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How Do Insurance Companies Detect Fraud?

Our Connecticut insurance fraud lawyers at Tomeo Sills, LLC have extensive experience with white collar crime litigation, both at the state and federal level. Because more people than ever are being charged with this serious criminal offense, it is useful to know how to protect yourself from baseless fraud charges. Even if you are only being investigated and haven’t been arrested, it’s useful to have a criminal defense lawyer familiar with white collar crime law to help you strategize a defense beforehand, so you are ready if the time comes.

Insurance fraud is one of the most commonly perpetrated white collar crimes, only behind tax evasion. Perpetrating insurance fraud is not a victimless crime, as it places undue burdens on fellow policyholders who pay their premiums and obey the law. Insurance companies are naturally suspicious of any claim filed, as they are companies in the business of collecting premiums, not paying out claims. Although sometimes insurance fraud is obvious and easily scrutinized, other attempts to defraud insurers are harder to detect. To that end, insurance companies have sophisticated algorithms for detecting fraud, although these are not always 100% accurate, and every accusation of fraud needs a closer look at the facts.

Insurance companies may suspect fraud if the following applies to the claimant:

  • Financial distress
  • The policyholder increased their coverage right before making a claim
  • Valuable items were removed from premises before a fire loss
  • No witnesses to an accident that caused dubious injuries
  • Delay in reporting a claim
  • Conflicting incident reports

Although none of these situations are clear indicators of fraud, if any of these apply to you, it will make insurance agents put your claim under a microscope to investigate you and try to nail you for committing fraud. We know the facts aren’t always black and white, and we want to hear directly from you about the specific circumstances of your claim and why it was rejected.

Individuals who falsify insurance documents or accept payments without legitimate reasons face extremely serious penalties. Those may include hefty fines, a mark on your permanent criminal record, restitution, and prison time. To avoid this, you’ll need to prove you did not attempt to defraud your insurance company, and you’ll need a skilled criminal defense lawyer familiar with white collar criminal law.

Contact a Connecticut Insurance Fraud Defense Lawyer

We want to hear your side of the story, so we can best defend you and protect your legal rights. Don’t leave your freedom to fate, as the penalties for insurance fraud can leave a permanent stain on your reputation. We will use our extensive experience in white collar crime defense to represent you; even if a plea arrangement is the best choice for you, we can negotiate for the most favorable terms possible.

Are you being investigated for insurance fraud? Even if you haven’t been arrested, you should seek a Connecticut criminal defense attorney to hear your side of the story. Contact us today for a free consultation at (844) 913-7747!