The rising challenge of fraudulent claims demands an experienced and strategic defense. At Waldon Adelman Castilla McNamara & Prout, our Insurance Fraud practice is dedicated to investigating, defending against, and litigating cases involving suspected insurance fraud across various lines of coverage. We represent insurance carriers in uncovering and challenging false or exaggerated claims, protecting their financial integrity and discouraging fraudulent activities. Our commitment is to safeguard our clients’ assets by pursuing all available legal avenues to deny fraudulent claims and, where appropriate, seek restitution.

Understanding Insurance Fraud

Insurance fraud encompasses a wide range of deceptive practices used to obtain an undeserved benefit from an insurance policy. It’s a serious issue that affects the entire insurance industry, leading to increased costs and financial exposure. Our attorneys are experienced in identifying and litigating cases involving various forms of fraud, including:

• Staged Accidents: Collisions intentionally caused to create a fraudulent claim.
• Inflated Medical Bills: Exaggerating the extent of injuries or the cost of treatment.
• Unauthorized/Unnecessary Treatment: Providing medical treatment which is unnecessary or outside the scope authorized for purpose of building a claim.
• Deceptive Property Damage Claims: Falsifying the cause or severity of property damage.
• Misrepresentation: Providing false information on an insurance application or in a claim.

Our deep understanding of these schemes allows us to develop effective strategies for defense and litigation.

A Thorough Investigation

Our approach to insurance fraud is a proactive and meticulous process. We don’t just react to claims; we actively investigate them to identify potential deception from the outset. We work closely with a network of professionals, including forensic experts, private investigators, and law enforcement, to build a robust defense. This collaborative effort allows us to analyze evidence and identify red flags that others might miss.

When fraud is suspected, our attorneys are skilled in employing aggressive legal tactics to expose the truth. This includes detailed discovery, vigorous cross-examination, and a robust motion practice. Our commitment is to protect our clients’ financial interests by not only denying fraudulent claims but also, where appropriate, seeking restitution to recover funds that were improperly paid.

When Is an Insurance Fraud Attorney Necessary?

Insurance carriers require specialized legal counsel when they suspect a claim is fraudulent. Our services are essential when:

• A claim’s details appear inconsistent or suspicious during the investigation.
• You need to challenge the validity of medical bills, repair estimates, or other claim-related costs.
• There are indicators of a staged accident, fabricated injury, or other forms of misrepresentation.
• You need to pursue a legal action to deny a claim or seek restitution for damages already paid.