NY Penal Law § 176.10: Insurance fraud in the fifth degree

Insurance fraud is a white collar crime that involves deceiving an insurance company in order to receive insurance money. Insurance fraud can involve any type of insurance policy, plan or arrangement such as life insurance, automobile insurance, property insurance, workers' compensation, health insurance, commercial insurance, and publicly funded insurance arrangements such as Medicare or Medicaid. Under the New York criminal code you will have committed an fraudulent insurance act if with intent to defraud you present any written statement that is part of an insurance application or claim that contains false information or that conceals information. Examples of insurance fraud include 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 burglary when it was not, or overstating the value of stolen or damaged property.

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. While most insurance fraud crimes are felonies, there are a few that are misdemeanors such as insurance fraud in the fifth degree. Under New York Penal Code § 176.10 you will be charged with insurance fraud in the fifth degree if you commit a fraudulent insurance act and amount of money received or that you attempted to receive was $1000 or less.

Michael Palmeri was an orthopedic surgeon. Over a period of several years he filed reports with the Workers' Compensation Board to the effect that one of his patients was totally disabled from his work as a corrections officer and was not working. In reality Palmeri had examined the corrections officer several times and knew that he was engaged in substantial work activities. In fact, Palmeri had observed the corrections officer performing substantial work activities. Thus, Palmeri's reports to the Workers' Compensation Board were false. Palmeri was charged with several crimes, including insurance fraud in the fifth degree. People v. Palmeri, 942 N.Y.S.2d 759 (N.Y. App. Div., 2012)

Chase lost his job and his bills are piling up. In a desperate move, he takes his car to a remote area and leaves it. He then calls the police and his insurance company to report that the car was stolen. He receives money from the insurance company per the terms of his insurance policy. Chase could be prosecuted for insurance fraud since he lied about his car being stolen in order to get money from the insurance company.

1. Life settlement fraud in the fifth degree: New York Penal Code § 176.45
2. Health care fraud in the fifth degree: New York Penal Law § 177.05

You would not be guilty of insurance fraud if you did not have the intent to defraud the insurer. For example, if you submit a claim for property loss in a burglary, but you did not realize that the specific piece of property was previously removed by family member, then you would not have committed insurance fraud. Similarly, if the claim relates to vehicle damage in an accident and you mistakenly include damage that actually occurred in a previous incident, you would not have committed insurance fraud.

Insurance fraud in the fifth degree is a class A misdemeanor if you are convicted you could be sent to jail for up to one year and you could be ordered to pay a fine. In addition, the judge could sentence you to serve a probation term of 3 years.

A person is guilty of insurance fraud in the fifth degree when he commits a fraudulent insurance act.

Because insurance fraud in the fifth degree is a misdemeanor and not a felony, you may be inclined to not take it seriously. However, if you are convicted you could end up in jail for up to a year and face stiff fines. The best way to avoid these consequences is to be represented by someone with experience. The staff at the Law Offices of Stephen Bilkis & Associates has years of experience successfully defending clients in New York criminal courts who have been charged with felonies and misdemeanors in violation of New York state law and federal law. Contact us at 800.696.9529 to schedule a free, no obligation consultation regarding your case. We represent clients in the following locations: the Bronx, Brooklyn, Long Island, Manhattan, Nassau County, Queens, Staten Island, Suffolk County and Westchester County.