76-6-521. Insurance fraud.
| (1) |
Attorney's NoteUnder the Utah Code, punishments for crimes depend on the classification. In the case of this section:
| Class | Prison | Fine |
|---|
| class A misdemeanor | up to 364 days | up to $2,500 | | class B misdemeanor | up to 6 months | up to $1,000 |
For details, see Utah Code § 76-3-204
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Terms Used In Utah Code 76-6-521- Act: means a voluntary bodily movement and includes speech. See Utah Code 76-1-101.5
- Actor: means a person whose criminal responsibility is in issue in a criminal action. See Utah Code 76-1-101.5
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
- Fraud: Intentional deception resulting in injury to another.
- Offense: means a violation of any penal statute of this state. See Utah Code 76-1-101.5
- Person: means an individual, public or private corporation, government, partnership, or unincorporated association. See Utah Code 76-1-101.5
- Property: includes both real and personal property. See Utah Code 68-3-12.5
- written: includes any handwriting, typewriting, printing, electronic storage or transmission, or any other method of recording information or fixing information in a form capable of being preserved. See Utah Code 76-1-101.5
| (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. |
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| (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:
| (i) |
| (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; |
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| (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. |
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| (3) |
| (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. |
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| (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. |
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| (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. |
Amended by Chapter 111, 2023 General Session
