{"id":376457,"date":"2016-03-31T21:36:48","date_gmt":"2016-04-01T02:36:48","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/state\/tennessee-law\/tennessee-insurance-fraud.html"},"modified":"2016-06-20T23:00:00","modified_gmt":"2016-06-21T04:00:00","slug":"tennessee-insurance-fraud","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/state\/tennessee-law\/tennessee-insurance-fraud.html","title":{"rendered":"Tennessee Insurance Fraud"},"content":{"rendered":"\n
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Tennessee Insurance Fraud<\/h1>\n
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Created by FindLaw’s team<\/a> of legal writers and editors<\/i><\/p>\n\n | Last updated\n

\n \n <\/i>\n Legally Reviewed\n <\/summary>\n\n
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This article has been written and reviewed for legal accuracy, clarity, and style by FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with our editorial standards<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n\n

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The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n<\/section>\n

Insurance fraud<\/a> typically involves an attempt to make money in an insurance transaction through lies and misrepresentations. Insurance fraud can occur in many ways, including casualty fraud<\/i>, faking or exaggerating an accident or injury to get money from an insurer, and property fraud<\/i>, exaggerating damage to your home or car, deliberately damaging possessions for insurance reimbursement, or seeking reimbursement for items neither lost nor stolen.<\/p>\r\n

Details on Tennessee’s insurance fraud<\/a> laws are outline in the table below.<\/p>\r\n\r\n

Code Sections<\/b><\/p>\r\n<\/td>\r\n

Tennessee Code Title 56 Insurance, Chapter 53: Insurance Fraud<\/a><\/p>\r\n

Tennessee Code Section 39-14-133: False or Fraudulent Insurance Claims<\/a><\/p>\r\n<\/td>\r\n<\/tr>

What Is Prohibited?<\/b><\/p>\r\n<\/td>\r\n

For Consumers<\/u>: It’s a criminal violation<\/a> to knowingly, with intent to defraud for money or other value, submit insurance transactions containing false representations of any facts in an application, renewal, or payment of any insurance policy. Doing so knowingly or recklessly could be a civil violation<\/a>. Also, intentionally submitting a false insurance claim for benefits or false documents to support the false claim is prohibited.<\/p>\r\n

For insurers<\/u>: It’s criminally prohibited to present false representations on material facts in selling insurance, applying for a certificate, providing financial condition of any insurer, for the merger, formation, or dissolution of an insolvent insurer. It\u2019s also a crime to embezzle<\/a> insurer funds or to remove or destroy records or assets from the insurer. It’s a civil violation to solicit or accept new or renewal insurance risks by or for an insolvent insurer. Insurers also shouldn\u2019t break state insurance regulations, such as failing to have an anti-fraud plan.<\/p>\r\n<\/td>\r\n<\/tr>

Penalties<\/b><\/p>\r\n<\/td>\r\n

Insurance fraud can be punished criminally and administratively, as well as by sued in civil court.<\/p>\r\n

Criminal Penalties<\/u><\/p>\r\n

Insurance fraud, including false insurance claims<\/a>, are punished the same as theft. The penalty changes based on the value of the property or services obtained through the fraud:<\/p>\r\n

Types of Insurance Fraud<\/b><\/p>\r\n<\/td>\r\n

Some examples of insurance fraud are:<\/p>\r\n

Insurance Fraud Enforcement Agencies<\/b><\/p>\r\n<\/td>\r\n

If you’ve been victimized by insurance fraud, you can file a complaint with the Tennessee Consumer Insurance Services online<\/a> or at 1-800-342-4029.<\/p>\r\n

If you’ve been billed for services or supplies you never received or suspect other fraud and use Medicare or TennCare (Medicaid<\/a>), you can call your Medicare plan provider to ask them about the possible fraud. You can also report the suspected fraud for Medicare at 1-800-Medicare or for TennCare to the fraud hotline at 1-800-433-3982.<\/p>\r\n

If you believe a licensed professional (your doctor, counselor, chiropractor, etc.) has committed insurance fraud, you may also wish to file a complaint with their professional licensing board.<\/p>\r\n<\/td>\r\n<\/tr><\/tbody><\/table>\r\n

If you have questions about your situation, you should consult an experienced criminal defense attorney<\/a> or insurance lawyer<\/a>.<\/p>\r\n

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