Insurance Fraud

Allegations of insurance fraud can surface at moments when people are already vulnerable. These claims may arise after you have been injured in an accident or have suffered property damage and have made a claim. You may already be worried whether your insurance claim will cover you and may be trying to rebuild your life after a challenging time, only to be accused of a crime.

At The Ishak Law Firm, we represent clients who have been accused of insurance fraud in South Florida. We recognize that the playing field is uneven in these cases. Insurance companies are large corporations with deep pockets and teams of attorneys. We are passionate about defending our clients and making sure they get a fair chance against insurers.

If you have been charged with insurance fraud or think your insurer is building a case against you, schedule a consultation. Let’s review your options.

Types of Insurance Fraud

Insurance fraud allegations arise in many settings, and the underlying facts can vary widely from case to case. Some accusations involve auto insurance claims following collisions, where questions arise about fault, injuries, or repair costs. Others involve property claims after storms, fires, or theft, where insurers dispute the extent or cause of damage.

Health insurance fraud cases may stem from billing disagreements, overlapping coverage, or confusion about treatment authorization. Disability and workers’ compensation claims are also common sources of allegations, particularly when insurers challenge medical assessments or claim timelines.

In many situations, insurers rely on patterns, inconsistencies, or statistical flags rather than direct proof of intentional wrongdoing. What may appear suspicious on paper can often be explained by evolving circumstances, reliance on professionals, or simple human error.

Why Insurance Fraud Matters

Insurance fraud is pursued aggressively because insurers view it as a threat to the integrity of the system. Companies argue that improper claims increase costs and premiums, and they invest heavily in investigative units designed to detect irregularities.

For individuals accused of fraud, the impact is immediate and personal. A single allegation can affect employment, licensing, and financial stability. Even before charges are filed, accounts may be frozen, benefits suspended, or coverage canceled. Understanding why insurers escalate these matters helps explain why a careful and informed response is essential from the outset.

Our Approach to Defense and Outreach

At The Ishak Law Firm, we approach insurance fraud defense with both strategy and perspective. We begin by examining the full sequence of events and documents, not just the claim itself. This includes reviewing communications, understanding who prepared or submitted information, and identifying where assumptions replaced facts. Our defense strategies are tailored to the specific circumstances of each client rather than relying on generic approaches.

We also examine the artificial intelligence (AI) tools insurers use. In some cases, charges are pressed because a system mistakenly identified a regular transaction as suspicious.

Outreach is also an important part of our work. When appropriate, we engage early with investigators or prosecutors to address misunderstandings and present clarifying information before positions harden. Throughout the process, we prioritize clear communication with our clients so they are never left guessing about where their case stands.

Florida Insurance Fraud Statutes

Florida Statute 817.234

Florida insurance fraud charges are most commonly brought under Florida Statute section 817.234. This statute makes it a crime to knowingly present false, incomplete, or misleading information as part of an insurance claim. The law applies to a wide range of policies, including auto, property, health, disability, and workers’ compensation insurance.

The severity of the charge depends largely on the value of the alleged fraud. Claims involving smaller dollar amounts may be charged as misdemeanors, while larger claims can lead to felony charges. As the alleged amount increases, so do the potential penalties.

Florida Statute 626.989

Investigations are often conducted under Florida Statute section 626.989, which authorizes insurers and the state to investigate suspected insurance fraud. Under this law, insurers share information with the Division of Investigative and Forensic Services, which can refer cases for criminal prosecution. Once a referral is made, the matter may move beyond the insurer’s control and into the hands of prosecutors.

Understanding how these statutes interact is essential. Many people do not realize that statements made to an insurer during a routine claim review can later be used as evidence in a criminal case.

Insurance fraud cases rarely exist in isolation. Prosecutors often add enhancement charges that significantly increase potential exposure. When claims are submitted electronically, allegations may be paired with federal wire fraud charges under 18 U.S.C. section 1343. Wire fraud carries severe penalties, including lengthy prison sentences and substantial fines.

Other common enhancements include forgery, uttering a forged instrument, identity theft, or organized fraud if prosecutors allege a pattern of conduct. In cases involving multiple claims or policies, each submission may be charged separately, multiplying the potential penalties.

Sentencing exposure can increase dramatically when prosecutors argue that the alleged conduct involved sophisticated means, multiple victims, or significant financial loss. These enhancements make early and strategic defense planning especially important.

Evidence and Discovery in Insurance Fraud Cases

Evidence plays a central role in insurance fraud prosecutions, but it is often less definitive than it appears. Insurers may rely on claim forms, recorded interviews, medical records, repair estimates, photographs, or surveillance footage to support their allegations.

Discovery allows both sides to examine how this evidence was gathered and interpreted. Statements may have been taken during stressful moments or without full explanation. Medical records may reflect changing diagnoses rather than exaggeration. Surveillance may capture isolated activities that do not tell the whole story.

We scrutinize the methods used to collect evidence and the conclusions drawn from it. Challenging context, accuracy, and reliability is often key to undermining the insurer’s narrative and exposing gaps in their case.

Potential Penalties and Consequences

The consequences of an insurance fraud conviction depend on the specific allegations and the value involved. Charges can range to serious felonies, carrying the possibility of incarceration, probation, fines, and restitution. The penalties depend on the amount of money involved, but can include up to 30 years in prison and up to $10,000 in fines. Insurers sometimes try to claim that an accused committed wire fraud, forgery, and other crimes, which can increase the penalties an individual faces.

Beyond the courtroom, the repercussions can be long lasting. Insurance coverage may be terminated or denied in the future. Professional licenses can be placed at risk. Reputational harm can affect careers and personal relationships.

What to Do If You Are Under Investigation

Responding to Insurer Inquiries

If an insurer contacts you with questions about a claim, it is important to proceed carefully. Requests for recorded statements or additional documentation are often framed as routine, but they may be part of a broader investigation. Speaking with counsel before providing detailed responses can help protect you from inadvertent misstatements.

Preserving Documents and Records

Insurance fraud cases often turn on paperwork. Preserving emails, text messages, medical records, repair estimates, and correspondence with adjusters or contractors can be critical. These records frequently provide context that insurers overlook or ignore.

Avoiding Escalation

Well intentioned attempts to clarify a situation can sometimes make matters worse. Providing additional explanations without guidance may introduce inconsistencies that investigators later use against you. A measured, strategic approach can prevent unnecessary escalation.

Our Defense Strategy at The Ishak Law Firm

At The Ishak Law Firm, we take a comprehensive and individualized approach to insurance fraud defense. We examine the full timeline of events, identify who prepared or submitted information, and determine where assumptions replaced facts. We also analyze the role of automated and artificial intelligence based fraud detection tools that may have misclassified legitimate claims as suspicious.

When appropriate, we engage early with investigators or prosecutors to address misunderstandings before positions become entrenched. Throughout the process, we maintain clear communication with our clients so they understand what is happening and why each step matters.

Contact Our Insurance Fraud Defense Firm

Insurance fraud allegations can escalate quickly, and the consequences often extend far beyond the courtroom. An investigation alone can disrupt your finances, your employment, and your peace of mind. Waiting to see how matters unfold or assuming that a misunderstanding will resolve itself can leave you exposed to unnecessary risk. Early legal representation allows you to control the narrative, protect your rights, and respond strategically before insurers or prosecutors lock into their version of events.

The Ishak Law Firm represents clients accused of insurance fraud throughout Palm Beach County and South Florida. Whether your case involves auto, property, health, disability, or workers’ compensation allegations, we tailor our defense to the specific facts, agencies, and courts involved.

If you have received a request for a recorded statement, a notice of investigation, or formal charges related to insurance fraud, now is the time to act. Our team will take the time to understand your situation, explain your options, and develop a plan designed to protect your future.

Contact The Ishak Law Firm to schedule a confidential consultation and learn how we can advocate for you at every stage of an insurance fraud investigation or prosecution.