Insurance fraud

Legal definiton 

Section 210 of the Criminal Code:

(1) Whoever provides false or grossly distorted information or conceals essential information:

a) in connection with the conclusion or modification of an insurance contract, 

b) in connection with the settlement of an insurance claim, or 

c) when laying claim for compensation from insurance or other similar benefits,

shall be punished by imprisonment for up to two years, a disqualification, or the forfeiture of the item.

(2) The same sentence shall be imposed on anyone who, with the intent to gain benefit for themselves or another, causes or pretends an event associated with a right to compensation from insurance or other similar benefits, or maintains a state caused by an insured event, and thereby causes non-insignificant damage to another's property.

(3) Whoever commits the act specified in paragraphs 1 or 2 and has been convicted or punished for such an act in the last three years shall be punished by imprisonment for six months to three years.

(4) Imprisonment for one to five years or a financial penalty shall be imposed on the offender if they cause greater damage by the act mentioned in paragraphs 1 or 2.

(5) Whoever commits the act specified in paragraph 1 shall be punished by imprisonment for two to eight years if

a) they commit the act mentioned in paragraph 1 as a member of an organized group,

b) do so as a person specially entrusted with protecting the interests of the aggrieved person,

c) they cause significant damage by such an act.

(6) Imprisonment for five to ten years shall be imposed on the perpetrator if

a) they cause large-scale damage by the act mentioned in paragraph 1, or

b) they commit such an act with the intent to enable or facilitate the commission of a terrorist criminal offence, the criminal offence of financing terrorism (Section 312d), or the threat of a terrorist criminal offence (Section 312f).

(7) Preparation is criminal.

Subjective aspect - intent

Insurance fraud is an intentional criminal offence. A criminal offence is committed intentionally if the perpetrator wanted to violate or endanger a legally protected interest in the manner specified by the Criminal Code (direct intent), or if the perpetrator knew that his actions could result in such a violation or endangerment and accepted the possibility of it occurring (indirect intent).

If the act can be deemed as mere negligence rather than intent, it does not constitute the described criminal offence. 

Defense

There are various defense strategies available. Given the elements of this crime, the following questions may be relevant:

• Were the information provided false or grossly distorted?
• Were the concealed information essential?
  
• What was the significance of the relevant information for assessing the insurance risk?
  
• Was the perpetrator's intent directed towards the decisive facts?