Insurance Fraud Laws by State (2026)
How each state handles insurance fraud and the penalties, from each state's code.
| State | Insurance fraud |
|---|---|
| Alabama | Insurance fraud (knowingly and with intent to defraud presenting false information in an insurance claim or application, or other listed acts such as stealing insurance funds or hiding an insurer's assets) is a felony at every level. If the loss or potential loss is over $1,000, it is first degree, a Class B felony (2 to 20 years). If it is $1,000 or less, it is second degree, a Class C felony (1 year and 1 day to 10 years). Ala. Code 1975 §§ 27-12A-2, 27-12A-3, 27-12A-4; § 13A-5-6 |
| Alaska | Knowingly presenting, or helping prepare, a false or misleading statement to an insurer to support a claim, with intent to defraud, is a fraudulent insurance act graded by the amount sought. It is a class B felony (up to 10 years) at $10,000 or more, a class C felony (up to 5 years) at $500 to under $10,000, and a class A misdemeanor (up to 1 year) under $500. Lying on an insurance application is a class B misdemeanor (up to 90 days), and forging an insurance certificate is a class C felony; issuing one is a class B felony. These criminal penalties are in addition to civil penalties under the insurance code. AS 21.36.360(b), (o), (p), (q); AS 12.55.035, 12.55.125, 12.55.135 |
| Arizona | Arizona's insurance code lists fraudulent practices, such as knowingly giving false or misleading statements in an insurance application, claim or rating, hiding assets from regulators, or using 'runners' to steer claims. Committing one of these with intent to injure, defraud or deceive an insurer is a class 6 felony (first-offense range 0.33 to 2 years). Separately, knowingly presenting a false or fraudulent claim for a loss, or making a document to support one, is a class 5 felony (0.5 to 2.5 years). The statutes read set no dollar-based grades. A.R.S. §§ 20-463(A), 20-466.01, 44-1220; § 13-702(D) |
| Arkansas | Committing a fraudulent insurance act is a Class D felony (up to 6 years), and the court must order restitution to those harmed in addition to any fine or prison term. A person convicted of a felony involving dishonesty or breach of trust generally may not work in the insurance business without the Insurance Commissioner's written consent, a pardon or expungement, and licensees can also face license suspension or revocation and civil fines of up to $10,000 per violation. The sections read set no dollar-based grades. Ark. Code §§ 23-66-502, 23-66-512; §§ 5-4-201, 5-4-401 |
| California | Knowingly filing a false or fraudulent insurance claim, filing multiple claims for the same loss, or staging a car accident to make a claim is a felony punishable by 2, 3 or 5 years under Pen. Code 1170(h) and a fine up to $50,000 or double the amount of the fraud, whichever is greater. Other listed acts, such as certain false health-care claims and false statements supporting a claim, can be charged as a misdemeanor or felony when the amount is over $950 (2, 3 or 5 years and the same fines, or up to 1 year in jail and $10,000); at $950 or less they are misdemeanors (up to 6 months and/or $1,000) unless the claims add up to more than $950 within 12 months. Restitution must be ordered. Cal. Pen. Code 550(a)-(c); Pen. Code 17, 18, 19, 1170(h) |
| Colorado | Insurance fraud is presenting, with intent to defraud, a claim or supporting statement containing false material information or leaving out requested information, staging or faking a vehicle collision for a claim, claiming a loss outside the coverage period, or faking proof of insurance; these are a class 6 felony (1 year to 18 months). Lying on an application that results in a policy being issued is a class 2 misdemeanor (up to 120 days). Knowingly diverting or misappropriating premium funds is a class 5 felony (1 to 3 years). The insurance commissioner must revoke the license of any insurance producer convicted under this section. C.R.S. § 18-5-211; §§ 18-1.3-401, 18-1.3-501 |
| Connecticut | Insurance fraud (presenting, or helping prepare, a written or oral statement with false, incomplete or misleading material information in support of an insurance application or claim, intending to defraud the insurer) is a class D felony (up to 5 years, up to a $5,000 fine), regardless of the amount. Money obtained this way can also be charged as larceny, graded by value. Conn. Gen. Stat. § 53a-215; §§ 53a-35a, 53a-41 |
| Delaware | Insurance fraud (presenting, or helping prepare, a statement in support of an insurance claim knowing it contains false, incomplete or misleading material information, intending to defraud the insurer) is a class G felony (up to 2 years), with no dollar tiers. Health-care fraud (fraudulent claims to a health-care benefit program) is a class G felony, raised to class D (up to 8 years) for an intended loss over $50,000, a provider, or a pattern of claims, and to class B (2 to 25 years) for $100,000 or more or a provider with a pattern; a fine of up to five times the gain sought may be added. 11 Del. C. §§ 913, 913A; 11 Del. C. § 4205 |
| District of Columbia | First-degree insurance fraud (knowingly lying to or hiding material facts from an insurer, tampering with insurer records, misusing insurance funds, or similar acts, intending to defraud, and actually obtaining $1,000 or more of another's property) is punishable by up to 15 years in prison. Second-degree insurance fraud carries up to 5 years, or up to 10 years for someone with a prior insurance fraud conviction. Fines follow the general D.C. fine schedule. D.C. Code §§ 22-3225.02, 22-3225.03, 22-3225.04, 22-3571.01 |
| Florida | Insurance fraud (presenting or preparing a statement for an insurance claim or application knowing it contains false, incomplete or misleading material information, intending to defraud the insurer) is graded by the value involved: under $20,000 is a third-degree felony (up to 5 years), $20,000 to under $100,000 is a second-degree felony (up to 15 years), and $100,000 or more is a first-degree felony (up to 30 years). Fraud aimed at motor vehicle insurance proceeds also brings a civil penalty, up to $5,000 for a first offense. Fla. Stat. § 817.234(1), (11), (12); §§ 775.082, 775.083 |
| Georgia | Insurance fraud (knowingly or willfully making, or helping make, a false or fraudulent statement of a material fact to an insurer, converting premium money, issuing counterfeit policies, or falsely claiming death or disability) is a felony punishable by 2 to 10 years in prison, a fine of up to $10,000, or both, regardless of the amount involved. O.C.G.A. § 33-1-9 |
| Hawaii | Insurance fraud (intentionally or knowingly misrepresenting or hiding material facts to get insurance coverage, benefits or payment, including false applications or claims, duplicate claims, and fabricating or destroying documents) is graded by the value obtained or sought: a misdemeanor (up to 1 year) for $750 or less, a class C felony (5 years) for more than $750 up to $20,000, and a class B felony (10 years) for more than $20,000. HRS § 431:2-403 |
| Idaho | Insurance fraud includes knowingly presenting a false, incomplete or misleading statement to support an insurance claim, making false statements to get or extend workers' compensation benefits, taking premiums knowing no coverage will be provided, and misstating payroll or employee numbers for workers' compensation insurance. Idaho does not grade it by amount: every violation is a felony punishable by up to 15 years in prison, a fine up to $15,000, or both, plus mandatory restitution, and each instance may be a separate offense. Burning or destroying insured property to defraud the insurer is a separate felony punishable by 1 to 15 years in prison, also with restitution. Idaho Code §§ 41-293, 41-294 |
| Illinois | Insurance fraud is knowingly obtaining or trying to obtain an insurer's or self-insured entity's property through a false claim. Grades depend on the amount: $300 or less is a Class A misdemeanor (under 1 year); more than $300 up to $10,000 is a Class 3 felony (2 to 5 years); more than $10,000 up to $100,000 is a Class 2 felony (3 to 7 years); and more than $100,000 is a Class 1 felony (4 to 15 years). Committing insurance fraud 3 or more times within 18 months (aggravated insurance fraud) is a Class 1 felony regardless of amount, and organizing an aggravated insurance fraud conspiracy is a Class X felony (6 to 30 years). Health care benefits fraud against a private provider is a Class A misdemeanor, and restitution, including court costs and attorney's fees, is mandatory. 720 ILCS 5/17-10.5(a), (b), (d); 730 ILCS 5/5-4.5-25 to -65 |
| Indiana | Indiana repealed its separate insurance-claim fraud section in 2021; filing a false insurance claim is now prosecuted under the general fraud law, which covers making a false or misleading statement, or causing a claim containing one to be presented, to obtain property. Fraud is a Class A misdemeanor (up to 1 year); a Level 6 felony (6 months to 2 1/2 years) if the loss is $750 to under $50,000, it is a repeat within 7 years, or it is done by a written document; a Level 5 felony (1 to 6 years) for a loss of $50,000 to under $100,000; and a Level 4 felony (2 to 12 years) for $100,000 or more (lower thresholds apply when the victim is an endangered adult or a minor). The remaining section titled 'insurance fraud' covers insiders who loot or hide an insurer's assets or write business for an insolvent insurer, a Class A infraction with a judgment of up to $100,000. IC 35-43-5-4, 35-43-5-4.7; IC 35-50-2-4 to -7, 35-50-3-2 to -4 |
| Iowa | With intent to defraud an insurer, presenting (or helping or conspiring to present) a written or oral statement that contains false information about a material fact, either to support an insurance claim or in an application for coverage, is a class D felony in Iowa. Iowa does not grade this offense by amount; the class D felony carries up to 5 years and a fine of $1,025 to $10,245. 'Statement' is broad and includes proofs of loss, estimates, medical bills and records. Iowa Code §§ 507E.3, 902.9 |
| Kansas | A 'fraudulent insurance act' is knowingly, with intent to defraud, presenting or preparing a materially false statement (written, electronic or oral) in an insurance application, rating, or claim, or concealing material facts to mislead. It is graded by amount: a severity level 6 nonperson felony at $25,000 or more; severity level 7 at $5,000 to under $25,000; severity level 8 at $1,000 to under $5,000; and a class C nonperson misdemeanor under $1,000 (up to 1 month and $500). Fraudulent acts within six consecutive months totaling $25,000 or more carry a presumptive prison sentence regardless of grid position. Felony prison ranges come from the sentencing grid, which combines the severity level with criminal history. K.S.A. 40-2,118(a), (e), 21-6602, 21-6611, 21-6804 |
| Kentucky | A 'fraudulent insurance act' includes knowingly presenting false, incomplete or misleading information to support an insurance or workers' compensation claim or application, inflating repair or damage costs, taking premium money without buying insurance, faking a death or disability, or issuing fake insurance cards or certificates. It is graded by the total amount involved: a Class A misdemeanor under $500; a Class D felony from $500 to under $10,000 (1 to 5 years); a Class C felony from $10,000 to under $1 million (5 to 10 years); and a Class B felony at $1 million or more (10 to 20 years). Fines can reach $10,000 per individual for a felony (or twice the gain), and the court may order restitution and investigation costs. KRS 304.47-020(1), (2), (4), (5), 532.060 |
| Louisiana | Insurance fraud (with intent to defraud an insurer, the Department of Insurance, an insured or a claimant, committing a fraudulent insurance act or presenting or helping prepare a claim statement known to contain false, incomplete or fraudulent material information) is a felony punished by up to 5 years with or without hard labor, a fine up to $5,000, or both, on each count. If the benefit involved is $1,000 or less, the maximum is six months and $1,000 per count. The defendant must also repay the insurer any payments not owed plus its costs of investigating and defending the claim, including attorney fees. Knowingly and willfully committing health care fraud is punished the same way. La. R.S. 22:1924(A) |
| Maine | Insurance fraud is charged as theft by insurance deception: obtaining another's property through an intentional misrepresentation or written false statement about a material fact to an insurer concerning an application, rating, payment, claim or premiums. Like other thefts it is graded by value: Class E (up to 6 months) for $500 or less, Class D for more than $500 up to $1,000, Class C (up to 5 years) for more than $1,000 up to $10,000 or with 2 or more prior theft-type convictions, and Class B (up to 10 years) for more than $10,000. It is no defense that the deception was about a matter of no financial significance or that the insurer relied on it unreasonably. 17-A M.R.S. § 354-A; 17-A M.R.S. §§ 1604(1), 1704 |
| Maryland | Fraudulent insurance acts include knowingly presenting a claim (including a claim of vehicle theft) supported by false or misleading material information, misappropriating premiums or policy benefits, and lying in viatical settlement applications. When the claim or act is worth $300 or more, it is a felony punishable for each violation by up to 15 years and/or a fine of at least $500 up to the greater of $10,000 or three times the claim value; under $300, it is a misdemeanor with up to 18 months and the same fine range. Restitution to the victim is required, fines are mandatory and cannot be suspended, and the Insurance Commissioner may separately impose administrative penalties up to $25,000 per act. Md. Code, Ins. §§ 27-403, 27-408 |
| Massachusetts | Presenting, or helping prepare, a claim document to an insurer knowing it contains a false or fraudulent material statement, with intent to defraud, is punished by up to 5 years in state prison, or 6 months to 2½ years in jail, and/or a fine of $500 to $10,000. Fraudulent applications or claims under motor vehicle, theft or comprehensive insurance carry up to 5 years in state prison or 6 months to 2½ years in a house of correction and/or a $1,000 to $10,000 fine, with mandatory restitution to the insurer; where possible the fine should equal twice the loss. A licensed damage appraiser or registered repair shop that inflates an appraisal or repair bill can also lose its license or registration for up to 2 years. Mass. G.L. c. 266, §§ 111A, 111B |
| Michigan | Committing a fraudulent insurance act (such as knowingly presenting a false or misleading statement in support of a claim or an application, as defined in MCL 500.4503) is a felony punishable by up to 4 years, a fine up to $50,000, or both. Agreeing or conspiring to commit a fraudulent insurance act is a felony with up to 10 years and/or $50,000. Restitution is mandatory, and the court must notify the licensing authority when a licensed practitioner or insurer is found responsible. MCL 500.4511; MCL 500.4503 |
| Minnesota | Insurance fraud is presenting or preparing, with intent to defraud, information with a false or concealed material fact about an insurance application, rating, claim or payment, as well as related schemes such as selling policies for an insolvent insurer or embezzling insurer funds. It is sentenced on the theft scale based on the greater of the value obtained or attempted or the total economic loss caused: up to 90 days for $500 or less, up to 364 days for over $500 to $1,000, up to 5 years for over $1,000 to $5,000, and up to 10 years and/or $20,000 for over $5,000. Restitution to victims is mandatory, and prosecution may begin when the fraud is discovered but no later than seven years after the act. Minn. Stat. § 609.611; § 609.52, subd. 3 |
| Mississippi | Insurance fraud includes knowingly running a scheme to defraud an insurance plan or obtain claim money by false pretenses, making false statements or concealing material facts in insurance matters, paying or taking kickbacks for referrals, bribing an insurance official, and fraudulently denying a claim. A violation is a felony punishable by up to 3 years in prison and a fine up to $5,000 or twice the amount of the fraud, whichever is higher (organizations up to $150,000 per violation). The court must also order the defendant to pay double the reasonable investigation costs. The statute does not grade the offense by amount. Miss. Code Ann. §§ 7-5-303, 7-5-309 |
| Missouri | A 'fraudulent insurance act' means knowingly presenting or preparing materially false information (or hiding material facts) in an insurance application or claim, including medical billing schemes such as unbundling, upcoding, exploding or duplicating claims. A first offense is a class E felony (up to 4 years); a repeat offense is a class D felony (up to 7 years). The statute does not grade the offense by amount. RSMo §§ 375.991.2, .3, .6, 558.011 |
| Montana | Criminal insurance fraud means purposely or knowingly presenting false, incomplete or misleading information in support of an insurance claim, submitting a materially false or altered insurance application, a health care provider submitting a false bill or report, or presenting false insurance documents. When the benefit is worth $1,500 or less, the penalty is up to 6 months in county detention and/or a $1,500 fine; over $1,500, or as part of a common scheme, up to 10 years in state prison and/or a $50,000 fine. MCA 33-1-1504 |
| Nebraska | A fraudulent insurance act includes knowingly presenting or helping prepare a claim with false or misleading material information, false statements about death or disability to get benefits, and converting premium money or insurer funds. Those acts are graded by amount: under $500, Class II misdemeanor; $500 to under $1,500, Class I misdemeanor (a Class IV felony for a repeat); $1,500 to under $5,000, Class IV felony; $5,000 or more, Class III felony (up to 4 years plus 2 years of post-release supervision, and/or $25,000). Issuing fake insurance cards or policies, false filings with the Department of Insurance, and misreporting employees to cut workers' compensation premiums are Class IV felonies; possessing fake insurance documents is a Class I misdemeanor. Neb. Rev. Stat. §§ 28-631, 28-105, 28-106 |
| Nevada | Insurance fraud means knowingly and willfully presenting false or misleading material information in an insurance application or claim (or hiding material facts), helping or conspiring with someone to do so, knowingly accepting benefits from such an act, or hiring people to recruit clients for it. It is a category D felony, punishable by 1 to 4 years in prison and a fine up to $5,000, regardless of amount. The court may also order the person to pay the costs of investigation and prosecution, and an insurer is treated as a victim for restitution. NRS 686A.2815, 686A.291, 686A.292; NRS 193.130, 193.140, 193.150 |
| New Hampshire | Insurance fraud means knowingly, with intent to defraud an insurer, hiding a material fact or presenting false, incomplete or misleading material information in an insurance application, rating, claim, premium or payment. It is a class A felony (up to 15 years) if the fraudulent portion is more than $1,500, a class B felony (up to 7 years) if more than $1,000 up to $1,500, and a misdemeanor otherwise. Workers' compensation premium fraud also brings a 1- to 3-year ban from public works projects and restitution. RSA 638:20, 651:2 |
| New Jersey | Insurance fraud (knowingly making or omitting a material fact in a claim, application, payment or other insurance document) is a crime of the third degree (3-5 years), or second degree (5-10 years) if the person commits five or more acts and the total wrongfully obtained or sought is at least $1,000; each act is a separate offense. Falsely claiming an out-of-state residence or garaging to get out-of-state car insurance is fourth degree (up to 18 months). Health care claims fraud is a separate crime: second degree for a practitioner acting knowingly, third degree for others (second degree for five or more acts totaling $1,000), with fines up to five times the benefit sought. N.J.S. 2C:21-4.6; N.J.S. 2C:21-4.3; N.J.S. 2C:43-6 |
| New Mexico | Knowingly or willfully making a false or fraudulent material statement in an insurance application, presenting a false or fraudulent claim or proof of loss to get money or benefits under a policy, or preparing false documents to support a claim is a crime graded by the purported loss to the insurer: $250 or less a petty misdemeanor; over $250 to $500 a misdemeanor; over $500 to $2,500 a fourth degree felony (18 months); over $2,500 to $20,000 a third degree felony (3 years); and over $20,000 a second degree felony (9 years). A false statement made under oath is also perjury. The Insurance Fraud Act defines insurance fraud as any act in an insurance transaction that is a crime under the Criminal Code or Insurance Code and sets up investigation and reporting. NMSA 1978, 59A-16-23, 59A-16C-3; NMSA 1978, 31-18-15, 31-19-1 |
| New York | Committing a fraudulent insurance act (such as a knowingly false claim or application) is insurance fraud in the fifth degree, a class A misdemeanor. When it is used to take or try to take property, it is graded by value: over $1,000 is fourth degree, a class E felony (up to 4 years); over $3,000 is third degree, a class D felony (up to 7 years); over $50,000 is second degree, a class C felony (up to 15 years); over $1 million is first degree, a class B felony (up to 25 years). Aggravated insurance fraud (a fraudulent insurance act with a prior insurance-fraud conviction within 5 years) is a class D felony. N.Y. Penal Law 176.10, 176.15, 176.20, 176.25, 176.30, 176.35 |
| North Carolina | Insurance fraud (knowingly presenting, or helping prepare, a written or oral statement with false or misleading material information in support of or against an insurance claim, intending to injure, defraud or deceive an insurer or claimant) is a Class H felony when the claim is under $100,000 and a Class C felony when it is $100,000 or more. Each claim is a separate count. N.C. Gen. Stat. 58-2-161(b)-(c) |
| North Dakota | Committing a fraudulent insurance act is a crime graded by value: a class A misdemeanor in general; a class C felony if property or services retained exceed $1,000 (up to $10,000), or the value of the act associated with the fraud exceeds $10,000; a class B felony if property retained exceeds $10,000 or the value of the act exceeds $50,000; and a class A felony (up to 20 years) if property or services retained exceed $50,000. The court must order restitution, and felony charges must be brought within three years after the fraud is discovered. N.D.C.C. 26.1-02.1-02.1, 26.1-02.1-05 |
| Ohio | Insurance fraud (with purpose to defraud, presenting or helping prepare a statement to an insurer in an application or claim knowing it is false or deceptive) is a first-degree misdemeanor; a fifth-degree felony if the claim is $1,000 to under $7,500; a fourth-degree felony at $7,500 to under $150,000; and a third-degree felony at $150,000 or more. R.C. 2913.47 |
| Oklahoma | Presenting a false or fraudulent insurance claim, or preparing false proof of loss or other documents to support one, is a Class D3 felony punishable by up to 2 years in prison, a fine of up to twice the aggregated loss amount, or both. The statute does not set separate grades by amount. 21 O.S. § 1662; 21 O.S. § 20P |
| Oregon | Knowingly making a health care claim containing a false statement of material fact, or hiding information to obtain a health care payment the person is not entitled to, is 'making a false claim for health care payment,' a Class C felony (up to 5 years); separate false claims may be aggregated (against multiple payors within 30 days, or the same payor within 180 days), and prosecution must begin within five years. The statute does not set grades by amount. ORS 165.692, 165.694, 165.990; ORS 161.605 |
| Pennsylvania | Insurance fraud includes knowingly presenting false or misleading information in support of an insurance claim, helping someone else prepare one, knowingly benefiting from the proceeds of insurance fraud, lending or using insurance ID cards to make fraudulent claims, filing false motor vehicle insurance information with a government agency, and paid soliciting of claims. These offenses are felonies of the third degree (up to 7 years and $15,000) regardless of amount; certain related acts listed separately in the section are first-degree misdemeanors. The court may order restitution, and an insurer may sue for damages (treble damages for a pattern of violations). 18 Pa.C.S. § 4117; 18 Pa.C.S. §§ 1103, 1104 |
| Rhode Island | Knowingly presenting a written statement containing material false information to an insurer to support a claim (or an insurer doing so to contest a claim) is treated as larceny, punished by the value involved: up to 1 year if $1,500 or less, up to 3 years over $1,500, up to 6 years over $5,000, and up to 10 years over $10,000. Preparing, or helping someone prepare, a false statement for an insurance application or claim is a misdemeanor (up to 1 year and/or $1,000). Obtaining health care services by false pretenses to defraud a health insurer is also larceny, and the insurance commissioner can separately suspend licenses and impose administrative penalties and restitution for fraudulent insurance acts. R.I. Gen. Laws §§ 11-41-29, 11-41-30, 11-41-5; 27-54.1-2, 27-54.1-6 |
| South Carolina | Knowingly making a false statement or misrepresentation to obtain an insurance benefit or other economic advantage is graded by the amount gained: under $1,000, a misdemeanor ($100 to $500 fine or up to 30 days); $1,000 to under $10,000, a misdemeanor ($2,000 to $10,000 and/or up to 3 years); $10,000 to under $50,000, a felony ($10,000 to $50,000 and/or up to 5 years); $50,000 or more, a felony ($20,000 to $100,000 and/or up to 10 years). Any second or later violation is a felony at the top tier, and the court must order full restitution. A separate section on presenting false claims to insurers or health plans grades the offense at $2,000 or less (misdemeanor), over $2,000 (felony, up to 5 years) and $10,000 or more (felony, up to 10 years). S.C. Code §§ 38-55-540, 38-55-170 |
| South Dakota | Fraudulent insurance acts include knowingly presenting or preparing a claim statement containing false, incomplete or misleading material information, issuing fake insurance cards or policies, an agent converting premium money, embezzling insurer funds, and falsely reporting a policyholder's death or disability. They are graded by amount: $400 or less is a Class 2 misdemeanor (up to 30 days); over $400 and under $1,000 a Class 1 misdemeanor (up to 1 year); $1,000 or more a Class 4 felony (up to 10 years and $20,000); other violations are Class 1 misdemeanors. A state insurance fraud prevention unit can investigate and prosecute. SDCL 58-4A-2, 58-4A-3; SDCL 22-6-1, 22-6-2 |
| Tennessee | Knowingly giving an insurer false or misleading material information (or hiding material facts) in an application, a claim or a payment, with intent that it be relied on, is an unlawful insurance act; the insurance fraud law says violators are punished under Tenn. Code § 39-14-133. That section makes it a crime to present a false or fraudulent insurance claim, or to prepare or sign false documents to support one, and says it is punished as theft, which is graded by value from a Class A misdemeanor ($1,000 or less) up to a Class A felony ($250,000 or more). Victims may also sue for the violator's gains and fees and, for a pattern of fraud, triple damages. Tenn. Code Ann. §§ 56-53-102, 56-53-103, 56-53-104, 56-53-107; § 39-14-133; § 39-14-105 |
| Texas | Insurance fraud is preparing or presenting a statement to an insurer that the person knows contains false or misleading material information, with intent to defraud or deceive, in support of a claim (or paying or receiving kickbacks tied to a claim). It is graded by the claim's value: under $100 a Class C misdemeanor; $100 to under $750 Class B; $750 to under $2,500 Class A; $2,500 to under $30,000 a state jail felony; $30,000 to under $150,000 third degree; $150,000 to under $300,000 second degree; and $300,000 or more, or conduct that puts someone at risk of death or serious injury, first degree. Lying on an insurance application is a state jail felony, and the court must order restitution to the insurer. Tex. Penal Code § 35.02; §§ 12.21-12.35 |
| Utah | Insurance fraud covers, with intent to deceive or defraud, giving an insurer false or fraudulent material information in an application or a claim (or in a personal injury or property damage claim), knowingly accepting proceeds of a fraudulent insurance act, using 'runners,' and failing to forward premiums. Lying on an application to get a policy the insurer would not otherwise issue is a class A misdemeanor. Other fraudulent insurance acts are graded by the total value sought or obtained: class B misdemeanor under $500; class A misdemeanor at $500 to under $1,500; third degree felony at $1,500 to under $5,000; second degree felony at $5,000 or more. Utah Code § 76-6-521; §§ 76-3-203, 76-3-204 |
| Vermont | Insurance fraud is, with intent to defraud, presenting an insurance claim containing false statements about a material fact or concealing a material fact, or giving false information when selling insurance or about an insurer's finances. If the benefit gained or loss caused is under $900, the penalty is up to six months and $5,000; over $900, up to five years and $10,000; and a second or later offense carries up to five years and $20,000 regardless of value. Convicted licensed practitioners are reported to their licensing authority. 13 V.S.A. § 2031 |
| Virginia | Virginia defines insurance fraud as committing or attempting the crime of obtaining money or property by false pretense (Va. Code § 18.2-178) in connection with insurance. Obtaining money by a false pretense with intent to defraud is treated as larceny, so it is graded by value: grand larceny at $1,000 or more (1 to 20 years, or up to 12 months in jail and/or a $2,500 fine) and petit larceny, a Class 1 misdemeanor, under $1,000. Insurers and insurance professionals must report suspected fraud, and insurance applications and claim forms must carry a fraud warning. Va. Code §§ 52-36, 52-40, 18.2-178, 18.2-95, 18.2-96 |
| Washington | Knowingly presenting a false or fraudulent insurance claim, or preparing or signing false documents to support one, is a gross misdemeanor (up to 364 days and $5,000), and a class C felony (up to 5 years and $10,000) if the claim exceeds $1,500. Paying or accepting payment for referring claimants to service providers, or regularly waiving insurance deductibles, is 'trafficking in insurance claims,' a gross misdemeanor for one violation and a class C felony for each later violation. RCW 48.30.230, 48.30A.015; RCW 9A.20.021 |
| West Virginia | Committing a fraudulent insurance act is a felony when the benefit sought is $1,000 or more: 1 to 10 years, a fine up to $10,000, or both (or, at the court's discretion, up to 1 year in jail and a fine up to $10,000). Below $1,000 it is a misdemeanor: up to 1 year in jail, a fine up to $2,500, or both. Convicted persons are subject to restitution, and a person convicted of a felony related to the business of insurance is barred from working in it. The Insurance Commissioner can also impose civil penalties up to $10,000 per violation. W. Va. Code §§ 33-41-11, 33-41-12 |
| Wisconsin | Knowingly presenting a false or fraudulent insurance claim or supporting document, making false documents to support a claim, lying to get fraternal benefits, filing false claims under the state employee benefit program, or giving false information or misclassifying employees on a worker's compensation insurance application is a Class A misdemeanor if the claim or benefit is $2,500 or less (up to 9 months, a fine up to $10,000, or both) and a Class I felony if it is more than $2,500 (up to 3 years and 6 months, a fine up to $10,000, or both). Wis. Stat. §§ 943.395, 939.50(3)(i), 939.51(3)(a) |
| Wyoming | Knowingly or willfully making a false or fraudulent statement in an insurance application or to obtain money or a benefit, presenting a false or fraudulent claim or proof of loss, or preparing a false document to support a claim violates the Insurance Code. The insurance code's general penalty is a misdemeanor punishable by a fine up to $1,000, up to 6 months in county jail, or both, unless another law provides a greater penalty; the Insurance Commissioner may also impose civil penalties of up to $5,000 per offense ($50,000 a year). W.S. 26-13-201, 26-13-202, 26-1-107 |
General legal information, not legal advice. Laws change and local rules can differ; check the linked official source or talk to a lawyer about your situation.