Insurance Fraud

Insurance fraud is a serious offense in Pennsylvania. If you are found guilty, you face a felony charge, punishable by up to seven years in prison as well as a $15,000 fine, in addition to restitution and associated court costs. That’s why it’s critical to have a strong legal defense to back you. Let Mazzoni Karam Petorak & Valvano be the team to support you.

Elements of Insurance Fraud

You may be found guilty of insurance fraud in the Keystone State if you act with the intent to defraud another person. This individual can be a single entity, an agency, insurer, etc.

The elements of insurance fraud in Pennsylvania are to knowingly:

  • And with the intent to defraud a state or local government agency files incorrect or misleading information relating to the approval or disapproval of a motor vehicle insurance action
  • And with the intent to defraud any insurer or self-insured, supplies incomplete or misleading information concerning any fact that is specific to the claim
  • And with the intent to defraud any insurer or self-insured, works with another to provide false or misleading information including documents which create an excess of what the actual damages would cost
  • Engages in unlicensed agent, broker, or unauthorized party in activity with the intent to defraud an insurer, public, etc.
  • Benefits directly or indirectly from the proceeds derived from an insurance fraud violation

In addition, you can be found guilty of insurance fraud if you fall under one of the following categories:

  • You are the owner, administrator, or employee of a health care facility and knowingly allows the use of such facility to further a scheme or conspiracy
  • You borrow or use another person’s financial responsibility or other insurance identification card, or allow someone to use yours with the intent to defraud
  • You directly or indirectly solicit another to bring about a case for damages for negligence; or directly or indirectly solicit another to bring forward a case to recover damages for personal injury or death 

Defenses to Insurance Fraud in Pennsylvania

While being accused of insurance fraud is a serious offense, there are potential defenses to this charge that may be applicable. The common defenses are:

  • Lack of knowledge or intent to defraud
  • Duress
  • Entrapment
  • Insanity

However, to prove that you are not guilty, or to receive a lesser sentence, you need a strong criminal defense attorney by your side from the very beginning of the claim.

Failure to secure representation can result in hefty penalties you won’t want to deal with.


Depending on the severity of your case and the strengths of your legal representation, you can be charged with anything from a summary offense to a second-degree felony for your insurance fraud accusation. 

  • Summary Offense: Up to 90 days in jail and a fine of $300
  • Third-Degree Misdemeanor: Up to one year in jail and a $2,000 fine
  • Second-Degree Misdemeanor: Up to two years in jail and a $5,000 fine
  • First-Degree Misdemeanor: Up to five years in jail and a $10,000 fine
  • Third-Degree Felony: Up to seven years in prison and a $15,000 fine
  • Second-Degree Felony: Up to 10 years in prison and a $25,000 fine

There is a large difference in 3 months in jail and a 10-year prison sentence. That’s why you need Mazzoni Karam Petorak & Valvano.

Contact Pennsylvania Insurance Fraud Attorneys: Mazzoni Karam Petorak & Valvano

Being accused of any crime can be stressful. But when the stakes are this high, you can’t afford to take it on alone. The time to act is now. Contact the Scranton criminal defense attorneys at Mazzoni Karam Petorak & Valvano today for a free consultation.

Put your trust in a law firm that puts your best interests first. We offer a free case evaluation to all potential clients.

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