Insurance Fraud

Insurance fraud is a very popular context in which the mail and Wire fraud statutes are applied. In fact, most insurance fraud, including Medicare Fraud and Medicaid Fraud, is prosecuted under the mail fraud or wire fraud statute. Any mailing of any application or proceeds between the insured and the insurer, agent, or office will confer federal jurisdiction under the statute.

The easy case is where an insured commits arson in order to collect the insurance proceeds. In filing the claim, the insured can reasonably foresee use of the mails, and the remaining elements of mail fraud are easily satisfied. A more difficult situation is when the mailing occurs well after payment of the alleged loss. Here the issue is with the “in furtherance of the scheme” requirement – was the scheme over or still in effect? Prosecutors will argue that the scheme was still in effect, often characterizing such late mailings as attempts to “lull” current victims or give an appearance of normalcy to potential victims.