West Virginia Insurance Fraud Laws

In the Mountain State, insurance fraud consists of intentionally providing false material information for the purpose of obtaining insurance benefits. West Virginia specifically outlaws insurance fraud and penalties vary depending upon the value of the benefit sought or received.

For example, if the fraudulently received insurance payment was $1,000 or less, the crime is punishable by up to 1 year in prison and up to $2,500 in fines. If the payment was more than $1,000, the crime is punishable by up to 10 years in prison and up to $10,000 in fines. In addition to prison time and fines, the defendant may also be enjoined from continuing their fraudulent behavior and may be ordered to pay restitution and other costs. The following is a quick summary of West Virginia's insurance fraud laws.

West Virginia Insurance Fraud Laws

The following table outlines West Virginia's insurance fraud laws.

Code Sections

W. VA. CODE ยง 33-41-1 et seq.: Insurance Fraud Prevention Act

What is Prohibited?

Knowingly and willfully providing a false material statement for an insurance claim or payment with the intent of defrauding the insurance company.

Penalties

If the benefit sought or obtained is $1,000 or more, it is a felony punishable by up to 10 years in prison and up to $10,000 in fines. If the benefit sought or obtained is under $1,000, it is a misdemeanor punishable by up to 1 year in prison and up to $2,500 in fines.

Insurance agents, brokers, or companies who commit insurance fraud are punishable by up to $10,000 in fines per violation.

Remedies

In addition to the above criminal penalties and fines, the defendant may be ordered to pay restitution.

Insurance companies who commit insurance fraud may also be ordered to pay restitution to the victim(s), be enjoined temporarily or permanently from further fraudulent activities, and have their licenses suspended or revoked. If convicted of an insurance related felony, the agent, broker, or company may be disqualified altogether from working in the insurance industry.

How do I File a Complaint Against a West Virginia Insurance Company?

If you suspect insurance fraud by a company or agent, a report may be filed with the West Virginia Offices of the Insurance Commissioner.

West Virginia Insurance Fraud Law: Related Resources

Insurance fraud laws can sometimes be confusing. If you have been charged with insurance fraud, you may want to consult an experienced West Virginia criminal defense attorney for questions about your specific situation. You can also visit Findlaw's section on insurance fraud for more information on this topic.

Next Steps: Search for a Local Attorney

Contact a qualified attorney.