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Q: Insurance Fraud - for tutuzdad-ga ( Answered 5 out of 5 stars,   0 Comments )
Question  
Subject: Insurance Fraud - for tutuzdad-ga
Category: Miscellaneous
Asked by: cvenom-ga
List Price: $20.00
Posted: 26 Aug 2005 19:00 PDT
Expires: 25 Sep 2005 19:00 PDT
Question ID: 560998
This is of course purely hypothetical...

Let?s say someone?s wife made a claim against their insurance company
for a lost Rolex watch. The husband knew nothing about the claim;
however the wife received a settlement for about $20,000. The husband
only found out about the claim after the fact. To make matters worse,
the wife knows the watch is "hot", and sells it to her mother. Husband
informs mother-in-law of the "possible" insurance fraud. Mother-in-law
hides watch, but does not contact anyone about the possible fraud.
Where does the husband stand legally? Where does mother-in-law stand legally? If
he knows a crime has been committed, is he obligated to report his
wife's crime? Or does spousal privilege come into play here? If he did
turn in wife and mother-in-law (who knows the watch was reported
"lost"), could he be held accountable for the crime as well seeing as
he knew about it?

This is pretty much the scenario I'm interested in. How does the law
break this down, and what would be the suspected outcome if the info
was revealed to the insurance company? Also is there a way to
anonymously report fraud to an insurance company?

Once again I'm aware of the G**GLE legal disclaimer, no need to go
there. I'm just looking for general information for this situation.
Answer  
Subject: Re: Insurance Fraud - for tutuzdad-ga
Answered By: tutuzdad-ga on 26 Aug 2005 20:44 PDT
Rated:5 out of 5 stars
 
Hello again, cvenom-ga;

Thank you for requesting my assistance specifically. While some of
your questions probably do have specific statutory answers much of
what you are interested in calls for educated speculation. Because of
this, and the fact that you?d understandably like to remain anonymous
and not divulge more about your identity, location, etc, I will
generalize as much as possible.

>>>Let?s say someone?s wife made a claim against their insurance
company for a lost Rolex watch. The husband knew nothing about the
claim; however the wife received a settlement for about $20,000. The
husband only found out about the claim after the fact.

PROBLEM! The husband became aware of the fraud. Because his wife is
the primary suspect it can be presumed (or at least argued to a jury)
that because he learned of the crime but failed to prevent it, rectify
it or report it, that he also condoned it and in doing so benefited
from the criminal proceeds as well. Should this argument be presented
convincingly ?husband? could easily be projected as an accomplice to
the crime (the term ?aiding and abetting a crime? is often used here
in some states, while other prefer to use the term ?conspiracy to
commit?? ).

>>>To make matters worse, the wife knows the watch is "hot", and sells
it to her mother. Husband informs mother-in-law of the "possible"
insurance fraud. Mother-in-law hides watch, but does not contact
anyone about the possible fraud. Where does the husband stand legally?

In most jurisdictions a husband is not legally obligated to testify
against his wife in a criminal proceeding (and visa versa). The
problem arises when the authorities find out what has happened and
learn that the husband had personal knowledge of the crime and thereby
participated in it. Once the authorities come after the husband too,
he no longer has the luxury that spousal privilege affords. He either
has to dummy up and call his lawyer (and maybe even sit in jail), or
start trying to talk his way out of it. If he talks, he can?t help but
implicate his wife and if he remains silent (which is his right to do)
he?s faces having to go to prison too. It?s a no win situation once
the law gets involved.

>>>Where does mother-in-law stand legally? 

Mother-in-law was a victim up until she decided to conceal a crime
too. The watch now legally belongs to the insurance company. When an
insurance company pays a client for a claim then the property, if it
is ever recovered, is rightfully theirs. To knowingly deprive someone
of property and their rightful ownership thereof is ?theft?. By
concealing the watch and failing to report it, Mother-in-law is
technically committing the crime of ?Theft by Receiving? and
?hindering apprehension and prosecution?. If the authorities really
wanted to ?stack? charges they could also charge her with ?conspiracy
to ?commit fraud?, ?tampering with evidence? and perhaps ?interfering
with governmental operations?.

>>>If he knows a crime has been committed, is he obligated to report
his wife's crime?

In some jurisdictions the answer is NO, not legally.. In others it is
understood that ANYONE who witnesses or has information about a crime
is obligated to report it. Again, as I mentioned earlier, ?husband? is
not PART of the crime because he not only knows his wife perpetrated a
fraud but he is enjoying the proceed of the crime. To further
complicate matters, ?husband? also knows a third party who is involved
in this mess from who he enjoys no spousal protections. Let us not
forget that he NOW knows that Mother-in-law has a hand in this
criminal scheme and as hard as it may be to believe, he DOES
(technically) have an obligation to report it as one would any crime
they witness.

>>>Or does spousal privilege come into play here? 

See above

>>>If he did turn in wife and mother-in-law (who knows the watch was
reported "lost"), could he be held accountable for the crime as well
seeing as he knew about it?

It really depends on how long he has known about all this. If he just
found out last Friday we might not have that big of a problem. If all
this happened this past June and he has known about it since July, It
might be more difficult to argue his innocence, especially if some or
all of the criminal proceeds from the insurance fraud have been spent.
If all this happened in 2002 and all the cash has since been spent,
well, yeah he?d probably be in a world of trouble.

>>>How does the law break this down, and what would be the suspected
outcome if the info was revealed to the insurance company?

Speculation:  If the insurance company was notified and they were
presented with a $20,000 check and an apology, the insurance company
would either accept the apology or prosecute you all (or as many of
you as they could). There?s no way to know for sure which one they
might do. If you were prosecuted AFTER returing the money it would be
a fair guess to say that (if convicted) you?d receive a minimal
sentence (probations, fine and/or community service, etc).

>>>Also is there a way to anonymously report fraud to an insurance company?

Sure, you can call the 1-800 number from a pay phone, tell them your
name is "Carl" or something and spill your guts about what you know.
(I can't imagine what you think that might resolve though - and of
course, its none of my business).

If I were you I?d take the wife and mother-in-law to my attorney?s
office and lay the thing out on the table. I?d say help me get this
watch, or this $20,000 bucks back to where it belongs with the least
amount of hardship on any of us. The insurance company probably won?t
care much about the recovery details (if the watch was ?found? under a
couch cushion, or returned anonymously in your mailbox, etc); their
primary interest will be FULL COMPENSATION FOR THEIR LOSS. If cleverly
fixes the hole in the insurance company's purse and he?s a smooth
talker your attorney can probably wrangle some forgiveness from the
insurance company. In the end if the insurance company does not want
to pursue the matter criminally the state probably won?t be interested
in prosecuting you either.

I hope you find that my research exceeds your expectations. If you
have any questions about my research please post a clarification
request prior to rating the answer. Otherwise, I welcome your rating
and your final comments and I look forward to working with you again
in the near future. Thank you for bringing your question to us.

Best regards;
Tutuzdad ? Google Answers Researcher

Clarification of Answer by tutuzdad-ga on 26 Aug 2005 20:55 PDT
Let me also mentioned that I have a family member who, in their youth,
got the brilliant idea to take her car out of state, fly home and
report the car stolen. VERY DUMB. The cops found out but in this case
luckily the insurance company had not yet paid off on the claim. The
cops wanted her blood but the insurance company did not want to
prosecute so that alone saved her hide.

Once a crime is committed its often up to the victim to decide what
action is taken next.

tutuzdad-ga


PS  Here's a correction for you: In paragraph 7 where I said
"...husband is NOT part of the crime...", that should have read:
"...husband is NOW part of the crime..."
cvenom-ga rated this answer:5 out of 5 stars and gave an additional tip of: $5.00
Thanks again for a very detailed answer. I also look forward to
working with you again.

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