Seasoned Tennessee Defense Attorneys Representing Clients Facing Federal Charges of Insurance Fraud

Help for individuals and business owners in Sevierville, the Tri-Cities, Greeneville and throughout East Tennessee

Every day, you can find at least one piece in a newspaper or a magazine decrying the insurance industry. We all need it – in some cases, we’re required to have it – and no one likes paying those premiums. What many people don’t realize is that the associated costs of their policies incorporate the losses the industry takes each year because of fraudulent activity. Insurance fraud is a multi-billion-dollar enterprise. According to the Federal Bureau of Investigation, the average US family ends up paying between $400 and $700 each year in increased premiums because of it.

Delius & McKenzie, PLLC provides comprehensive and aggressive representation on behalf of individuals and businesses in Sevier County, the Tri-Cities and throughout East Tennessee, who are facing federal charges of insurance fraud. Our defense strategies are tailored to your exact and unique needs, but also respect all federal laws regarding data sharing and privacy.

Common insurance fraud schemes

The FBI lists a handful of insurance fraud schemes that they pursue. That list includes:

• Premium diversion, a form of embezzlement where agents keep your premiums for themselves.
• Fee churning, in which a number of people exact fees from your policy so that, in the event of a disaster, you are left with nothing.
• Asset diversion, a form of “robbing Peter to pay Paul” that occurs almost exclusively in mergers and acquisitions.

In each of these examples, it is the insurance company (or its employees) which attempts to bilk policyholders out of money. There are two other types of fraud on the FBI’s radar, but they differ in that these acts can be committed by policyholders and by insurance companies.

Workers’ compensation fraud, wherein an employee lies about the severity of his or her injury, in order to obtain additional funds, or to retain compensation after he or she has recovered, is a common form of insurance fraud. From the other perspective, employers can commit workers’ compensation fraud by misappropriating funds for it.

Disaster relief scams are like a larger-scale version of an insurance claim on your own home. Exaggerating claims, misclassifying damage (by the homeowner or the insurer), “bid-rigging” contractors, and contractor schemes involving up-front payments for no work – all of these are considered acts of insurance fraud. So is setting up a charity to help with relief, and then pocketing the proceeds, either through outright theft or more subtle forms of misappropriation. Such actions may also constitute wire fraud.

When do insurance fraud charges become federal charges?

Most insurance fraud charges would be brought by the state of Tennessee. However, if you attempt to defraud the government, you may be charged under the federal False Claims Act. If convicted, you will be held “liable to the United States Government for a civil penalty of not less than $5,000 and not more than $10,000… plus 3 times the amount of damages which the Government sustains because of the act of that person” per count.

An insurance fraud scheme which crosses state boundaries may lead to federal charges of insurance fraud; so will charges of defrauding Social Security, Medicare/Medicaid, or any other federal insurance program.

Skilled defense for Tennessee clients facing federal charges of insurance fraud

If you are convicted of insurance fraud, you could face years of incarceration, and potentially millions in fees and fines. You want an aggressive and experienced federal defense attorney on your side. The Sevierville-based attorneys of Delius & McKenzie, PLLC may be able to help. Please call 865-428-8780 or fill out our contact form to learn more. We represent clients throughout East Tennessee, including those in and around Bristol, Johnson City, Kingsport, Greeneville, Sevierville, Seymour, Gatlinburg and Pigeon Forge.