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Insurance Fraud

New Jersey Insurance Fraud Defense Lawyers

Tenacious Defense Team Committed to Building Strong and Effective Defense Strategies for Clients Accused of Insurance Fraud in Essex County, Union County, Morris County, Middlesex County, Bergen County and Somerset County, NJ

New Jersey takes insurance fraud claims extremely seriously in this day and age where insurance rates of all kind are skyrocketing—in fact, our state imposes some of the harshest penalties in the country on individuals convicted of insurance fraud, and has even established a 24-hour tip line that offers a substantial $25,000 reward to anyone who provides useful information that leads to an arrest for insurance fraud. The insurance fraud statute applies in all situations where a person intends to defraud an insurance company, whether to obtain a payment or some other benefit.

At Zegas Law, our seasoned North Jersey insurance fraud defense lawyers work tirelessly to protect the rights of our clients who have been accused of committing any type of insurance fraud. We know that your freedom and your reputation are on the line, and we will use our years of experience litigating insurance fraud claims to challenge every element of the prosecution’s case against you. The New Jersey Office of the Insurance Fraud Prosecutor is tasked with the sole purpose of investigating and punishing individuals for committing insurance fraud in New Jersey, so you need a strong legal team on your side to advocate on your behalf. If you are under investigation or have already been arrested on insurance fraud charges, call or contact our offices today.

Potential Penalties For Fraud Charges Conviction in New Jersey

Under New Jersey law, insurance fraud is a criminal offense that covers a wide array of situations where a person intentionally makes false or misleading statements to an insurance company. Although characterized as a white collar criminal offense—meaning generally that it is non-violent in nature—insurance fraud is most often prosecuted as a third-degree crime that can result in a three to five-year prison sentence and up to $15,000 in fines.  Second-degree charges may apply if:

  • The defendant engaged in five or more acts (or omissions) that constitute insurance fraud
  • The value of the benefit obtained (or attempted to be obtained) was $1,000 or more

If convicted of second-degree insurance fraud charges, the defendant will face between five and ten years in prison, along with monetary fines of up to $150,000.

Either second or third-degree insurance fraud charges can apply in a variety of situations, but pursuant to the New Jersey insurance fraud statute, the prosecution must generally establish that the defendant:

  • Either (1) made some type of claim for payment, reimbursement or other benefits from an insurance policy or the insurance company generally, or the Unsatisfied Claim and Judgement Fund of New Jersey, (2) filed an application to obtain or renew an insurance policy, (3) obtained a payment under an insurance policy or a premium finance transaction, or (4) issued an affidavit, certification, record or some other type of document used in a premium finance transaction
  • Made (or otherwise caused to be made) some type of false, fictitious, misleading or fraudulent statement in (or omitted a material fact from) any type of record, bill, claim or written document, and that statement or omission was material in obtaining the coverage or benefit
  • Acted knowingly to procure the benefit by fraudulent means

Mounting A Strong Legal Defense For NJ Insurance Fraud Cases 

Although the New Jersey Office of the Insurance Fraud Prosecutor has substantial resources available in investigating and prosecuting alleged insurance fraud cases, this does not mean that establishing your guilt beyond a reasonable doubt is simple. Our skilled defense lawyers can challenge the prosecution’s evidence on any number of grounds. Depending upon the facts of your case, we will:

  • Consult with experts to establish that your claim was reasonable and not actually false (offering a mere opinion in connection with an insurance claim, for example, may not rise to the level of fraud even if that opinion was incorrect)
  • Work to establish that you did not knowingly make a false statement or omission,
  • Argue to show a mistake of fact
  • Challenge whether the false statement or omission involved was “material”
  • Challenge the number of insurance fraud acts involved in your case
  • Argue that the prosecution has insufficient evidence to establish the elements of insurance fraud

Schedule a Free Confidential Consultation 

If you have been charged with insurance fraud in Morris County or elsewhere in North Jersey, you need an experienced insurance fraud defense lawyer by your side to build a compelling defense strategy to counter the prosecution’s case.  Call or contact our office to schedule a confidential consultation to discuss your case with our skilled insurance fraud defense lawyers today.

Frequently Asked Questions About Insurance Fraud Cases

FAQ: What are some examples of insurance fraud in New Jersey?

Insurance fraud can take on any number of forms, and can involve false statements or omissions made to obtain health insurance, life insurance, disability insurance, homeowner’s insurance, car insurance or even unemployment insurance benefits. Lying on the application to obtain the insurance coverage, or omitting a material fact when making a claim under an existing policy, can both constitute actionable insurance fraud. Insurance fraud charges can also hold when the false or misleading statement indirectly is used to obtain insurance benefits, such as when the defendant lies in the police report filed after a car accident. Exaggerating the damage to property in order to obtain a larger insurance check from a homeowner’s insurance policy is insurance fraud. 

FAQ: What does it mean that the false statement or omission must be “material”?

In order to convict on insurance fraud charges, the prosecution must show that the false statement or omission involved was “material”, meaning that it was important in influencing the insurance company’s decision to grant you a benefit under a policy or provide you with coverage in the first place. False statements that are not relevant to the insurance company’s decision-making process are insufficient grounds for conviction.

Reasons to Hire Zegas Law

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