When investigators open a case, a seasoned insurance fraud lawyer Florida steps in immediately. We handle requests for records, preserve phone and billing data, and manage contact with SIU adjusters and detectives. Consequently, you stay protected while we shape the facts that matter.
What the State Must Prove for Insurance Fraud (§817.234)
- False or misleading statement made or caused to be made;
- Knowledge and intent to defraud an insurer or obtain a benefit; and
- Connection to insurance—an application, claim, payment, or benefit.
Moreover, the statute reaches many roles: claimants, drivers, passengers, medical offices, contractors, and even runners or solicitors. Therefore, investigators often build wide cases around a single claim.
Common Florida Insurance-Fraud Scenarios
- PIP / Auto claims: staged crashes, inflated treatment, or duplicate billing;
- Provider billing: upcoding, unbundling, or services not rendered;
- Property claims: exaggerated damage, loss inflation, or contractor kickbacks;
- Application fraud: false statements on life, health, or auto applications.
Even so, paperwork mistakes and ambiguous forms occur. As a result, we separate honest error from criminal intent and push back on overbroad inferences.
Penalties & Collateral Risks
Penalties scale with alleged value and prior history. Charges can range from a misdemeanor to a first-degree felony. Meanwhile, expect restitution demands, possible forfeiture, and licensing or employment exposure. For statutory language, review §817.234.
Defense Strategies That Work
- No Intent to Defraud: clerical or billing error, misunderstanding, or reliance on staff or third parties;
- No Material Falsehood: statements were true, immaterial, or taken out of context;
- Search & Seizure Limits: overbroad subpoenas, metadata grabs, or device imaging without proper scope;
- Statements & Interviews: coerced or un-Mirandized statements, and SIU interviews used as criminal evidence;
- Value / Loss Disputes: inflated numbers, duplicate counts, or offsetting value that changes degree and restitution;
- Venue / Joinder: improper consolidation of unrelated claims or defendants.
Additionally, we engage experts—coding, billing, automotive, and construction—to test the State’s theories and numbers. Therefore, we negotiate from facts rather than assumptions.
If Investigators or SIU Contact You
- Do not give a statement before you speak with counsel.
- Preserve emails, texts, charts, estimates, EOBs, and billing logs—do not delete anything.
- Bring subpoenas, EUO notices, or demand letters to your consultation.
Related Defense Topics
- White Collar Crimes (Parent)
- Scheme to Defraud (§817.034)
- Money Laundering (§896.101)
- Civil Asset Forfeiture
- Federal Crimes Defense
- Identity Theft (§817.568)
Where We Help
We serve clients across Central Florida, including Orange, Osceola, Seminole, Lake, and Brevard counties.
Next Step: If SIU called or you received a subpoena, speak with a lawyer before any interview. Call 407-214-3837 or contact us for a confidential consultation.
Insurance Fraud Lawyer Florida — FAQs
Can I be charged for helping with someone else’s claim?
Sometimes. Prosecutors still must prove you knowingly made or helped make a false statement to obtain a benefit. Therefore, intent and context matter.
What if my doctor or contractor filled out the forms?
You can still defend the case. We show reliance on professionals, highlight ambiguous form language, and test whether any statement was actually false or material.
Is every insurance mistake a felony?
No. Honest errors happen. The State must prove knowledge and intent, and value drives the degree. We contest both the elements and the numbers.
