33-1-1202. Administrative or civil insurance fraud.
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/mt/title-33/chapter-1/part-12/33-1-1202·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
33-1-1202 . Administrative or civil insurance fraud. A person commits the act of administrative or civil insurance fraud when the person:
(1)for the purpose of obtaining any money or benefit, presents or causes to be presented to any insurer, purported insurer, producer, or administrator, as defined in 33-17-102 , any written or oral statement, including computer-generated documents, containing false, incomplete, or misleading information concerning any fact or thing material to, as part of, or in support of a claim for payment or other benefit pursuant to an insurance policy;
(2)assists, abets, solicits, or conspires with another to prepare or make any written or oral statement containing false, incomplete, or misleading information concerning any fact that is intended to be presented to any insurer or purported insurer or in connection with, material to, or in support of any claim for payment or other benefit pursuant to an insurance policy or contract;
(3)presents or causes to be presented to or by an insurer, purported insurer, producer, or administrator, as defined in 33-17-102 , a materially false or altered application of insurance;
(4)accepts premium money knowing that coverage will not be provided;
(5)as a health care provider, submits a false or altered bill or report of physical condition to an insurer;
(6)offers or accepts a direct or indirect inducement to file a false statement of claim with the intent of deceiving an insurer; or
(7)presents or causes to be presented counterfeit insurance documents to any person.