76-6-521. Insurance fraud.

712 words·~3 min read·/ut/title-76/chapter-6/76-6-521·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Effective 5/3/2023

(a)As used in this section, "runner" means the same as that term is defined in Section 31A-31-102 .

(b)Terms defined in Section 76-1-101.5 apply to this section.

(2)An actor commits a fraudulent insurance act if the actor with intent to deceive or defraud:

(a)presents or causes to be presented any oral or written statement or representation knowing that the statement or representation contains false or fraudulent information concerning any fact material to an application for the issuance or renewal of an insurance policy, certificate, or contract, as part of or in support of:

(i)obtaining an insurance policy the insurer would otherwise not issue on the basis of underwriting criteria applicable to the person;

(ii)a scheme or artifice to avoid paying the premium that an insurer charges on the basis of underwriting criteria applicable to the person; or

(iii)a scheme or artifice to file an insurance claim for a loss that has already occurred;

(b)presents, or causes to be presented, any oral or written statement or representation:

(A)as part of or in support of a claim for payment or other benefit pursuant to an insurance policy, certificate, or contract; or

(B)in connection with any civil claim asserted for recovery of damages for personal or bodily injuries or property damage; and

(ii)knowing that the statement or representation contains false, incomplete, or fraudulent information concerning any fact or thing material to the claim;

(c)knowingly accepts a benefit from proceeds derived from a fraudulent insurance act;

(d)intentionally, knowingly, or recklessly devises a scheme or artifice to obtain fees for professional services, or anything of value by means of false or fraudulent pretenses, representations, promises, or material omissions;

(e)knowingly employs, uses, or acts as a runner for the purpose of committing a fraudulent insurance act;

(f)knowingly assists, abets, solicits, or conspires with another to commit a fraudulent insurance act;

(g)knowingly supplies false or fraudulent material information in any document or statement required by the Department of Insurance; or

(h)knowingly fails to forward a premium to an insurer in violation of Section 31A-23a-411.1 .

(a)A violation of Subsection (2)(a)(i) is a class A misdemeanor.

(b)A violation of Subsections (2)(a)(ii) or (2)(b) through (2)(h) is:

(i)a class B misdemeanor when the value of the property, money, or thing obtained or sought to be obtained is less than $500;

(ii)a class A misdemeanor when the value of the property, money, or thing obtained or sought to be obtained is or exceeds $500 but is less than $1,500;

(iii)a third degree felony when the value of the property, money, or thing obtained or sought to be obtained is or exceeds $1,500 but is less than $5,000; or

(iv)a second degree felony when the value of the property, money, or thing obtained or sought to be obtained is or exceeds $5,000.

(c)A violation of Subsection (2)(a)(iii) is:

(i)a class A misdemeanor if the value of the loss is less than $1,500 or unable to be determined;

(ii)a third degree felony when the value of the loss is or exceeds $1,500 but is less than $5,000; or

(iii)a second degree felony when the value of the loss is or exceeds $5,000.

(4)A corporation or association is guilty of the offense of insurance fraud under the same conditions as those set forth in Section 76-2-204 .

(5)The determination of the degree of any offense under Subsections (2)(a)(ii) and (2)(b) through (2)(h) shall be measured by the total value of all property, money, or other things obtained or sought to be obtained by the fraudulent insurance act or acts described in Subsections (2)(a)(ii) and (2)(b) through (2)(h) .

(6)This section may not be construed to impose criminal or civil liability on any law enforcement officer acting within the scope of a criminal investigation.

(7)The forfeiture of property under this section, including any seizure and disposition of the property and any related judicial or administrative proceeding, shall be conducted in accordance with Title 77, Chapter 11a, Seizure of Property and Contraband , through Chapter 11c, Retention of Evidence .

Amended by Chapter 111 , 2023 General Session