Criminal Defense Without Compromise
Insurance Fraud
Beware the insurance adjustor in police clothing.
Insurance fraud, governed by G.L. c. 266, § 111B, is a complex and highly technical offense that can have severe repercussions. Allegations of fraud can arise from seemingly minor mix-ups, such as inaccuracies in a claim or policy application, and escalate into criminal charges with serious consequences. At Erkan & Sullivan, P.C., we bring a deep understanding of the law and an unwavering commitment to defending our clients’ rights against these charges.
Insurance fraud allegations are the sort where having the right lawyer can truly make all the difference. Lazy or inexperienced lawyers will quickly get overwhelmed with the paperwork, sometimes assuming that because there is a lot of documentation, their client must be guilty. The reality is though with documentary evidence, it’s the quality, not the quantity that matters. Having lawyers that are not afraid to take a deep dive into the documents, and who can identify the difference between a solid and speculative case, is crucial.
One example that sticks out in my mind is a case where the police claimed that my client falsely claimed his car was damaged in a hit and run. The insurance expert … ruled out the possibility of a collision with a moving object. We didn’t just accept his conclusion. Instead, we went to the business across the street and, sure enough, obtained video footage that actually captured the hit and run of our client’s car! So much for that “expert” opinion!
– Murat Erkan
Understanding Insurance Fraud
Insurance fraud occurs when someone knowingly provides false or misleading information to an insurer to gain an undeserved financial benefit. The law covers a wide range of conduct, including:
- Submitting inflated or fabricated claims for property damage or personal injury.
- Misrepresenting facts on an insurance application.
- Staging car accidents or falsifying details of an incident.
- Billing for medical procedures or services not actually provided.
Mistakes can happen in the claims process, but not every error constitutes fraud. At Erkan & Sullivan, P.C., we excel at distinguishing innocent oversights from intentional misconduct and holding the government to its burden of proof.
One thing that escapes most lawyers is knowing who is really driving the bus in these cases. Although the criminal complaints are filed by police officers, in the vast majority of cases it is the private insurance companies that have conducted the investigation. When you think about it from that perspective, the risk of erroneous prosecution fueled by bias and greed is truly enormous. In order to properly defend these cases, lawyers must be vigilant for evidence showing the shortcuts and unjust tactics the insurance companies take to get themselves a payday.
How Insurance Fraud is Prosecuted
Insurance fraud cases often involve:
- Circumstantial Evidence: Most accusations lack direct proof of intent, relying instead on circumstantial or speculative evidence. For example, a person can make an honest mistake when filling out reams of insurance claim paperwork. That doesn’t make them a criminal.
- Complex Investigations: These cases often require expert testimony, such as forensic accounting or crash reconstruction, which the prosecution may fail to utilize properly. Remember who is paying for these experts! More often than not, it is the insurance company who selects and pays for the expert. How do you think those experts get picked for this work? Often it’s because of their tendency to support allegations of fraud, whether or not fraud is truly at play.
- Prosecutorial Overreach: Prosecutors frequently charge defendants with trumped up or multiple charges an effort to pressure them into a plea deal. It’s important to know when a charge is supported by the evidence and when it it being used as a hammer to strongarm a plea.
Despite these challenges, the government often assumes that defendants will not challenge the allegations. That’s where we come in. While many lawyers cower at these cases because of their outwardly complex nature, our office has the experience necessary to quickly identify when a case is built on a teetering foundation of flawed assumptions. We enjoy knocking those cases down.
Defense Strategies for Insurance Fraud
We develop a tailored defense strategy for each case, always beginning with a thorough review of the evidence. We assume none of the allegations are true, eyeing all of the government’s assumptions with a critical view. From there, we focus on exposing weaknesses in the government’s evidence and narrative. We don’t simply rely on the government’s investigation or version of events. Rather, we conduct our own inquiry, oftentimes uncovering facts or witnesses that contradict the government’s story.
One example that sticks out in my mind is a case where the police claimed that my client falsely claimed his car was damaged in a hit and run. The insurance expert wrote a report stating that the type of paint transfer and strike pattern ruled out the possibility of a collision with a moving object. We didn’t just accept his conclusion. Instead, we went to the business across the street and, sure enough, obtained video footage that actually captured the hit and run of our client’s car! So much for that “expert” opinion! To add insult to injury, before we disclosed our findings, the insurance company sent our client a bill for the services of their so-called expert. Needless to say when we presented our case, the judge was far from amused by their antics.
Potential Consequences of a Conviction
A conviction for insurance fraud under G.L. c. 266, § 111B can result in:
- Imprisonment: Up to 5 years in state prison or up to 2½ years in a house of correction.
- Fines: Up to $10,000 or double the amount of the fraud, whichever is greater.
- Restitution: Reimbursement of the insurer for any losses.
- Professional Consequences: Loss of licenses, certifications, and employment opportunities.
- Immigration consequences: Because fraud is an element of the charge, the risk of deportation for conviction of these offenses is extreme. As a consequence, for non-citizens, the stakes of these prosecutions could not be higher.
The collateral consequences, such as damaged reputation and financial hardship, make fighting these charges critical.
While many lawyers cower at these cases because of their outwardly complex nature, our office has the experience necessary to quickly identify when a case is built on a teetering foundation of flawed assumptions. We enjoy knocking those cases down.
– Ryan Sullivan
Mistakes Are Not Crimes
It is important to remember that not every error in the claims process constitutes fraud. Honest mistakes, such as misremembering the value of an item or providing incomplete information, do not meet the legal standard for criminal intent. At Erkan & Sullivan, P.C., we work tirelessly to separate innocent errors from fraudulent conduct, forcing the prosecution to prove their case beyond a reasonable doubt, which they often cannot.
Why Choose Erkan & Sullivan, P.C.?
At Erkan & Sullivan, P.C., we bring decades of experience and a results-driven approach to defending clients accused of insurance fraud. Here’s what sets us apart:
- Unmatched Knowledge: We understand the technical nuances of insurance fraud cases and how to dismantle the government’s narrative.
- Relentless Advocacy: We are unafraid to challenge the prosecution’s evidence and hold them to their burden of proof.
- Proven Results: Our track record of success speaks for itself, with numerous dismissals and favorable resolutions in fraud cases.
Contact Erkan & Sullivan, P.C. Today
If you or a loved one has been accused of insurance fraud, don’t wait to protect your rights. Contact Erkan & Sullivan, P.C. at (978) 474-0054 or send us an email for a confidential consultation. Together, we’ll develop a powerful defense strategy to safeguard your freedom, reputation, and future.