False statements or misrepresentations on a submitted insurance form may lead to allegations of fraud. South Carolina’s Code of Laws classifies insurance fraud as either a misdemeanor or a felony.
Convictions may result in prison time and paying a fine, as noted by the South Carolina Legislature. The penalty imposed may depend on the amount allegedly obtained through fraudulent means.
Misdemeanor insurance fraud charges
Palmetto State residents may face a misdemeanor fraud charge for an alleged fraudulent claim made to obtain an economic advantage worth less than $10,000. If a prosecutor successfully obtains a conviction of misdemeanor insurance fraud, the charged individual may spend between 30 days and three years in jail. A judge may also order a fine of up to $10,000 plus restitution.
Felony insurance fraud charges
A felony fraud conviction requires proof that a defendant submitted a false statement or misrepresentation to gain an insurance benefit worth at least $10,000. When the value is less than $50,000, a conviction may result in spending up to five years in prison and paying a fine of at least $10,000. Repeat offenses, however, may lead to a 10-year sentence and a $20,000 fine.
False claims case leads to a suspended sentence
Insurance fraud investigators uncovered nearly two years’ worth of false claims and altered medical bills submitted by 20 individuals. The case involved insurance companies paying out more than $400,000 worth of benefits.
The purported ringleader was a 33-year-old South Carolina resident who prosecutors claim falsified her family’s bills and instructed others to submit fraudulent claims. After pleading guilty to two false claim charges, she received a 10-year sentence, which suspended after spending 90 days in jail, as reported by WMBF News. Her sentence required paying $60,000 in restitution and carrying out five years of supervised probation.