Insurance policy documentThe Federal Bureau of Investigations (FBI) reports that the annual cost of federal insurance fraud is more than $40 billion per year. That means Insurance Fraud costs the average U.S. family between $400 and $700 per year in the form of increased insurance premiums, according to the FBI.

If you or someone you know is being charged with crimes related to federal insurance fraud, the best thing you can do to help your case is contact a federal fraud defense attorney. Our South Florida federal insurance fraud lawyers at Rossen Law Firm are here to protect your rights and future. 

What is a Federal Insurance Fraud Crime? 

Insurance fraud can take many different forms – it could be something as ‘simple’ as a false statement on an insurance claim, or it could be something more dramatic such as involving a large complex criminal enterprise with multiple people participating in the insurance fraud scheme. 

As a Fort Lauderdale attorney could explain, insurance fraud can be simply defined as committing a fraudulent action in relation to an insurance company. Whether in the purchasing process, while holding a policy or terminating a policy, the crime of insurance fraud is wide-reaching and can be applied to a wide variety of insurance-related crimes. 

While insurance fraud is typically understood to be committed by the policyholder, or someone who is defrauding an insurance company, there is also a subset of insurance fraud crimes related to the insurance company itself.

Insurance fraud can be either a state or a federal crime in South Florida.

Common Types of Federal Insurance Fraud Schemes:

  • Premium Diversion
    • This is the embezzlement of insurance premiums and is the most common type of insurance fraud.
    • A Federal Premium Diversion Fraud Scheme, generally, is when an insurance agent fails to send premiums to the underwriter and instead keeps the money
    • Another type of premium diversion scheme involves selling insurance without a license, collecting premiums from people and then not paying claims 
  • Fee Churning
    • In a Federal Fee Churning Fraud Scheme, a series of intermediaries take commissions through reinsurance agreements
    • The initial premium is reduced by repeated commissions until there is no longer money to pay claims, and the company left to pay the claims is a business which conspirators intended to fail. 
    • Each transaction during the process seems legitimate, but the fraud emerges eventually.
  • Asset Diversion
    • A Federal Asset Diversion Fraud Scheme is the theft of insurance company assets – it almost exclusively happens in the context of an acquisition or merger of an existing insurance company
    • Asset Diversion typically means acquiring control of an insurance company with borrowed funds – once the purchase is made, the defendant uses assets of the acquired company to pay off the debt — then the remaining assets of the company can be taken as profit by the defendant. 
  • Workers’ Compensation Fraud
    • Some entities claim to provide workers’ compensation insurance at a reduced cost and then misappropriate premium funds without ever providing insurance.
  • Disaster-Related Fraud 
    • Federal Disaster Insurance Fraud Schemes involve a few different scenarios such as false or exaggerated claims by insurance policyholders
    • Misclassification of flood damage as wind, fire, or theft is included; Claims filed by individuals residing hundreds of miles outside the disaster-zone; Bid-rigging by contractors, falsely inflating the cost of repairs; Contractors requiring upfront payment for services, then failing to perform the agreed upon repairs; and Charity fraud scams designed to misappropriate funds donated for disaster relief are all forms of federal disaster-related insurance fraud. 

Wire Fraud and Mail Fraud can also be a form of insurance fraud, or may be other crimes committed when someone commits mail fraud. 

Individuals are always encouraged to report Insurance Frauds to their local FBI offices.


Committing a federal insurance fraud crime comes with the potential for harsh and serious punishment. You could be facing decades in federal prison and stiff fines. 

Depending on the type of insurance fraud crime and the nature and scope of the crime, people will typically face a max of up to 10 or up to  15 years in federal prison. 

Most federal insurance fraud crimes, including Insurance Company employees and insurance agents, face 5 to 10 years in federal prison for violating the law and committing a form of federal insurance fraud. 

There are certain crimes, which, if convicted of, make it illegal for someone to be employed in the insurance industry. If you are someone who was previously convicted of a state-level felony involving dishonesty or a breach of trust, you are banned from working in the insurance industry for life. If you violate this, you are looking at up to 5 year in federal prison.

Consequences for insurance fraud on the federal level include the following ranges:

  • Up to 20-30 years in prison
  • From $250,000 to $1 million dollars in fines 

There are also insurance fraud crimes at the state level in Florida.


Insurance Fraud is considered a very serious crime by federal prosecutors. Most of the time, people are unaware that they are under investigation for insurance fraud by a federal agency. The moment you realize or find out you are being targeted in a federal insurance investigation, you need to get in touch with a federal insurance fraud lawyer in Ft. Lauderdale as soon as possible. 

When it comes to federal insurance fraud cases, the cases are complex and often involve violations of state and federal laws and can involve multiple federal agencies. 

Federal Insurance Fraud Defense Strategies 

A successful federal insurance defense strategy should be unique to you, to the charges you’re facing and your story. 

Rossen Law Firm’s federal criminal defense attorneys can work with you before you’re even officially arrested and before charges are made official by doing prefile intervention and more in order to help you get the best possible result on your case. 

If you or someone you know is facing federal insurance fraud related charges, the best thing that you can do is immediately contact one of our experienced criminal defense attorneys at Rossen law firm. They will be able to consider all of the factors of your case and fight for the best outcome possible based on your specific set of circumstances. 

Free Federal Insurance Fraud Defense Strategy Session in Fort Lauderdale

We handle Federal Insurance Fraud cases of all types. We know how to protect your rights and provide you with a personalized and aggressive defense to your federal criminal charges. 

Due to the nature of insurance fraud and the various agencies involved, insurance fraud can be a difficult charge to understand and fight in court. The South Florida federal insurance lawyers at Rossen law firm will be able to represent your case with the utmost discretion and confidence, and will fight until the best possible outcome is reached. 

We offer FREE strategy sessions so you know how we’ll work to get the best possible result on your case for you. We tell you exactly how we’d fight for you all in the first consultation.


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