In New Jersey, providing false or misleading statements or neglecting to provide important information to an insurance company is a serious crime. In fact, the State considers “insurance fraud” a wide range of behavior, which may include providing false information during the application or renewal process, while filing a claim, or during a transaction or other proceeding. These instances commonly occur with regard to automobile accidents, automobile insurance, healthcare claims, insurance applications, Medicaid, disability benefits, unemployment insurance, and workers’ compensation.
Due to the seriousness of these offenses in the eyes of the law, legislators established the Office of the Insurance Fraud Prosecutor, which is tasked with dispensing information, promoting prevention, and prosecuting perpetrators of insurance fraud in New Jersey. The office also encourages citizens to come forward with information related to insurance fraud crimes, operating an around-the-clock tip hotline and providing incentives of up to $25,000 through the Insurance Fraud Detection Reward Program. For those accused of insurance fraud in New Jersey, your reputation, livelihood, and future are placed in jeopardy. Not only are you exposed to criminal penalties, but also to the revocation of your professional license, civil litigation, and a permanently marred public image.
At The Law Offices of Jonathan F. Marshall, our team of former municipal and county prosecutors and award-winning defense attorneys is committed to aggressively protecting the rights and reputations of our clients in court rooms across the State. Members of our firm have been recognized as leaders in our field through diligence, a relentless pursuit of further knowledge and education, and an unwavering commitment to the presumption of innocence. Having been named among the Top 100 Criminal Attorneys and Best Attorneys in America, we choose to support these honors with thousands of victories and satisfied clients who can move on with their lives unimpeded by criminal allegations. If you or someone you love has been charged with insurance fraud or another white collar crime in New Jersey, one of our lawyers is always available to address your questions and concerns. Simply contact us at 908-722-1011. Consultations are always free of charge.
New Jersey’s Fraud Prevention Act: § 17:33A
With the New Jersey Insurance Fraud Prevention Act (§ 17:33A), lawmakers sought to:
“Confront aggressively the problem of insurance fraud in New Jersey by facilitating the detection of insurance fraud, eliminating the occurrence of such fraud through the development of fraud prevention programs, requiring the restitution of fraudulently obtained insurance benefits, and reducing the amount of premium dollars used to pay fraudulent claims.”
The Crime of Insurance Fraud in New Jersey: N.J.S.A. 2C:21-4.6
Section N.J.S.A. 2C:21-4.6 of the New Jersey Criminal Code prohibits any form of behavior that may constitute insurance fraud, mandating the following:
A person is guilty of the crime of insurance fraud if that person knowingly makes, or causes to be made, a false, fictitious, fraudulent, or misleading statement of material fact in, or omits a material fact from, or causes a material fact to be omitted from, any record, bill, claim or other document, in writing, electronically, orally or in any other form, that a person attempts to submit, submits, causes to be submitted, or attempts to cause to be submitted as part of, in support of or opposition to or in connection with:
- A claim for payment, reimbursement or other benefit pursuant to an insurance policy, or from an insurance company or the “Unsatisfied Claim and Judgment Fund Law,” P.L. 1952, c. 174 (C. 39:6-61 et seq.);
- An application to obtain or renew an insurance policy;
- Any payment made or to be made in accordance with the terms of an insurance policy or premium finance transaction; or
- An affidavit, certification, record or other document used in any insurance or premium finance transaction.
Insurance fraud constitutes a crime of the second degree if the person knowingly commits five or more acts of insurance fraud, including acts of health care claims fraud pursuant to section 2 of P.L. 1997, c. 353 (C. 2C:21-4.2) and if the aggregate value of property, services or other benefit wrongfully obtained or sought to be obtained is at least $ 1,000. Otherwise, insurance fraud is a crime of the third degree.
Each act of insurance fraud shall constitute an additional, separate and distinct offense, except that five or more separate acts may be aggregated for the purpose of establishing liability pursuant to this subsection. Multiple acts of insurance fraud which are contained in a single record, bill, claim, application, payment, affidavit, certification or other document shall each constitute an additional, separate and distinct offense for purposes of this subsection
Penalties for Insurance Fraud in New Jersey
As mentioned above, insurance fraud can be classified as a second or third degree crime, each of which entails distinct penalties. Notably, a second degree charge for insurance fraud is associated with a term of imprisonment ranging from 5 to 10 years, as well as a presumption of incarceration. This means that even a defendant who has no prior criminal record is likely to be sentenced to serve time in prison. On the other hand, third degree charges for insurance fraud are punishable by a prison term ranging from 3 to 5 years, but these charges entail a presumption of non-incarceration, meaning a defendant with no criminal history may be considered a good candidate for parole or a diversionary program such as Pre-Trial Intervention.
Contact our Somerset County NJ Insurance Fraud Attorneys Today
Our highly knowledgeable defense team resolves cases through investigation, collaboration, negotiation, and if necessary, an aggressive trial strategy. We are committed to pursuing any and all available avenues to secure a positive result and will continuously assess and reassess your options in pursuit of the most favorable outcome. To speak with one of our talented criminal defense lawyers today, contact our Somerset County offices at 908 722-1011 for a free comprehensive consultation.