Terms Used In Michigan Laws 752.1009

  • Claim: means any attempt to cause a health care corporation or health care insurer to make the payment of a health care benefit. See Michigan Laws 752.1002
  • 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.
  • False: means wholly or partially untrue or deceptive. See Michigan Laws 752.1002
  • Health care benefit: means the right under a contract or a certificate or policy of insurance to have a payment made by a health care corporation or health care insurer for a specified health care service. See Michigan Laws 752.1002
  • Health care corporation: means a nonprofit dental care corporation incorporated under Act No. See Michigan Laws 752.1002
  • Health care insurer: means any insurance company authorized to provide health insurance in this state or any legal entity which is self-insured and providing health care benefits to its employees. See Michigan Laws 752.1002
  • knowingly: means that a person is in possession of facts under which he or she is aware or should be aware of the nature of his or her conduct and that his or her conduct is substantially certain to cause the payment of a health care benefit. See Michigan Laws 752.1002
  • Person: means an individual, corporation, partnership, association, or any other legal entity. See Michigan Laws 752.1002

A person who receives a health care benefit or payment from a health care corporation or health care insurer which the person knows that he or she is not entitled to receive or be paid; or a person who knowingly presents or causes to be presented a claim which contains a false statement, shall be liable to the health care corporation or health care insurer for the full amount of the benefit or payment made.