(a) An insurer or other licensee shall have a civil cause of action to recover payments or benefits from any person who has violated § 431:2-403; provided that no recovery shall be allowed if the person has made restitution pursuant to § 431:2-404 or fraud; administrative penalties” class=”unlinked-ref” datatype=”S” sessionyear=”2022″ statecd=”HI”>431:2-405(b)(1).

Terms Used In Hawaii Revised Statutes 431:2-408

  • Branch: means the insurance fraud investigations branch of the insurance division of the department of commerce and consumer affairs. See Hawaii Revised Statutes 431:2-401
  • county: includes the city and county of Honolulu. See Hawaii Revised Statutes 1-22
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fraud: Intentional deception resulting in injury to another.
  • Licensee: means an entity licensed under and governed by title 24, including an insurer governed by chapter 431, a mutual benefit society governed by article 1 of chapter 432, a fraternal benefit society governed by article 2 of chapter 432, or a health maintenance organization governed by chapter 432D, and their respective agents and employees engaged in the business of the licensee. See Hawaii Revised Statutes 431:2-401
  • Person: means any individual, company, association, organization, group, partnership, business, trust, or corporation; but shall exclude:

    (1) Insurers, as defined in § 431:1-202, and other licensees, as defined in this part; and

    (2) Licensed attorneys acting in their capacity as attorneys for a claimant other than the licensed attorney. See Hawaii Revised Statutes 431:2-401

  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
(b) A person, insurer, or other licensee, including an insurer’s or other licensee’s adjusters, bill reviewers, producers, representatives, or common-law agents shall not be subject to civil liability for providing information, including filing a report, furnishing oral, written, audiotaped, videotaped, or electronic media evidence, providing documents, or giving testimony concerning suspected, anticipated, or completed insurance fraud to:

(1) A court;
(2) The commissioner;
(3) The branch;
(4) The National Association of Insurance Commissioners;
(5) The National Insurance Crime Bureau;
(6) Any federal, state, or county law enforcement or regulatory agency; or
(7) Another insurer or other licensee,

if acting without actual malice and if the information is provided for the purpose of preventing, investigating, or prosecuting insurance fraud, except if the person commits perjury.

(c) Civil actions for insurance fraud under this part shall be filed within six years after the insurance fraud is discovered or should have been discovered by exercise of reasonable diligence; provided that no civil action shall be filed more than ten years after the date on which a violation of this part is committed.

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