Like other states, Florida has a law which makes insurance fraud a criminal act.

While it might seem straightforward enough that South Florida residents should not lie to their insurance companies, the sort of behavior that can lead to a state-level insurance fraud charge is surprisingly broad.

Insurance fraud charges can trap those unfamiliar with the system

People can probably guess that staging an accident or similar behavior could lead to an insurance fraud case.

However, even seemingly white lies or omissions on one’s insurance application, or in a claim, can also constitute insurance fraud.

Likewise, padding a claim by, for example, asking for more money than one actually paid or, in the case of health insurance, over-billing or double billing, can lead to the charge.

Other business practices which might seem innocent enough or, at worst, a little aggressive actually are prohibited as a type of insurance fraud under Florida’s complicated law.

In short, insurance fraud is not just a charge for people who, perhaps because of financial stress, addiction or other common human issues, made a bad decision.

Authorities can also accuse those who perhaps were a little careless or disorganized, but not intentionally so, in their business practice. Others in the Coral Gables area may have just not understood the way the insurance system works.

The penalties for insurance fraud are significant

No matter the reason for the charge, those facing a possible conviction for insurance fraud will be staring down severe penalties. Even a first-time offender faces a felony conviction, and jail time, even if the alleged fraud is only worth a few hundred dollars.

Those who commit a fraud worth more than $20,000 face harsher penalties, with those accused of defrauding more than $100,000 facing the possibility of years in prison, restitution, and other penalties.

In addition to criminal penalties, anyone convicted of insurance fraud in any amount must pay a civil penalty of up to $5,000. More serious charges can lead to harsher fines that can be as high as or even exceed $15,000.

Finally, a doctor who commits certain acts of insurance fraud will automatically lose his or her medical license for 5 years.

Insurance fraud is a serious white collar criminal offense in Florida, and a person accused of it should carefully evaluate his or her legal options to see if a defense is available.

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