Insurance Fraud in Poland: Criminal Consequences Explained

Insurance fraud in Poland is conduct aimed at obtaining an undue insurance payment by misleading an insurer, creating a false basis for compensation, or artificially causing an insured event. In criminal law, such conduct may qualify as fraud, causing an event that is the basis for an insurance payout, document forgery, false testimony, or other offences depending on the facts.

For a business, a false insurance claim is not only a dispute with an insurer. It may trigger a criminal investigation, asset seizures, reputational damage, internal disciplinary proceedings, and problems with future insurance coverage. For managers, the risk may also concern personal liability if the claim was prepared, approved, or concealed within the organisation.

This is informational material, not legal advice. The legal classification of a staged accident, inflated loss, or insurance scam depends on evidence, intent, the policy wording, and the procedural stage.

Insurance fraud Poland – main criminal law provisions

Polish law does not use one single provision for every insurance fraud case. The most common legal basis is Article 286 § 1 of the Polish Criminal Code, which penalises fraud. It applies when a person, acting to obtain a financial benefit, causes another person to unfavourably dispose of property by misleading them, exploiting their error, or exploiting their inability to properly understand the situation. The penalty is imprisonment from 6 months to 8 years [1].

Insurance cases may also fall under Article 298 § 1 of the Criminal Code. This provision specifically covers causing an event that is the basis for payment of compensation under an insurance contract, if the purpose is to obtain that compensation. The penalty is imprisonment from 3 months to 5 years [1]. This provision is particularly relevant to a staged accident, deliberate property damage, arson arranged to trigger a payout, or other artificially created insured events.

If the value of the damage or attempted benefit is substantial, Article 294 § 1 of the Criminal Code may apply to fraud involving property of substantial value. Under Article 115 § 5 of the Criminal Code, substantial value means value exceeding PLN 200,000. In such cases, the penalty may increase to imprisonment from 1 to 10 years [1].

False insurance claim, staged accident, and related offences

A false insurance claim may involve more than one offence. The prosecutor will usually analyse not only the claim form, but also supporting documents, photos, repair invoices, medical records, witness statements, and communication with the insurer.

Depending on the factual situation, additional provisions may include:

• Article 270 of the Criminal Code – forgery or use of a forged document, for example a fabricated invoice, altered medical certificate, or manipulated vehicle repair document [1].
• Article 271 of the Criminal Code – false certification by a public official or another person authorised to issue a document, if a document confirms untrue circumstances of legal significance [1].
• Article 273 of the Criminal Code – use of a document containing false certification [1].
• Article 233 of the Criminal Code – false testimony, false expert opinion, or other false statement in proceedings where the law requires truthfulness [1].
• Article 238 of the Criminal Code – false notification of an offence, for example reporting a theft that did not occur [1].

In practice, an insurance scam may also be connected with money laundering risks, especially if the scheme involves organised groups, repeated claims, shell companies, or circular payments. Compliance teams should therefore treat suspicious claims as a possible financial crime issue, not only as an insurance recovery problem. KKZ lawyers also describe related financial crime risks in materials on Poland’s anti-money laundering framework.

Three exceptions that must be separated from criminal insurance fraud

Not every rejected claim is a crime. In insurance disputes, the distinction between civil disagreement and criminal liability is essential. There are three important exceptions:

• A disputed insurance claim is not automatically insurance fraud. A disagreement over policy interpretation, valuation of damage, depreciation, causation, or exclusions may remain a civil or regulatory matter if there was no intentional deception.
• An incorrect insurance claim is not automatically insurance fraud. Errors in documents, estimates, dates, or descriptions may result from negligence, poor internal procedures, or misunderstanding. Criminal liability generally requires intent, although each case depends on the evidence.
• Under Article 298 § 2 of the Criminal Code, the offender is not subject to punishment if, before criminal proceedings are initiated, they voluntarily prevent the payment of compensation. This exception is narrow and applies to the specific offence under Article 298 § 1, not automatically to all related offences such as forgery or false testimony [1].

How prosecutors assess intent in an insurance scam case

Intent is usually the central issue. Prosecutors look for facts showing whether the claimant knew that the event, damage, documents, or statements were false and whether the purpose was to obtain an undue benefit.

Typical evidence may include:

• inconsistencies between the claim and technical evidence,
• vehicle telematics, CCTV, GPS, phone location data, or alarm logs,
• communications between participants before and after the event,
• financial pressure, debt, or recent policy changes,
• repeated claims involving the same persons, workshops, doctors, or intermediaries,
• expert opinions on accident reconstruction, fire origin, medical causation, or document authenticity.

For companies, the most serious risk arises when internal emails or approval paths show that warning signs were ignored. A weak internal procedure may not prove criminal intent by itself, but it can expand the investigation to managers, employees, brokers, service providers, or external experts.

Consequences for companies and managers

Insurance fraud Poland cases often create parallel consequences. A criminal investigation may run at the same time as a civil dispute with the insurer, internal disciplinary proceedings, regulatory reporting, and cooperation with auditors.

The consequences may include:

• criminal charges against individuals involved in preparing or supporting the claim,
• refusal of payment or recovery of compensation already paid,
• termination or non-renewal of insurance policies,
• higher premiums and reduced access to coverage,
• searches, seizure of documents, and preservation or disclosure of data,
• loss of trust among investors, banks, contractors, and regulators.

Where the issue concerns an organisation, the response should be coordinated. Fragmented communication between the legal department, management board, HR, compliance, insurer, and law enforcement may increase risk. Early fact-finding is important, but it must be conducted in a way that preserves evidence and avoids influencing witnesses.

Practical defence and risk management steps

In a suspected false insurance claim case, the first step should be to secure documents and data. This includes claim files, invoices, internal approvals, correspondence, access logs, photos, recordings, and accounting records. Selective deletion or informal “clean-up” may create additional criminal exposure.

The next step is a legal assessment of the facts. Kopeć & Zaborowski (KKZ) advises in matters involving insurance fraud, broader fraud allegations, forensic audits, and crisis response. In business cases, the assessment should cover criminal liability, insurance recovery, employment issues, personal rights, reputation, and reporting duties.

Companies should also consider preventive measures: claim approval rules, segregation of duties, document verification, whistleblowing channels, anti-fraud training, and monitoring of repeated claim patterns. These measures reduce the risk of an insurance scam and support the company if an incident later becomes the subject of criminal proceedings.

If a company, manager, or individual is facing an allegation involving a false insurance claim, staged accident, or broader insurance scam, it may be necessary to obtain an early criminal law assessment. To discuss possible steps with a lawyer, use the contact page: https://criminallawpoland.com/contact/.

FAQ – Insurance Fraud in Poland

Is insurance fraud a separate crime in Poland?

Polish law does not use one universal offence for all insurance fraud. The main provisions are Article 286 § 1 of the Criminal Code on fraud and Article 298 § 1 on causing an event that is the basis for payment of compensation under an insurance contract [1]. Other offences may apply depending on documents, testimony, and the method used.

Can a staged accident lead to imprisonment?

Yes. A staged accident may qualify under Article 298 § 1 of the Criminal Code, punishable by imprisonment from 3 months to 5 years. If the conduct also involves fraud, forged documents, injury, or substantial value, the legal consequences may be more serious [1].

Is an exaggerated insurance claim always a crime?

No. An inflated or incorrect claim is not automatically criminal. The key issue is whether the claimant intentionally misled the insurer to obtain an undue benefit. Negligence, valuation disputes, or unclear policy terms may require a different legal assessment.

What happens if compensation has already been paid?

The insurer may seek repayment, and the case may be reported to law enforcement. Payment of compensation may strengthen the allegation of unfavourable disposal of property under Article 286 § 1 of the Criminal Code, but the full assessment depends on evidence and intent [1].

Can a company be affected if only one employee filed a false claim?

Yes. The company may face internal, civil, insurance, and reputational consequences. Management should secure evidence, assess whether procedures failed, and determine whether the employee acted alone or with wider knowledge within the organisation.

Does withdrawing a claim eliminate criminal liability?

Not always. Article 298 § 2 of the Criminal Code provides that the offender is not subject to punishment if, before criminal proceedings are initiated, they voluntarily prevent payment of compensation. This does not automatically remove liability for other offences, such as document forgery [1].

Bibliography

1. Act of 6 June 1997 – Criminal Code, Journal of Laws 1997 No. 88 item 553, as amended, including Articles 115, 233, 270, 271, 273, 286, 294, 298.
2. Act of 6 June 1997 – Code of Criminal Procedure, Journal of Laws 1997 No. 89 item 555, as amended.
3. Act of 11 September 2015 on Insurance and Reinsurance Activity, Journal of Laws 2015 item 1844, as amended.
4. Polish Financial Supervision Authority, Recommendations concerning claims handling under motor insurance, adopted by the KNF on 18 July 2022.