Terms Used In Rhode Island General Laws > Chapter 27-54.1 - Anti-Fraud Act

• Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Business of insurance: means the writing of insurance or the reinsuring of risks by an insurer, including acts necessary or incidental to writing insurance or reinsuring risks and the activities of persons who act as or are officers, directors, agents or employees of insurers, or who are other persons authorized to act on their behalf. See Rhode Island General Laws 27-54.1-1
• Commissioner: means the director of the department of business regulation or his or her designee or the division of insurance. See Rhode Island General Laws 27-54.1-1
• 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.
• Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. ^{Source: OCC}
• 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.
• 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

• Insurer: means a person entering into arrangements or contracts of insurance or reinsurance and who agrees to perform any of the acts set forth in subdivision (4) of this section or fraternal benefit societies, medical and hospital service corporations, dental service corporations and/or health maintenance organizations. See Rhode Island General Laws 27-54.1-1
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• 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
• Policy: means an individual or group policy, group certificate, contract or arrangement of insurance or reinsurance affecting the rights of a resident of this state or bearing a reasonable relation to this state, regardless of whether delivered or issued for delivery in this state. See Rhode Island General Laws 27-54.1-1
• Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
• 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
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.