Ohio Insurance Fraud Laws & Charges + Statute of Limitations

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In Ohio, the crime of insurance fraud is defined as any action wherein people or entities attempt to make a false claim to an insurance company, to obtain compensation or money that they aren’t rightfully entitled to. For example, an act of insurance fraud in Ohio might occur when a person knowingly files an insurance claim that is false, or attempts to exaggerate the damages experienced, such as injuries or losses. It is also possible for an insurance company to be involved in an act of fraud, if they fail to provide people with the compensation that they have a right to receive.

Insurance fraud is a serious crime that refers to any act that is conducted fraudulently in an attempt to obtain insurance money. Most of the time, the driving force behind insurance fraud is the desire to benefit in a financial way. In fact, some people have been known to destroy their own properties in order to claim insurance if the payment is worth more to them, than the damage to the property.

Laws and Penalties

Usually insurance companies accuse people in Ohio of committing insurance fraud if they suspect that a claim that has been submitted is either exaggerated or completely false. Anyone may find themselves in the midst of a fraud investigation even if the claim is legitimate, and particularly when the amount of the claim is quite large in value.

In Ohio, and indeed across the United States, insurance fraud is often split into two distinct categories of offense, which are hard fraud and soft fraud. Hard fraud refers to the type of insurance fraud that is often associated with criminal behavior. For instance, those who have been convicted of hard fraud, may have attempted to fake an accident, theft, injury, or arson in an attempt to collect money from insurance companies. For instance, a hard fraud offense could include setting fire to your own resident, staging an accident, or faking a theft.

Meanwhile, soft fraud is the kind of insurance fraud that many people don’t often realize can be prosecuted as a felony. A soft fraud occurs when a generally honest person attempts to pad a legitimate claim by exaggerating injuries or losses. For instance, this may include an incident wherein a person claims to have suffered more injuries than what has actually been experienced as a result of a car accident. Although soft fraud may not seem serious, this can lead to felony charges.

In Ohio, any fraudulent insurance claim with a value of over $1,000 will be prosecuted as a felony. Depending on the amount involved in the fraudulent claim, the following penalties may be provided:

  • The loss of business licenses
  • A fine of between $2,500 and $10,000
  • Between six months and five years’ incarceration

Even the smallest acts of insurance fraud can lead to significant penalties, and people accused of insurance fraud that amount to a value of under $1,000 might still face first-degree misdemeanor charges. If convicted, the penalty for a misdemeanor charge may be a fine of up to $1,000, and up to 180 days in jail.

Insurance Fraud Defenses

There are various ways for individuals to defend themselves against a conviction of insurance fraud in Ohio. The most common defenses are the same as many defenses that are frequently used in fraud-related charges, such as:

  • Insufficient evidence – If the prosecution is unable to present enough proof to show that the defendant in question is actually guilty of an act of insurance fraud, then a conviction cannot be obtained.
  • Lack of intent – If the defense lawyer is able to show that the defendant had no intention to defraud the insurance company or damage anyone else, then it may be possible for the defendant to be exonerated of the insurance fraud charge.
  • Non-fraudulent statement – Finally, it is possible to show that a false statement issued with an insurance statement wasn’t necessarily fraudulent. For example, if the company considers an account of an injury to be exaggerated, but it is actually just an opinion, then this is not a case of fraud.

Statute of Limitations

The statute of limitations for insurance fraud in Ohio is outlined in the criminal statute of limitations laws for less serious felonies. In most cases, insurance fraud is classed as a felony that contains a statute of limitations that is six years long. However, if there are other factors involved in the insurance fraud, then this might extend the length of the statute of limitations.

Ohio Insurance Fraud Cases