Medical Insurance Fraud
January 30, 2016 6:44 PM   Subscribe

A friend from out of state (US) has asked if they could use my address to be considered to be in my city's insurance network, thereby saving them a lot of cost. I realize this is insurance fraud. I'm going to turn them down, but what would be the potential ramifications if I didn't?
posted by ElectricGoat to Law & Government (9 answers total) 1 user marked this as a favorite
Their insurance policy could end up cancelled leaving them uninsured. As was noted in a similar question here recently, insurance companies look to disqualify people who make expensive claims. They could potentially be hit with fraud charges, though that's less likely.
posted by Candleman at 6:53 PM on January 30, 2016 [1 favorite]

Response by poster: Oops, forgot to add- I'm interested in knowing of the ramifications for both them AND me!
posted by ElectricGoat at 6:56 PM on January 30, 2016

It is possible but unlikely that you could be prosecuted for fraud as well.
posted by Candleman at 7:07 PM on January 30, 2016

You think they are your friend. They are not.

All it takes is one employee at a lonely desk who wants to keep busy or push Johnson out of the corner office and they will find you and prosecute you.

You think they are your friend. They are not.
posted by four panels at 8:06 PM on January 30, 2016 [2 favorites]

I deeply doubt there'd be any ramifications from the insurance company for you, assuming you didn't sign any of your friend's paperwork or claim them on your own insurance.

Your friend, on the other hand: the insurance company will take their payments, even if they suspect something is off from the beginning. If/when the company finds out for sure that there is fraud the very LEAST they'll do to your friend is deny coverage. And they WILL find out; right off the bat, I'd say the easiest way would be when they notice Friend says they live in your state A, but Friend has only seen doctors in state B. So the least-worst outcome for Friend would be to make insurance payments for zero benefits, basically throwing his money away.
posted by easily confused at 1:20 AM on January 31, 2016 [2 favorites]

I doubt there would be any ramifications for you. After all, your friend could have used your address without asking you. If you aren't signing anything or providing any documentation, the insurance company probably wouldn't come after you. (Would your friend be using your address as their legal address for anything else? It could lead to a mess even if it's not your fault).

It could end up being very expensive for your friend. He could be denied coverage, and there are all kinds of tax implications now. If most of their medical care takes place out of state, it may be difficult to find providers who accept your city's plan, and is an easy way to trigger an insurance company inquiry.
posted by bluefly at 7:55 AM on January 31, 2016

Conviction for fraud can include jail time. It can also include being asked to pay the money back.

I suggest you make some effort to create a paper trail proving you turned them down just in case they try to use your address anyway. If things do go wrong, do not cover for your friend. If investigators show up, be cooperative and tell them everything you know and make sure you make it clear that you said "no." Accessory after the fact or conspiracy to commit x crime are not good things to be charged with either.
posted by Michele in California at 1:37 PM on January 31, 2016 [1 favorite]

If investigators show up, then you need a lawyer.
posted by werkzeuger at 3:51 PM on January 31, 2016

Response by poster: Thanks, everyone, those are the kind of answers I was looking for. I turned them down citing some of these risks.
posted by ElectricGoat at 5:08 AM on February 1, 2016

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