New Jersey has the toughest criminal insurance fraud statutes in the country. The Health Care Claims Fraud statute, N.J.S.A. 21-4.3 and the Insurance Fraud statute, N.J.S.A. 2C:21-4.6, make many acts of insurance fraud second-degree crimes. For starters, a second-degree crime in New Jersey carries with it a prison term of up to ten years and fines of up to $150,000.

According the 2007 OIFP report, there was “a 10% increase in criminal sentences over last year’s figure and sent defendants to prison for a combined total of 147 years”. The report exemplifies the wide array of individuals who found themselves in trouble for insurance fraud: ” In 2007, OIFP recorded OIFP won convictions of four former police officers, two of whom will serve a total of 12 years in State prison. Four licensed health care providers received State prison sentences totaling 12 years. A licensed insurance agent was sentenced to a five-year State prison term. An auto body shop owner and his accomplice were sent to State prison for a total of nine years. The sentences imposed on several members of vehicle theft rings totaled 77 years in State prison, over $1.8 million in restitution, and $9,500 in civil insurance fraud fines”. The list goes on. So, what is “insurance fraud” made of? One large area of Insurance fraud in New Jersey is Automobile Insurance Fraud. The most popular crime here is auto theft and “give up schemes”, where the owner or lessee of a car abandons the car or gives it up to a someone who agrees to dispose of the car. Next come staged accidents and fraudulent Personal Injury Protection Claims and criminal use of “runners”. These types of cases normally involve organized rings of “runners”, medical providers, and lawyers. Vehicle Insurance policies in New Jersey provide medical benefits for persons injured in car accidents as part of Personal Injury Protection (PIP) coverage. PIP insurance typically covers diagnostic testing and treatment for persons injured in automobile accidents. In many cases, uninjured passengers involved in accidents are contacted by “runners” who convince them to file claims for “soft tissue” injuries, such as “whiplash”. Such injuries are not easily verifiable by x-rays and MRI. In the end, “runners” receive their illegal commissions, medical and chiropractic mills provide unnecessary medical services, including fake diagnostic and treatment, for which they bill, and lawyers file unwarranted lawsuits.