(a)  Notwithstanding any similar requirements in title 28, every claim form and application for insurance, regardless of the form of transmission, shall contain the following statement or a substantially similar statement:

“Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.”

Terms Used In Rhode Island General Laws 27-54.1-3

  • Fraudulent insurance act: means an act or omission committed by a person who, knowingly and with intent to defraud, commits, or conceals any material information concerning, one or more of the following:

    (i)  Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by an insurer, a reinsurer, broker or its agent, false information as part of, in support of or concerning a fact material to one or more of the following:

    (A)  An application for the issuance or renewal of an insurance policy or reinsurance contract;

    (B)  The rating of an insurance policy or reinsurance contract;

    (C)  A claim for payment or benefit pursuant to an insurance policy or reinsurance contract;

    (D)  Premiums paid on an insurance policy or reinsurance contract;

    (E)  Payments made in accordance with the terms of an insurance policy or reinsurance contract;

    (F)  A document filed with the commissioner or the chief insurance regulatory official of another jurisdiction;

    (G)  The financial condition of an insurer or reinsurer;

    (H)  The formation, acquisition, merger, reconsolidation, dissolution or withdrawal from one or more lines of insurance or reinsurance in all or part of this state by an insurer or reinsurer;

    (I)  The issuance of written evidence of insurance; or

    (J)  The reinstatement of an insurance policy;

    (ii)  Solicitation of acceptance of new or renewal insurance risks on behalf of an insurer, reinsurer or other person engaged in the business of insurance by a person who knows or should know that the insurer or other person responsible for the risk is insolvent at the time of the transaction;

    (iii)  Removal, concealment, alteration or destruction of the assets or records of an insurer, reinsurer or other person engaged in the business of insurance;

    (iv)  Willful embezzlement, abstracting, purloining, or conversion of monies, funds, premiums, credits or other property of an insurer, reinsurer or person engaged in the business of insurance;

    (v)  Transaction of the business of insurance in violation of laws requiring a license, certificate of authority or other legal authority for the transaction of the business of insurance; or

    (vi)  Attempt to commit, aiding or abetting in the commission of, or conspiracy to commit the acts or omissions specified in this subsection. See Rhode Island General Laws 27-54.1-1

  • Insurance: means a contract or arrangement in which one undertakes to:

    (i)  Pay or indemnify another as to loss from certain contingencies called "risks" including through reinsurance;

    (ii)  Pay or grant a specified amount or determinable benefit to another in connection with ascertainable risk contingencies;

    (iii)  Pay an annuity to another; or

    (iv)  Act as surety. See Rhode Island General Laws 27-54.1-1

  • Person: means an individual, a corporation, a partnership, an association, a joint stock company, a trust, an unincorporated organization, or any similar entity or any combination of the foregoing. See Rhode Island General Laws 27-54.1-1
  • Reinsurance: means a contract, binder of coverage (including placement slip) or arrangement under which an insurer procures insurance for itself in another insurer as to all or part of an insurance risk of the originating insurer. See Rhode Island General Laws 27-54.1-1

(b)  The lack of a statement as required in subsection (a) of this section does not constitute a defense in any prosecution for a fraudulent insurance act.

(c)  The requirements of this section shall not apply to reinsurance claims forms or reinsurance applications.

(d)  The requirements of this section shall not apply to any claim form for health insurance which is on a form promulgated by the centers for Medicare and Medicaid services or in electronic format pursuant to 45 C.F.R. part 162.

History of Section.
P.L. 2010, ch. 54, § 1; P.L. 2010, ch. 71, § 1.