PREMIUM FRAUD- CIVIL & CRIMINAL

“Experience counts double when dealing with the statewide prosecutor, a state attorney, or a carrier’s special investigation unit.” J. Layne Smith

Insurance carriers sue employers and their principals for premium fraud. Civil lawsuits for premium fraud present significant financial risks for the defendants because they often involve claims for treble or greater damages and punitive damages. A fraud judgment cannot be discharged in bankruptcy. J. Layne Smith defends and consults with businesses and individuals sued by insurers for premium fraud.

Businesses and individuals targeted for a premium fraud investigation by the state or federal government often are not aware they are being investigated. Representation by counsel is recommended as soon as possible. Insurers use contract rights and civil lawsuits to obtain information that the government uses in subsequent criminal prosecutions.

Anytime an insurer is pursuing a civil action for premium fraud, the state or the federal government may be conducting an investigation to determine if probable cause exists to prosecute criminally for premium fraud. Sometimes civil and criminal premium fraud cases are prosecuted at the same time. Simultaneous civil lawsuits and criminal investigations, or prosecutions, create dilemmas. Such situations call for a deliberate legal strategy and informed decisions.

Mr. Smith has experience managing the delicate balance involved between defending a civil action and protecting the client's rights in a criminal investigation or prosecution. He has a thorough understanding of the civil law, rules, and standards, and the criminal law, rules, and standards. He uses this background to obtain the best result in both forums. Benefit from his knowledge of the insurance industry, government prosecutors, and a network of expert witnesses whose testimony may be needed to expose reasonable doubt, or reduce inflated premium claims.

In addition to premium fraud cases, Mr. Smith represents people and businesses that are being investigated or prosecuted for white collar crimes.