Massachusetts Insurance Fraud Laws

In the Commonwealth of Massachusetts, insurance fraud can occur in several different ways, including automobile fraud, worker's compensation fraud, property fraud, and casualty fraud. Generally, insurance fraud offenses can occur when someone tries to make money from insurance transactions through deception.

Common Insurance Fraud Schemes

By far, automobile fraud is the most common type of insurance fraud crime. Here are some examples:

  • Staged auto accidents with faked reports of injuries
  • False report of a hit-while-parked accident.
  • Jump-in passengers who are added to the claim and/or accident report but were not in the vehicle at the time of the accident
  • Exaggerated injury claims with prolonged treatment
  • False reports of auto theft
  • Vehicle damage enhanced after the accident
  • Vehicle damage claims for pre-existing damage
  • Vehicle is garaged in another town than listed on the policy
  • Reports of falsified claims that occurred before the policy period began.

Who Enforces and Prosecutes Insurance Fraud Laws?

The Insurance Fraud Bureau of Massachusetts (IFB)and local prosecutors handle insurance fraud cases under the state's penal laws. The Feds can also prosecute insurance fraud under a number of criminal statutes including as "mail fraud," "criminal racketeering" or other federal offenses.

How do I File a Complaint Against a Massachusetts Insurance Company?

You can file an online complaint against insurance carriers and discount health plan providers, including reporting suspected insurance fraud.

The following table highlights the main provisions of Massachusetts insurance fraud laws. See also, Association of Certified Fraud Examiners, Fraud, Fraud and Financial Crimes, and Arson.

Code Section

MGL Chapter 266, 111A et seq.

What is Prohibited

Any time a person files a claim against an insurance company or policy using false information or intentionally deceiving the claim representative, they are committing a felony fraud.

Penalties

Typically a felony punishable by up to 5 (five) years in prison or from 6 months to 2 ½ years in jail, or a fine of $500-$10,000, or both.

Possible civil penalties including fines, revocation of business license, etc.

Who Can Be Prosecuted Consumers, providers (such a doctor and auto repair shop), and insurance companies, adjusters and others.
Types of Insurance Fraud
  • Automobile accidents and insurance
  • Health care claims such as medical and dental.
  • Insurance applications
  • Medicaid
  • Disability benefits
  • Unemployment insurance
  • Workers' compensation
 

Enforcement Agency

If you feel you have been victimized by insurance fraud, here is some contact information that can help you:

Because insurance fraud laws can sometimes get complicated, it may also be a good idea to consult an experienced criminal defense attorney if you have questions about your specific situation.

Next Steps: Search for a Local Attorney

Contact a qualified attorney.