Well, unfortunately this line of thinking is false. When insurance companies are forced to pay out millions of dollars for false claims, insurance premiums can go up. So, if the criminals are attacking the insurance company’s pockets, they are in the long run affecting yours as well.

Legal Definition of Insurance Fraud in Florida

So, what exactly is the legal definition of insurance fraud in Florida? Florida statute 817.234 gives the precise and detailed definition, but insurance fraud is essentially when a person knowingly presents false or misleading information to an insurance company with the intent to defraud or deceive the company. Examples would be a doctor giving a statement that exaggerates on the injuries a patient sustained in an auto accident or a doctor excessively charging the insurance company for services. While doctors found guilty of insurance fraud face the risk of losing their license to practice for about 5 years, a person participating in staging an auto accident could face a minimum of 2 years in prison.

Investigation of Insurance Fraud in Florida

How is the investigation process conducted with insurance fraud? Insurance companies tend to have firms dedicated solely to investigating claimants. The investigators will monitor the claimant, look up previous accidents to see if the claimant reports an abnormal number of previous claims, interview witnesses of the accident, look through previous medical records, and analyze physician billing statements. Because of our technological advanced society today, claimants can make it easier for investigators to identify insurance fraud. Social media has grown rapidly overtime. People constantly take pictures and record videos to load onto social networks. Because insurance fraud investigators are aware of this, they now track the claimant’s social media as well. For example, your doctor reported to the insurance company that due to an auto accident caused by the insurance company’s insured, you have life changing injuries such as never being able to move without back pain. The investigator monitors your Facebook and Twitter and finds pictures posted not even two weeks after your accident of you in a 5k marathon or lifting heavy weights; this should raise a red flag, right?

Insurance Fraud is a Crime in Florida

Here are some examples to make the crime more realistic. In June of 2015, the Division of Insurance Fraud arrested a doctor who owned an injury clinic located in the west central region of Florida. The doctor and his coconspirators would recruit patients to come for treatment after staged auto accidents. The doctor would compensate the patients depending on the amount of treatment visits for non-existing injuries. In January of 2015, the Division of Insurance Fraud also arrested nine people for staging auto accidents in the south region of Florida. The people had filed over $242,000 to the PIP insurance companies that were all fraudulent.

Insurance fraud hurts everyone in the end. No one wants higher insurance premiums, but that’s what happens when insurance companies have to pay so much money for fraudulent claims along with claims unassociated with fraud. That is why it’s so vital for insurance companies to find and stop people participating in insurance fraud. Don’t be a participant in insurance fraud because it always catches up with you in the long run.

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