NY Penal Law § 176.15: Insurance Fraud in the Fourth Degree
Understanding Insurance Fraud as a White Collar Crime
Insurance fraud is a white collar crime that occurs when someone provides false information to an insurance company in order to receive a payment from the insurance company that they would otherwise not have received. While it is often associated with medical insurance, it can involve any type of insurance arrangement such as life insurance, automobile insurance, property insurance, workers’ compensation, commercial insurance, and publicly funded insurance arrangements such as Medicare or Medicaid.
Under the New York criminal code you would have committed a fraudulent insurance act if with intent to defraud you provide an insurance company with false information or you hide information from the insurance company. Examples of insurance fraud include:
Need Help With Your Case?
Don't face criminal charges alone. Our experienced defense attorneys are ready to fight for your rights and freedom.
- 100% Confidential
- Response Within 1 Hour
- No Obligation Consultation
Or call us directly:
(212) 300-5196- burning property to collect insurance money
- falsely claiming that a car was stolen in order to collect the insurance money
- claiming that property was damaged in an accident or stolen during a robbery when it was not
- overstating the value of stolen or damaged property
Insurance Fraud Classifications in New York
There are several different insurance fraud offenses in the New York criminal code. If you commit 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 involved.
Todd Spodek
Lead Attorney & Founder
Featured on Netflix's "Inventing Anna," Todd Spodek brings decades of high-stakes criminal defense experience. His aggressive approach has secured dismissals and acquittals in cases others deemed unwinnable.
After a minor fender-bender, your chiropractor suggested billing your auto insurance for 12 sessions you never actually attended, assuring you it was 'standard practice' and that you'd split the reimbursement. Now you've received a letter from the insurance company's Special Investigations Unit requesting documentation of your treatment dates.
Can I really be charged with insurance fraud even though it was my chiropractor's idea and I never personally submitted the false claims?
Under NY Penal Law § 176.15, Insurance Fraud in the Fourth Degree, you can be charged as long as you knowingly participated in a scheme to defraud an insurance company, even if someone else physically submitted the paperwork. This is a Class E felony carrying up to four years in prison, and prosecutors only need to show that you acted with intent to defraud and that the fraudulent claim exceeded $1,000 in value. The fact that your chiropractor initiated the scheme does not absolve you — agreeing to split proceeds and allowing false claims to be filed in your name demonstrates the requisite intent. An experienced defense attorney may be able to argue lack of knowledge or negotiate reduced charges, but ignoring that SIU letter would be a serious mistake.
This is general information only. Contact us for advice specific to your situation.
Under New York Penal Code § 176.15, you will face a charge of insurance fraud in the fourth degree if you carry out an insurance fraud act and thereby obtain or attempt to obtain property with a value of more than $1000 but less than $3000.
