NY Penal Law § 176.25: Insurance fraud in the second degree

Insurance fraud is a widespread crime that involves intentionally making a false claim to an insurance company. A common form of insurance fraud involve a health care provider such as a doctor, dentist, or chiropractor submitting claims to an insurer for treatment that was never completed. Arson is often used to try to defraud insurers. The owner of a home, business or vehicle intentionally sets the property on fire, claims that the fire was accidental and then attempts to collect the proceeds of a property insurance policy. Other types of insurance fraud include lying about the extent of loss after a burglary or lying about residence in order to get a lower car insurance rate. 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. Under New York Penal Code § 176.15 you will be charged with insurance fraud in the second degree if you commit an insurance fraud act and thereby obtain or attempt to obtain property with a value of over $50,000 but not over $1,000,000.

Fire officials were called to put out a vehicle fire. A 2014 Maserati was engulfed in flames. Firefighters extinguished the fire, but the $100,000 vehicle was a total loss. The car belonged to Angela who lived a few blocks away. Upon learning that her car was destroyed by fire, Angela filed a claim with her insurance company. Because of where the damage to the car was located, fire investigators concluded that the car was set on fire intentionally and not by a malfunction. The investigators discovered further evidence that the fire was intentional and that Angela had set the fire. She was charged with insurance fraud in the second degree based on the value of the car.

1. Life settlement fraud in the second degree: New York Penal Code § 176.60
2. Health care fraud in the second degree: New York Penal Code § 177.20

In order to convict you of insurance fraud in the second degree, the prosecutor must prove that the amount of money involved was more than $50,000. If you are accused of setting your vehicle on fire in an attempt to receive the insurance proceeds, you can avoid being convicted of insurance fraud in the second degree if you can show that the amount of money that you would have received from the insurance company was than $40,000. However, if the prosecutor still suspects that you committed insurance fraud, you could be charged with insurance fraud in the third, fourth, or fifth degree. In addition, you would not have committed insurance fraud if you had no intent to defraud the insurer. For example, suppose you are a health care provider and submit a claim that is inaccurate. If you can show that the inaccuracy was a mistake and not intentional, then you would not have committed insurance fraud.

Insurance fraud in the second degree is a class C felony. If you are convicted you could be sent to prison for up to 15 years and you could be ordered to pay a fine. In addition, the judge could sentence you to serve a probation term of 5 years. Furthermore, if you received payment from the insurance company to which you were not entitled, the judge may order you to pay it back to the insurance company as restitution.

A person is guilty of insurance fraud in the fourth degree when he commits a fraudulent insurance act and thereby wrongfully takes, obtains or withholds, or attempts to wrongfully take, obtain or withhold property with a value in excess of fifty thousand dollars.

If you are under investigation for insurance fraud in the second degree it is critical that you immediately contact an experienced attorney. The consequences of a conviction are serious and may include significant time in prison. 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.