56-47-103 - Fraudulent insurance acts.
56-47-103. Fraudulent insurance acts.
(a) Any person who, knowingly and with intent to defraud, and for the purpose of depriving another of property or for pecuniary gain, commits or participates in or permits its employees or its agents to commit any of the following acts, has committed a fraudulent insurance act:
(1) Presents, causes to be presented or prepares with knowledge or belief that it will be presented, by or on behalf of an insured, insurer, claimant or applicant to an insurer or insurance professional in connection with an insurance transaction any information that contains false representations as to any material fact, or that withholds or conceals a material fact concerning any of the following:
(i) The application for, rating of or renewal of, any insurance policy;
(ii) A claim for payment or benefit pursuant to any insurance policy; or
(iii) Payments made in accordance with the terms of any insurance policy;
(2) Presents, causes to be presented or prepares with knowledge or belief that it will be presented, to or by an insurer or insurance professional in connection with an insurance transaction, any information that contains false representations as to any material fact, or that withholds or conceals a material fact, concerning any of the following:
(i) The solicitation for sale of any insurance policy or purported insurance policy;
(ii) An application for certificate of authority; or
(iii) The financial condition of any insurer;
(3) Solicits or accepts new or renewal insurance risks by or for an insolvent insurer;
(4) Removes the assets or records of assets, transactions and affairs or the material part of the assets or records of assets, transactions and affairs from the home office or other place of business of the insurer, or from the place of safekeeping of the insurer, or destroys or sequesters the same from the department of commerce and insurance;
(5) Diverts, misappropriates, converts or embezzles funds of an insurer, an insured, claimant or applicant for insurance in connection with:
(i) An insurance transaction; or
(ii) The conduct of business activities by an insurer or insurance professional; or
(6) Presents, causes to be presented or prepares with knowledge or belief that it will be presented, by or on behalf of an insured or insurer, or insurance professional, to a claimant or any other person in connection with an insurance transaction, any information that contains false representations as to any material fact, or that withholds or conceals a material fact concerning any of the following:
(i) A claim for payment or benefit pursuant to any insurance policy; or
(ii) Payments made in accordance with the terms of any insurance policy.
(b) It is unlawful for any person to commit, or to attempt to commit, or to aid, assist, abet or solicit another to commit, or to conspire to commit a fraudulent insurance act.
(c) A practitioner violates this section only if the practitioner has been engaged in conduct that constitutes a pattern or practice of violation of this section.
(d) It is unlawful for an employer subject to the Workers' Compensation Law, compiled in title 50, chapter 6, to intentionally fail to secure payment of compensation by providing workers' compensation insurance coverage or by qualifying as a self-insurer pursuant to the workers' compensation law.
[Acts 1996, ch. 944, § 48; 2000, ch. 852, § 10.]