It’s a CRIME.
Who Commits Insurance Fraud in NJ?
“With possible exception of murder and drug abuse, no serious crime attracts as wide a variety of perpetrators as insurance fraud. People who would never think of robbing a bank, stealing a car or burglarizing a home can find the temptations of “easy money” from insurance fraud hard to resist.The files of the Office of Insurance Fraud Prosecutor demonstrate that Insurance Fraud is crime committed by people in a wide range of occupations.”
Fraud Examples
Auto Accidents
| It’s illegal to receive treatment for phony injuries |
| It’s illegal for doctors, medical facilities, chiropractors, etc. to overbill for treatments, or to bill for treatments not provided. |
| It’s illegal for people to stage car accidents to bilk or cheat insurance companies. |
| These are all violations of the Health Care Claims Fraud Act. |
Automobile Insurance
| It’s illegal to make or sell a fake motor vehicle insurance card. |
| This is a violation of N.J.S.A. 2C:21-2.1a. |
| Punishable by up to 18 months in jail and a $10,000 fine. Also, a person convicted is required to perform 30 days of community service. |
To find out more about automobile insurance and coverage options go to NJ Department of Banking and Insurance – Shopping for Automobile Insurance in NJ Web site
Health Care Claims Fraud
| It’s illegal to submit a false claim form to an insurance company in order to be paid for health care services which were not received or provided. |
| This is a violation of the New Jersey Health Care Claims Fraud Act, N.J.S.A. 2C:21-4.2 and 2C:21-4.3. |
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In addition, this person can be required to pay a fine of up to $150,000 or up to five times the amount of the claim.
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| A person who is not a doctor, chiropractor, etc., could be sentenced to 3 to 5 years in jail for filing just one false claim. |
Insurance Applications
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It’s illegal to make or sell a fake motor vehicle insurance card. | |
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So if you don’t live in New Jersey…don’t try to insure your car here! | |
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It’s illegal to make an oral or written statement which is false or misleading in order to obtain insurance (such as home, health, life or automobile insurance). | |
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So tell the truth to your insurance agent and on your application! | |
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Licensed professionals who violate the insurance laws, from electricians to lawyers, may lose their State licenses! | |
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A person who is not a doctor, chiropractor, etc., could be sentenced to 3 to 5 years in jail for filing just one false claim.
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In addition to possible criminal penalties, a person violating the insurance laws may be required to pay a civil penalty of up to $5,000 N.J.S.A. 17:33A-5. | |
Medicaid Fraud
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Disability Benefits
| It’s illegal to receive these benefits if you are not disabled and can really perform the functions of your job. | |
| To do so is considered theft. |
Unemployment Insurance Fraud
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Worker's Compensation
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Various Fraud Scenarios
