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A Typical Insurance Fraud Investigation

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Miami-Dade County is notorious for insurance fraud. Everything from medical billing fraud to staged accidents, the State of Florida is fully aware of the high number of insurance fraud incidents.

Counties such as Miami-Dade and Broward have an extraordinary amount of insurance fraud. The prosecutors and police departments in these counties are well-prepared to deal with this.

Insurance fraud can mean a number of things, but the most basic - and obvious - definition is a person submitting claims to an insurance company for injuries or property damage that did not actually occur, were done on purpose (staged accident), or have been grossly exaggerated.

Insurance fraud is a third-degree felony in Florida, punishable by up to 5 years in prison. However, numerous other charges such as grand theft or organized scheme to defraud, can also be filed. These additional charges add to the potential maximum sentence you can receive, as well as increase the amount of bond you must post.

The first thing that will happen in an insurance fraud investigation is an in-house investigation by the insurance company. Most insurance companies have fraud investigators who are not law enforcement officers but they investigate fraud for the insurance company like private investigators. These people will reach out to you first. Since they are not police officers, they are not required to read you Miranda rights. However, anything you say to them can be used as evidence against you.

It is strongly advised that if you are contacted by a fraud investigator from an insurance company, you do not speak to them. You do not have to speak to them and should consider consulting a criminal defense attorney at that time.

Once the fraud investigation within the insurance company is complete, the investigation will usually be handed over to fraud investigators from the Department of Financial Services. These investigators are sworn law enforcement officers in the State of Florida. Once they have the case, things have gotten serious. Be prepared for an arrest at this point.

The insurance fraud investigators may want to speak with you. Depending on the evidence against you this may be advisable or not. You cannot make this decision without speaking to a criminal defense attorney first. Sometimes, cooperation is helpful to the overall resolution of your case. Sometimes it is not. You need to consult with an attorney before you make this very important decision.

An arrest can be done the easy way or the hard way. The easy way is to negotiate a surrender. Your attorney can do this. The hard way is to let police come to your house and embarrass you in front of your neighbors. An arrest at home can also be very traumatic for your family members to witness, so contact a lawyer and surrender. Insurance fraud charges are bondable so you should be able to secure a release from custody within a few hours after arrest.

After you are released, your arraignment date will be set and you will need to fight the charges.

Eric Matheny is a criminal attorney representing clients charged with insurance fraud in Miami-Dade and Broward.