Fighting Accusations of Philadelphia Insurance Fraud

Fighting Accusations of Philadelphia Insurance Fraud

Getting accused of insurance fraud is no joke, especially in Philadelphia where prosecutors take it super seriously. But just because the DA’s office suspects you doesn’t mean you’re guilty. There’s ways to fight the charges and protect yourself. This article will break it down so you know your options if the heat comes down on you.

First off, what exactly is insurance fraud? Basically it’s lying or misleading your insurance company to get more money from them. Things like padding a claim, staging an accident, or just straight up lying about what happened. Prosecutors in Philly have a whole unit dedicated to sniffing out fraud and they get pretty gung-ho about bringing charges.

So what should you do if the DA accuses you of insurance fraud? Don’t panic. Get yourself a good lawyer, like a really good one, and start building your defense. Here’s some of the main ways lawyers defend Philly clients against these charges:

Lack of Criminal Intent

Prosecutors have to prove you intended to defraud the insurance company. But lots of times, mistakes or misunderstandings happen that look sketchy but weren’t on purpose. Your lawyer can argue you lacked criminal intent and were just confused or got something wrong by accident. This is a solid defense that often creates reasonable doubt.

Reliance on Expert Advice

Let’s say an accountant or lawyer told you to report income or losses a certain way that prosecutors claim is fraudulent. Your attorney can argue you were relying on expert advice and got bad guidance. This can show you weren’t trying to trick the insurance company and shift blame to the professionals advising you.

Paperwork Errors

Another common defense is claiming the paperwork just had errors or omissions that made things look fishy when it was really just a paperwork screw up. This works well when the supposed fraud isn’t too egregious. With sloppy recordkeeping, misunderstandings happen.

Unclear Policy Language

Insurance policies can be super confusing, full of technical jargon and exceptions. Your lawyer may be able to argue the policy language was unclear or contradictory and you did the best you could to comply with it. It’s not fraud just because the insurer interprets the policy different than you.

Collateral Source Rule

This is a rule that says the insurer isn’t entitled to deduct payments you received from other sources, like health insurance or workers comp, from what they owe you. Often prosecutors accuse people of fraudulently “double dipping” by not disclosing these other payments. But if they fall under the collateral source rule, you may not have committed any crime.

Padding vs. Negotiation

It’s obviously fraud if you blatantly lie and make up damages or injuries that didn’t happen. But “padding” a claim through aggressive negotiation is different. It’s expected that claims will be negotiated up, and exaggeration is part of the process. Skilled lawyers know how to differentiate padding from deception.

Independent Valuations

What’s that antique vase really worth? How much damage did the flood actually cause? If you relied on independent appraisals and valuations from qualified experts, it’s hard to accuse you of fraud just because the insurer disagrees with their estimate of value.

Civil Dispute vs. Criminal Act

At the end of the day, disputes over claim value come down to civil contract disagreements. Even if the insurer believes you sought too much money, your lawyer can argue it’s a civil matter involving interpretation of policy terms and valuations. Not every claim dispute means someone committed a crime.

There’s many other creative ways skilled lawyers defend these cases by focusing on intent, technicalities, and independent opinions that contradict the prosecution’s fraud theory. The bottom line is don’t assume you’re doomed just because the DA accuses you of insurance fraud. Fight back with an aggressive legal strategy. And next time, make sure your paperwork is air tight so you don’t get accused in the first place.

Hopefully this gives you an idea of how insurance fraud charges can be battled in court. If the DA’s office comes after you, don’t go it alone. Get an experienced white collar defense attorney on your side asap. Insurance policies are complex and the law gives leeway for legitimate disputes over claims. With a solid lawyer and smart defense strategy, you can avoid getting railroaded for normal insurance disputes.

Here’s some examples of good Philly lawyers who regularly help beat these charges:

– John Doe Law is a former insurance fraud prosecutor who knows all the tricks the DA uses. He’s gotten tons of cases tossed out or ended in acquittals.

– Jane Smith Defense only handles insurance fraud cases. She’s known for picking apart the prosecution’s exaggerations and showing juries the reasonable doubt.

– Bob’s White Collar Firm has a whole team focused on insurance fraud. Bob has 30+ years experience and won’t be intimidated by aggressive prosecutors.

The key is acting fast when you learn you’re being investigated, not waiting until charges are filed. Don’t go it alone against the DA’s office. The system is stacked against you. Get a pit bull lawyer ready to fight tooth and nail.

Hopefully you never need to battle insurance fraud accusations. But if you do, remember: stay calm, lawyer up with the best, and never assume you’re doomed. There’s plenty of ways to poke holes in the case against you. With smart legal moves, you can avoid getting railroaded for normal insurance disputes.