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. Pursuant to the New York criminal code, you will have committed a fraudulent insurance action if, with intent to defraud, you give any written statement as part of an insurance application or claim for benefits that contains untrue information or that conceals required information. Some examples of insurance fraud include burning property to collect an insurance payout, falsely claiming that a vehicle was stolen in order to collect the insurance payout, falsely claiming that property was damaged in an accident or lost to theft during a burglary when it was not, or overstating the dollar value of stolen or damaged items. In the New York criminal code, there are a number of different insurance fraud offenses. If you do commit a fraudulent insurance act, the specific insurance fraud charge you would be looking at 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. While the majority of insurance fraud crimes are felonies, there are a few that are misdemeanors, including insurance fraud in the fifth degree. Pursuant to New York Penal Code § 176.10, you will be charged with insurance fraud in the fifth degree if you commit a fraudulent insurance act and the amount of money you received or that you attempted to receive was $1000 or less. Two Examples

Dr. Michael Palmeri was a local orthopedic surgeon. Over a number of years, he filed multiple reports with the Workers' Compensation Board claiming that one of his patients was completely disabled from his work as a corrections officer and was not on the job. In reality, Dr. Palmeri had examined the corrections officer a few times and knew that the CO was taking part in substantial work activities. In actuality, Dr. Palmeri had personally observed the corrections officer performing substantial work activities. Therefore, Dr. Palmeri's reports to the Workers' Compensation Board were fraudulent. Dr. Palmeri was charged with numerous crimes, including insurance fraud in the fifth degree. This was the case of the People v. Palmeri, 942 N.Y.S.2d 759 (N.Y. App. Div., 2012)
Cheng lost his job, and now, his bills are piling up. In an act of desperation, he drives his car out to a remote area and leaves it there. He then calls both the police and his insurance company to report that the car was stolen. From the insurance company, he receives a payout as per the terms of his insurance policy. In this scenario, Cheng could be prosecuted for insurance fraud because he lied about his car being stolen in order to get money from the insurance company.

Offenses that are Related Life settlement fraud in the fifth degree: New York Penal Law § 176.45 Health care fraud in the fifth degree: New York Penal Law § 177.05 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 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 to defraud the insurer. For example, if you put in a claim for property loss from a burglary, but you did not realize that the specific item was removed by a family member before the burglary took place, then you would not have committed an insurance fraud crime. Likewise, if the claim is connected to vehicle damage in an accident, and you mistakenly include damage that really occurred in a previous incident, then here again, you would not have committed insurance fraud. The Sentence Insurance fraud in the fifth degree is categorized as a class A misdemeanor. If you are convicted, the judge could send you to jail for up to one year and you could be required to pay a fine. Additionally, the judge could sentence you to serve a probation term of 3 years.

NY Penal Law § 176.10: Insurance Fraud in the Fifth Degree

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