Indiana Insurance Fraud Laws
Created by FindLaw's team of legal writers and editors | Last reviewed March 10, 2018
Insurance fraud generally occurs when someone tries to make money from an insurance transaction through lying or misrepresenting what happened. In Indiana, this can occur many different ways. Insurers can also violate insurance laws in many ways, such as misrepresentation in selling insurance, inappropriate cancellation of policies, or wrongful denial of coverage. A few examples of insurance fraud are:
- Casualty Fraud: Faking or exaggerating an injury or accident to get money or services from an insurance company.
- Property Fraud: Exaggerating the extent of damage to your home, car, or other property; deliberately damages your own possessions for reimbursement by your insurer; or seeking reimbursement for a “lost” or “stolen” item that you still have or you gave away.
- Workers' Compensation: Claiming to have suffered an injury while at work that you either didn't suffer at all, or you were injured at home or on vacation.
Who Enforces and Prosecutes Insurance Fraud Laws?
State and local prosecutors in Indiana handle insurance fraud cases under the applicable criminal and insurance codes. When insurance companies or agents act illegally or unprofessionally, the issues can also be handled administratively by the Indiana Department of Insurance, for example by revoking an insurer’s license. The U.S. federal government also prosecutes insurance fraud under federal criminal laws, including mail fraud or racketeering.
Indiana's insurance fraud laws are outlined below.
Indiana Code Title 27: Insurance
Indiana Administrative Code Title 760: Department of Insurance
IC Section 35-43-5-4.5 - Insurance Fraud
What is Prohibited?
For consumers: Lying about or concealing important facts related to an insurance claim or payment made under an insurance policy or damaging property to get the insurance benefits.
Criminal penalties for insurance fraud include jail time, fines, and restitution. Civil penalties are also possible, including fines, cancellation of your insurance policy, and revocation of insurance or professional license.
The crime insurance fraud described above is generally a Level 6 felony, which carries a penalty range of 6 months to 2.5 years incarceration and a fine up to $10,000. However, insurance fraud is a Level 5 felony if the person has a prior insurance fraud conviction or the value of property or services unlawfully obtained or economic loss suffered by another due to fraud is at least $2,500. The penalty for Level 5 felonies is 1-6 years incarceration and a fine up to $10,000. Lying on an insurance application is a Class A misdemeanor, punishable by up to 1 year incarceration and a fine of up to $5,000
Who Can Be Prosecuted?
Consumers, insurance companies, adjusters, service provides (mechanics, doctors, etc), and others.
Types of Insurance Fraud & Examples
Insurance Fraud Enforcement Agencies
The appropriate agency to call depends on the type of insurance fraud you've witnessed or experienced. If you feel you were victimized by insurance fraud, file a complaint with the Indiana Department of Insurance online.
For Medicare fraud, you can call your plan provider to ask them about possible fraud, such as being billed for services or supplies you never received. If you're uncomfortable doing so or the issue remains unresolved, you can call Medicare at 1-800-Medicare to report the fraud.
If you suspect a licensed professional, such as your doctor, counselor, or other professional, has committed insurance fraud, you may also wish to file a complaint with their professional licensing board or the Indiana Attorney General's Office .
Medicaid, food stamps, or other Public Assistance fraud can be reported to the Indiana Family and Social Services Administration Fraud Hotline at 1-800-403-0864. Medicaid fraud can also be reported online.
To report Workers' Compensation fraud, call the Indiana Worker's Compensation Board at 1-800-824-2667.
Note: State laws are always subject to change through the passage of new legislation, rulings in the higher courts (including federal decisions), ballot initiatives, and other means. While we strive to provide the most current information available, please consult an attorney or conduct your own legal research to verify the state law(s) you are researching.
Get Legal Help Understanding Indiana Insurance Fraud Laws
Insurance fraud laws can be complicated. Between car insurance fraud, medical insurance fraud, and welfare fraud, there's a lot to know and many ways to be in violation of the law. That's why it's best to consult with an experienced white collar crimes attorney if you have questions about your particular situation.
You Don’t Have To Solve This on Your Own – Get a Lawyer’s Help
Meeting with a lawyer can help you understand your options and how to best protect your rights. Visit our attorney directory to find a lawyer near you who can help.
Next Steps: Search for a Local Attorney
Contact a qualified attorney.