720 ILCS 5/17-10.5(c) – Conspiracy to Commit Insurance Fraud

720 ILCS 5/17-10.5(c) – Conspiracy to Commit Insurance Fraud

This law explains what happens if someone works together with others to commit insurance fraud and what punishments they can face.

This Illinois law explains how people can be charged if they plan or take part in a scheme to commit insurance fraud and what the possible punishments are, depending on how much money or property was involved in the crime.

(c) Conspiracy to commit insurance fraud. If someone plans to commit aggravated insurance fraud with others, they can be charged even if the people involved in each incident are not always the same, as long as the accused was part of the same plan or scheme for three or more times.

If a person helped organize, supervise, finance, or managed a plan to commit three or more acts of aggravated insurance fraud, they can also be charged with conspiracy, even if the group members changed, as long as the accused had a leadership role in each case.

(d) Sentence:

1. If the fraud involved $300 or less, it is a Class A misdemeanor.
2. If the fraud involved more than $300 but not more than $10,000, it is a Class 3 felony.
3. If the fraud involved more than $10,000 but not more than $100,000, it is a Class 2 felony.
4. If the fraud involved more than $100,000, it is a Class 1 felony.
5. If the fraud is health care benefits fraud, it is a Class A misdemeanor.
6. If the fraud is aggravated, it is a Class 1 felony, no matter the amount of money involved.
7. If was in charge of a group committing aggravated fraud, it is a Class X felony.
8. Anyone found guilty of insurance fraud, vendor fraud, or certain federal Medicaid fraud must pay back the insurance company or person who lost money, including costs for court, lawyers, and any medical evaluations or treatments paid for by the State or insurance company.
9. A person can be punished both for conspiring or organizing an aggravated insurance fraud plan and for committing the related crime itself.

(e) Civil damages for insurance fraud.

1. If someone lies to get money from an insurance company, they must pay back either three times the money wrongfully received or twice the value of what they tried to get–whichever is higher–plus attorney’s fees.
2. However, if an insurance company sues someone in bad faith (without good reason), that company must pay the person twice the amount claimed, plus attorney’s fees.

(f) Determination of property value. If the exact dollar amount isn’t listed, the “value” means the fair market replacement value or the reasonable cost to replace or reimburse services.

(g) Actions by State licensing agencies.

1. State police and licensing agencies must work together to enforce this law.
2. If someone with a professional license in Illinois is convicted of insurance fraud, the Illinois State Police must tell all licensing agencies.
3. Those agencies must report within 6 months on what actions were taken, such as suspending or revoking the person’s license.

(h) Definitions. Words like “obtain,” “deception,” and “property” have the same meanings as they do in Article 15 of the Illinois Criminal Code.

View the full statute here.

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