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NYC Criminal Attorney > NYC Criminal Defense > NYC Federal Insurance Fraud Attorney

NYC Federal Insurance Fraud Attorney

Insurance fraud is when you file a false or exaggerated claim to obtain insurance benefits from an auto or homeowner’s insurance, life insurance, workers’ compensation, or health insurance company. Filing a false or exaggerated claim is insurance fraud, and it can fall under both state and federal regulations, depending on the circumstances.

If you or a loved one is being investigated or is being charged with federal insurance fraud, you need a New York City criminal defense attorney who has experience defending these types of matters in federal court. Defending a case prosecuted in federal court means there are different rules, and the process can be more complicated. You need a New York City federal insurance fraud attorney who understands the nuances of the federal criminal court system.

What is Insurance Fraud?

Most people think about auto insurance when it comes to presenting a fraudulent claim, but these represent only a portion of the types of fraudulent claims filed in the United States. Think about the worker who attempts to keep their long-term disability or workers’ compensation claim going by falsely claiming they have a chronic condition.

The federal government closely monitors Medicare and Medicaid fraud due to physicians who may be caught upgrading or downgrading medical codes to receive more money for services. You can be unknowingly caught up in these federal investigations and accused of being part of it to obtain additional treatment or some type of financial kickback.

Types of Health Insurance Fraud

Health insurance fraud can also include dental insurance fraud. The penalties for federal insurance fraud can be even worse if Medicare or Medicaid are involved because they can be federal insurance fraud cases now. Common scenarios that may result in being charged for insurance fraud can include:

  • Offering a financial kickback for patient referral or accepting a kickback for referring a patient;
  • Performing medical treatments that are not needed with the purpose of padding the bill;
  • Lying about your health status in order to obtain insurance coverage at a lower premium;
  • Billing for medical services that were not provided, or upgrading the billing for services that cost more than those actually offered to the patient;
  • Using another person’s insurance coverage to get medical care for yourself; and
  • Billing for multiple insurance codes, or unbundling, when the procedure should be billed under one code.

Mail Fraud and Wire Fraud

Mail fraud and wire fraud are two distinct federal offenses that can give the federal government jurisdiction over an insurance fraud case that wouldn’t otherwise necessarily attract the federal government’s attention. Committing an act of fraud that extends over multiple state lines through the postal service can result in a mail fraud charge. Wire fraud involves a scheme to defraud someone or obtain money based on false promises or lies using electronic communication methods like email, phone call, social media messaging, text messages, etc.

Contact a New York Criminal Defense Attorney Today

If you are being charged with federal insurance fraud, it’s imperative to reach out to a New York City federal insurance fraud attorney right away. Contact Mark I. Cohen, Esq., today to schedule an initial consultation.

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"... Mr. Cohen's effort... in everything he has done before the Court, is A-Plus... [R]ecently, in another case... [before me], the result he achieved for his client... was quite impressive." Honorable Kenneth M. Karas, United States District Judge for the Southern District of New York.


"So I have very sophisticated counsel here and, Mr. Cohen, [your client] is very fortunate in having you as his attorney, and I hope he appreciates that." – Quote from the Honorable Denise L. Cote, United States District Judge for the Southern District of New York.


"As Mark Cohen, a defense lawyer who has tried cases throughout the city and was a prosecutor in the Bronx, pointed out, there is a saying among defense lawyers in New York." – As provided in the New York Times City Room Blog.

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