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Insurance Fraud Laws in Tennessee

How Tennessee law treats insurance fraud: what is illegal, whether it is a misdemeanor or felony, and the penalties, from the state code.

Short answer: 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; Tenn. Code Ann. §§ 56-53-102, 56-53-103, 56-53-104, 56-53-107; § 39-14-133; § 39-14-105

Insurance fraudKnowingly 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.
Unlawful acts: https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-53-103/ ; penalty cross-reference: https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-53-104/ ; civil remedies: https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-53-107/ . Applying the theft grades of § 39-14-105 follows from the 'punished as in the case of theft' wording. Read on codes.findlaw.com (a public copy of the official code); check against the official code. Mirror pages state they are current as of January 2, 2024.

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FAQ

Is insurance fraud a felony in 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.
Can I get a court-appointed lawyer for insurance fraud in Tennessee?
Tennessee's rule on court-appointed lawyers: In felony cases, when the accused has no lawyer and the court finds the accused indigent, the court must appoint the public defender (if the county has one) or another competent licensed attorney. A person who says he or she cannot afford a lawyer must complete the uniform affidavit of indigency, and statements are made under oath. In deciding indigency the court considers the nature of the services, usual attorney charges in the community, the accused's income from any source, federal poverty guidelines, ownership or equity in property, the amount of the bond and whether the person was able to make bond, and any other relevant circumstances. A defendant given court-appointed counsel is assessed a nonrefundable administrative fee of $50 at the time of appointment; the court must waive or reduce it if the defendant lacks the resources to pay, may raise it to no more than $200 if the defendant has sufficient resources, and the fee is collected even if the charges are dismissed. Tenn. Code Ann. §§ 40-14-202(a)-(c), (i)(1); 40-14-103(b)
What happens after an arrest for insurance fraud in Tennessee?
How release before trial works in Tennessee: A magistrate deciding pretrial release for a bailable offense may release the defendant on personal recognizance, on an unsecured appearance bond, or on conditions that may include a bail deposit. The magistrate 'shall give first consideration to ensuring the safety of the community' and, if releasing the defendant, must impose the least restrictive conditions that will reasonably assure appearance and community safety. The magistrate must consider any available results of a validated pretrial risk assessment and the defendant's financial resources, and may also consider the defendant's length of residence in the community; employment status; prior criminal record, including prior releases on recognizance or bail; whether the defendant was on release for another offense when charged; the nature of the offense, the apparent probability of conviction, and the likely sentence; substance use or mental health issues better addressed in community-based treatment; and other ties to the community or factors related to the risk of willful failure to appear. Tenn. Code Ann. § 40-11-115(a), (b) What happens after an arrest.
Can a conviction for insurance fraud be removed from my record in Tennessee?
Each state sets its own rules for sealing or expunging records. See Tennessee expungement and record sealing rules.

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.