What constitutes fraud in insurance law?

Insurance companies do not make it easy for policyholders to fully understand their coverage and rights. This is partially because of the complexity of insurance law, but it is also because companies can use any confusion to their own advantage. Even minor mistakes are sometimes cited when denying a claim. In more serious situations, a person might even be wrongly accused of insurance fraud.

Insurance fraud is when one person attempts to make money through deceptive insurance transactions. Insurance fraud is not limited to any one type of insurance in Washington. Someone can be wrongly accused of this offense involving all types of insurance. This includes claims and even payments made to or by companies providing coverage for medical care, auto liability, property damages and more.

There are many different actions that may constitute insurance fraud. For example, providers who bill insurance companies for equipment and services that were never rendered may be accused of fraud. Providing unnecessary medical care or services for the sole purpose of billing an insurance company is another example.

Although these are both examples involving medical professionals, insurance companies may also accuse policyholders of insurance fraud. Under Washington state insurance law, anyone who knowingly conceals or lies about important information related to an insurance claim or payment may be committing insurance fraud. However, there are many situations in which a policyholder leaves out relevant information by mistake. In these and similar circumstances, it can be helpful to speak with an experienced attorney about options for handling the accusation.

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