Lackawanna Insurance Group Fraud Resource Center
When someone provides false information to an insurance company in order to gain something of value that he or she would not have received if the truth had been told, they've committed insurance fraud.
In Pennsylvania, fraud is defined as "Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties." This type of dishonest act is classified among the most serious of crimes - it's considered a felony. Those convicted of the crime face prison time, fines, legal fees and more - not to mention a wide range of personal and professional consequences.
As with other forms of insurance fraud, workers compensation insurance can be compromised if false or misleading information is provided to insurance companies.
The most common ways an individual commits insurance fraud is if he or she:
- Fakes an injury at work to get paid time off.
- Exaggerates the severity of a legitimate injury to get additional time off work with benefits.
- Claims an injury occurred on he job when it actually took place elsewhere.
- Takes a new job and lies to the insurance company about being unable to return to work at the previous place of employment or lies by concealing his income from another job.