Massachusetts Insurance Fraud Attorney

Have you or a loved one been charged with insurance fraud in Massachusetts? If you are in this situation, contact attorney Kathleen McCarthy for a consultation. Attorney Kathleen McCarthy has practiced law for over twenty-five years. She has obtained favorable case results on behalf of her clients.

Insurance Fraud Overview

The Commonwealth of Massachusetts Insurance and Unemployment Fraud Division investigates individuals who commit insurance fraud. Based on the division's recommendations, formal charges can be filed against individuals for criminal prosecution. The prosecutor must prove beyond a reasonable doubt the following in order for a defendant to be convicted of insurance fraud:

  1. The defendant knowingly made a false or misleading statement;
  2. The defendant's statement was made in connection with a claim or payment made or to be made under the terms of an insurance policy; and
  3. The defendant's statement must be material to the insurance claim or payment.

Common types of insurance fraud consist of the following:

  1. Automobile Insurance Fraud

    It is illegal in Massachusetts to stage an auto accident and submit fraudulent reports to an insurance company. Individuals who exaggerate injury claims, file false reports of auto theft, or submit false reports of a damage claim for pre-existing damage of their vehicle to their insurance company, can face prosecution. Some people unintentionally file claims with false information, or exaggerate the accident. Depending on the circumstances, individuals in this position may be investigated and/or prosecuted. If you think you may be the target or an investigation or if you are charged with automobile insurance fraud contact Attorney McCarthy.

  2. Workers' Compensation Insurance Fraud

    It is not uncommon for Boston residents to be charged with workers' compensation fraud. Common charges derive from individuals staging injury accidents at work, submitting false reports, working while collecting workers' compensation, or reporting a non-work related injury.

    Companies can also be subject to prosecution for workers' compensation insurance fraud. If a company fraudulently reduces an employees pay to reduce workers' compensation premium payments, fails to carry workers' compensation insurance, or tries to hide a potential claim, the company (including officers/employees who engaged in the fraudulent activity) will be subject to prosecution.

  3. Property Insurance Fraud

    Homeowners' insurance fraud occurs when a person files a false report of theft of property, intentionally damages their property, or exaggerates the value of stolen property in order to file a claim. Some homeowners have been known to exaggerate the extent of damage a natural disaster (example - hurricane) caused to their property in order to obtain insurance.

    Being accused of property insurance fraud is a serious offense in Massachusetts. A conviction can not only affect one's liberty but also interfere with a person's career and personal life.

  4. Medical Insurance Fraud

    Patients and health care providers can be prosecuted for health care fraud if any of the following occur:

    1. A patient uses a family member's insurance card to obtain health care.
    2. Health care provider commits insurance fraud by billing insurance companies for procedures that were not performed on patients. Additionally, health care providers can be prosecuted if they bill for procedures in which they did not perform.
Fraudulent Claim Penalties

Under Massachusetts GLC 266 section 111A, if a person is convicted of insurance fraud, he/she may face imprisonment in the state prison for up to five years or in jail for up to two and one-half years. Because there is the potential for someone convicted of this crime to serve time in state prison, this crime is a felony in Massachusetts. Fines for conviction on this type of offense range from $500 to $10,000.

Insurance companies classify fraudulent claims as "soft fraud" or "hard fraud."

  1. Soft Fraud

    Soft fraud occurs when a person has suffered an injury, but misrepresents the nature and extent of their injury in order to increase his/her recovery under the insurance policy. This type of fraud is harder to catch. It often occurs when a person tells small "white lies."

    Soft Fraud Example: Anne is on workers' compensation due to a slip-and-fall injury at work. She continues to exaggerate the extent of her damages in order to receive prolonged medical treatment so she can remain on workers' compensation. Anne continues to receive payments each month due to her "white lies."

    Contact attorney Kathleen McCarthy if you have recently been charged with soft insurance fraud in the Boston area.

  2. Hard Fraud

    Hard fraud occurs when a person intentionally stages a situation in order to file an insurance claim. Some people have been convicted of hard fraud as a result of intentionally burning down their house to file a claim for homeowners insurance.

    Hard Fraud Example: Hank and his wife Anne are in need of money to pay for Anne's medical bills. Hank decides to "fake" his death in order for Anne to file a claim for his life insurance. Hank successfully stages his death as planned and Anne files a claim against the life insurance policy.

    In the above scenario, both parties could be charged with hard fraud.

Hire Boston Insurance Fraud Attorney Kathleen McCarthy

Attorney Kathleen McCarthy secures favorable results for clients charged with misdemeanors and felonies. She has secured dismissals and acquittals for a variety of criminal offenses. She provides legal representation to residents of Lawrence, Lowell, Haverhill, Concord, Ayer, Newburyport and throughout Massachusetts. If you are being investigated or have been charged with a crime and want experience and skill on your side contact Attorney McCarthy at 978-975-8060 and she will have a free phone consultation with you.