Insurance fraud happens when individuals deceive an insurance company to collect money to which they are not entitled. Depending on the extent, this can be a misdemeanor or a felony.

Fraud can also be committed by insurance companies, as insurers will deny legitimate claims made by policyholders. Insurance fraud is separated into two categories:

  • Soft Fraud: When a person exaggerates an existing claim, it is usually treated as a misdemeanor resulting in fines, jail time, community service, or probation.
  • Hard Fraud: When a person causes or fabricates a loss for the purpose of obtaining payment, this is a felony punishable by incarceration for a number of years.

What Is Considered a False/Misleading Claim?

To be charged with fraud, a defendant must knowingly make a false or misleading statement in support of, in opposition to, or in connection with a claim. This includes false or exaggerated claims made to physicians or false statements from providers regarding services performed.

To be considered fraudulent, the statement must be important to the claim. Types of insurance fraud include:

  • Healthcare Claims: Medical providers may submit claims for procedures they didn’t perform.
  • Automobile Claims: A person might claim that the damage from an accident is greater than it is.
  • Property Claims: A person may exaggerate the severity of damage incurred from a loss.
  • Life Claims: A person may attempt to obtain payment by fabricating their death or that of another.

If you have been accused of insurance fraud or suffered losses due to false claims, trust Carter Mario Law Firm to help. Contact our team today at 203-876-2711 to schedule your free, no-obligation consultation.


At Carter Mario, we have decades of combined legal experience negotiating insurance fraud cases. We understand what it takes to bring our clients maximum compensation for the losses they have suffered—and to do so in a timely manner.

We understand state and federal laws and will create a results-driven strategy crafted specifically around the details of your case. After carefully reviewing the evidence, we will file a claim seeking full, fair compensation for your injuries.

When you or a loved one suffers loss caused by insurance fraud, you need experience on your side. Let Carter Mario Law Firm protect your rights. Just call 203-876-2711 today. You can also submit a FREE Initial Consultation Form.

We provide 24/7 access to our compassionate attorneys along with our exclusive No Fee Warranty. With Carter Mario, you don’t owe any attorneys’ fees unless we recover on your behalf. It’s that simple. Call 203-876-2711 to find out what Carter Mario can do for you.

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