Insurance is there to help people when they need it. Unfortunately, many people try to take advantage of the system, so insurance companies are always on the lookout for fraudulent or questionable claims. Anyone in North Carolina or elsewhere who is thought to be abusing the system may be charged with insurance fraud, which can carry significant penalties if one is ultimately convicted.

Insurance fraud, by definition, is knowingly and intentionally abusing insurance for financial gain. Insurance fraud happens all too often, and it is costly to consumers, as insurance providers pass their losses on to their customers. Some claim that insurance fraud costs Americans upward of $150 billion per year.

What are some examples of insurance fraud? There is hard fraud, which includes things like faking an auto accident, theft, injury or other loss. There is also soft fraud, which includes things like telling lies to enhance one’s claim for maximum compensation — such as medical providers inflating claims.

For prosecuting attorneys to convict a North Carolina resident with insurance fraud, certain elements must exist in the case. These elements include the accused knowingly filing a false statement and achieving a payout following the claim submission. If convicted, the accused may be incarcerated, and be ordered to pay fees and restitution.

Insurance fraud is not a small thing. The state takes it seriously, as should anyone who finds him or herself being charged with this crime. With the assistance of legal counsel, one’s rights can be protected and a well-planned defense presented, which can help one either seek a case dismissal or, at least, a reduction in charges and penalties.