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NY Penal Law § 176.20: Insurance fraud in the third degree

July 6, 2020

Insurance fraud is among the white collar crimes that entails deceiving an insurance company in order to receive insurance money. This statute covers fraud that involves any type of insurance policy, plan or arrangement including  life insurance, property  or home owner’s insurance, automobile insurance, health insurance, workers’ compensation, commercial insurance, and publicly funded insurance programs, such as Medicare or Medicaid.

Faking a death, for example, in order to collect on a life insurance policy and then turning up years later, claiming memory loss would be an act of insurance fraud. In the case of a car accident, if you were to  file a claim for damages that did not actually take place in the accident, but occurred as a result of an earlier accident, you would have committed insurance fraud. There are a number of different insurance fraud offenses listed in the New York criminal code. If you carry out a fraudulent insurance act, the specific insurance fraud crime you will face will depend on several different factors, such as the type of insurance plan involved and the amount of money you received or attempted to receive. You will be charged under New York Penal Code § 176.20 with insurance fraud in the third degree if you commit an act of insurance fraud and thereby obtain or attempt to obtain property with a value of over $3000 but not over $50,000. It is critical to note that if you are suspected of insurance fraud, you will probably face additional criminal charges such as grand larceny.

Two Examples

Chase is interested in remodeling his kitchen. Unfortunately, the estimates for the remodel are much more than he could afford. To get the money, Chase decided he might set his kitchen on fire, get the payout from the insurance company and use that to build a whole new kitchen with all of the new features he wants. In this scenario, if Chase goes through with the plan and collects an insurance payment of more than $3000 but less than $50,000, then he could be charged with insurance fraud in the third degree in violation of New York Penal Code § 176.20.

Cassius, who doesn’t have a driver’s license, is in the driver’s seat in Mervin’s car.  Mervin is in the passenger seat. Coming around a corner, Cassius sideswipes Lemuel’s car, causing extensive damage. Cassius panics and keeps driving on. A block later, Mervin and Cassius pull over to exchange seats in the car, and Mervin drives back to the accident scene. He offers apologies and gives Lemuel his insurance information. Mervin would have committed insurance fraud, because his insurance company might not have paid the claim to Lemuel if they knew that Cassius was driving the car and not Mervin.

Offenses that are Related

Life settlement fraud in the third degree: New York Penal Code § 176.55

Health care fraud in the third degree: New York Penal Code § 177.15

Insurance fraud in the fifth degree: New York Penal Law § 176.10

Insurance fraud in the fourth degree: New York Penal Law § 176.15

Insurance fraud in the second degree: New York Penal Law § 176.25

Insurance fraud in the first degree: New York Penal Law § 176.30

Possible Defenses

You could not be prosecuted on an insurance fraud charge if you did not have intentions of defrauding the insurer.  For example, say you were in a car accident in June and you got a payment from your insurance company for the damage to your vehicle. Regardless, you never get the car fixed. Then, in November, you are involved in another car accident that resulted in further damage to your vehicle in the same spot where your car was already damaged from the accident back in June. It would probably be rather difficult, if not impossible, to distinguish the damage that occurred in the more recent accident.

The Sentence

Insurance fraud in the third degree is categorized as a class D felony offense.  If you are convicted, the judge could send you to jail for up to 7 years and you could be required to pay a fine. Additionally, the judge could sentence you to serve a probation term of 5 years. On top of that, the judge may order you to pay restitution to the victim. 

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