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NY Penal Law § 176.25: Insurance Fraud in the Second Degree

July 6, 2020 Federal Criminal Attorneys

Insurance fraud is a widespread crime that involves intentionally making a false claim to an insurance company. A common type of insurance fraud is committed by  health care providers, such as doctors, dentists, or chiropractors, filing insurance claims for treatment or procedures that were never carried out. Arson is frequently used to attempt to defraud insurers. In these cases, the owner of a home, a business or a vehicle intentionally sets the property on fire, claims that the fire was an accident and then files a claim to collect the proceeds of a property insurance policy. 

Other acts of insurance fraud include lying about the extent of loss from a burglary or lying about place of residence in order to get a lower car insurance rate.  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.  Pursuant to New York Penal Code § 176.15, you will be charged with insurance fraud in the second degree if you carry out an insurance fraud act and thereby obtain or attempt to obtain property with a value of over $50,000 but less than $1,000,000.

An Example

The fire department was called to extinguish a vehicle fire. When they arrived, they saw a 2014 Maserati engulfed in flames. They put out the fire, but the $100,000 vehicle was a total write off. The car belonged to Brianna, who lived just a few blocks away from the scene. When she learned that her car was destroyed by fire, Brianna filed a claim with her insurance company. Because of the location of the damage to the car, fire investigators concluded that the car was intentionally set on fire and not by a malfunction. The investigators uncovered further proof that the fire was intentional and that Brianna, herself, had set the fire. She was charged with insurance fraud in the second degree on the basis of the value of the car.

Offenses that are Related

Life settlement fraud in the second degree: New York Penal Code § 176.60

Health care fraud in the second degree: New York Penal Code § 177.20

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 third degree: New York Penal Law § 176.20

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

Possible Defenses

To get a conviction against you on a charge of insurance fraud in the second degree, the prosecutor must demonstrate that the amount of money involved was greater than $50,000. If, for example, you are accused of setting your car on fire in an attempt to get the insurance proceeds, you can evade conviction of insurance fraud in the second degree if you can show the court that the amount of money that you would have received from the insurance company was less than $40,000. That said, if the prosecutor continuous to suspect that you committed insurance fraud, you could still face a charge of insurance fraud in the third, fourth, or fifth degree. 

In addition, you could not be prosecuted on an insurance fraud charge if you did not have intentions of defrauding the insurer. For example, suppose you are a health care provider and submit a claim that is inaccurate. If you can show that the inaccuracy was a mistake and not intentional, then you would not have committed insurance fraud.

The Sentence

Insurance fraud in the second degree is categorized as a class C felony offense.  If you are convicted, the judge could send you to jail for up to 15 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 insurance company if you did get a payout from them.

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