NJ Insurance Fraud
Insurance fraud (2C:21-4.6) is becoming a very common white collar crime. In fact, the New Jersey Division of Criminal Justice has created a separate section of the office to focus on insurance fraud and related crimes. Although a third degree offense on its face, insurance fraud is often prosecuted as a second degree offense because the State can break down the crime into individual acts to come up with at least five individual acts.
For example, if the crime involved a false report to the police, calling the police is one act and filing a false police report is another. Afterwards, the State only needs three more acts. That is usually easily accomplished with all of the forms that the insurance company will need to process the payment. Thus, even first time offenders will receive at least five years in prison for this offense if convicted.
If you are facing charges or allegations of insurance fraud, me today to start the defense of your case!
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a. A person is guilty of the crime of insurance fraud if that person knowingly makes, or causes to be made, a false, fictitious, fraudulent, or misleading statement of material fact in, or omits a material fact from, or causes a material fact to be omitted from, any record, bill, claim or other document, in writing, electronically, orally or in any other form, that a person attempts to submit, submits, causes to be submitted, or attempts to cause to be submitted as part of, in support of or opposition to or in connection with: (1) a claim for payment, reimbursement or other benefit pursuant to an insurance policy, or from an insurance company or the “Unsatisfied Claim and Judgment Fund Law,” P.L. 1952, c. 174 (C. 39:6-61 et seq.); (2) an application to obtain or renew an insurance policy; (3) any payment made or to be made in accordance with the terms of an insurance policy or premium finance transaction; or (4) an affidavit, certification, record or other document used in any insurance or premium finance transaction.
b. Insurance fraud constitutes a crime of the second degree if the person knowingly commits five or more acts of insurance fraud, including acts of health care claims fraud pursuant to section 2 of P.L. 1997, c. 353 (C. 2C:21-4.2) and if the aggregate value of property, services or other benefit wrongfully obtained or sought to be obtained is at least $ 1,000. Otherwise, insurance fraud is a crime of the third degree. Each act of insurance fraud shall constitute an additional, separate and distinct offense, except that five or more separate acts may be aggregated for the purpose of establishing liability pursuant to this subsection. Multiple acts of insurance fraud which are contained in a single record, bill, claim, application, payment, affidavit, certification or other document shall each constitute an additional, separate and distinct offense for purposes of this subsection.
c. Proof that a person has signed or initialed an application, bill, claim, affidavit, certification, record or other document may give rise to an inference that the person has read and reviewed the application, bill, claim, affidavit, certification, record or other document.
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