Relative to other types of white-collar crimes, one could say that an average Houston resident could easily find himself accused of insurance fraud.
The reason for this is that just about everyone, whether for personal or business reasons, has some sort of dealings with the insurance industry.
Many types of insurance, such as automobile liability insurance, are mandatory. A person cannot legally drive without insurance.
Other types of insurance, while technically optional, are still very common. For instance, a would-be homeowner is unlikely to get a mortgage loan approved without having homeowner’s insurance in place.
Of course, it’s not just those who buy insurance who make claims to insurance companies. Medical providers, for example, will frequently bill automobile insurers and workers’ compensation carriers as well as health insurance companies.
Like other states, Texas has made insurance fraud a crime.
Basically, any false or even misleading statement that a person makes in order to make a claim for payment or secure coverage can lead to a fraud charge.
There are very few so-called white lies a person can tell an insurance company without running the risk of a charge.
Basically, any misleading statement that could affect whether a company offers coverage, or how a company handles a claim, is grounds for a charge.
In other words, insurance fraud is not just a charge for those who burn their own homes to collect insurance.
Prosecutors can just as easily file a charge against a doctor who routinely overbills insurance carriers or a skilled worker who decides to take a few extra days of workers’ compensation despite returning to a job.
Even first-time insurance fraud charges can be felonies
If the amount involved in an alleged fraud is more than $2,500, the State will likely charge it as a state jail felony. In the grand scheme of things, $2,500 is not much money. Most automobile accidents and significant medical procedures cost more. If the amount involved is more than $30,000, even a first-time offender can face years in prison.
In all insurance fraud cases, the judge is supposed to require the accused to pay restitution back to the insurance company, as well as the insurance company’s attorney fees.
Someone accused of insurance fraud will want to explore their legal options carefully.