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  1. #1
    Join Date
    Sep 2011
    Posts
    14

    Default Participation in Insurance Fraud

    My question involves criminal law for the state of: GA

    my wife was told she was part of insurance fraud.

    recently a customer of my wife's had an item stolen from him, that he was renting. in order to cover the item she needed a police report.
    The person went to the police station and tried to get a report. but because it was stolen right off him they wouldn't do it, not sure why but they said no. it was a snatch and run.
    My wife has dealt with the police many times as this is common in her industry (things getting stolen). So she said just say it was stolen out of your shopping cart.
    so later the man said this and he got a police report.

    When they called her she had forgotten and said the original story. then she told them the truth. Knowing she works with the police often and didn't want to lie.

    The detective said this was insurance fraud and he is sending this to his captain. Now she is worried. Insurance Fraud is a felony.

    The only thing that changed was how the item was stolen. since the cops wouldn't issue the police report which is all she needed to cover the item. she asked him to change the story just to get what the guy deserved a new item. the company requires police reports to charge off and get a new item for the customer.
    the customer tried and the police wouldn't do it. I don't see how it's fraud.

    any advice?

  2. #2
    Join Date
    Dec 2009
    Location
    Lake Chapala
    Posts
    3,043

    Default Re: Insurance Fraud

    It's definitely fraud. Lying to an insurance company to get a claim paid is fraud. Your wife's customer lied to the insurance company via his police report. Your wife is involved in the fraud because she advised her customer to do this.

    (Just curious, what is it your wife does that causes her to "work often with the police" and have customers who ask her for advice regarding their insurance claims?)

  3. #3
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: Participation in Insurance Fraud

    Under OCGA Sec. 33-1-9, aiding in the making of a false statement for the purpose of procuring or attempting to procure the payment of any false or fraudulent claim or other benefit by an insurer would constitute insurance fraud. The bulk of those requirements were met, but the question remains open of whether the insured was or was not entitled to the coverage if the item was stolen from his person as opposed to from a shopping cart. There are so many significant details missing from the account you've shared, that it really only makes sense for us to suggest that your wife consult a criminal defense lawyer with the details of what happened.

    It's not believable that the police won't take a report of a robbery, so there must be more to the story. (Pursuant to OCGA Sec. 16-8-40, "A person commits the offense of robbery when, with intent to commit theft, he takes property of another from the person or the immediate presence of another... By sudden snatching." Robbery is punishable by up to twenty years in prison.)

  4. #4
    Join Date
    Mar 2013
    Posts
    18,340

    Default Re: Participation in Insurance Fraud

    Quote Quoting Mr. Knowitall
    View Post
    there must be more to the story.
    Right. My guess is that the customer has, or had, some sort of personal relationship with the person who took the item, said person having had use and/or access to the item and then took it when the relationship went south.

    I wonder if we'll ever know the whole story.

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