Terms Used In Utah Code > Title 31A > Chapter 31 - Insurance Fraud Act

• Agency: means :

  (a)	a person other than an individual, including a sole proprietorship by which an individual does business under an assumed name; and

  (b)

  an insurance organization licensed or required to be licensed under Section 31A-23a-301, 31A-25-207, or 31A-26-209. See Utah Code 31A-1-301 Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it. Application: means a document: (a)  (i)  completed by an applicant to provide information about the risk to be insured; and (ii)  that contains information that is used by the insurer to evaluate risk and decide whether to: (A)  insure the risk under: (I)  the coverage as originally offered; or (II)  a modification of the coverage as originally offered; or (B)  decline to insure the risk; or (b)  used by the insurer to gather information from the applicant before issuance of an annuity contract. See Utah Code 31A-1-301 Authorized agency: means : (a)  the attorney general; (b)  the state fire marshal; (c)  any state law enforcement agency; (d)  any criminal investigative department or agency of the United States; (e)  a district attorney; (f)  the prosecuting attorney of any municipality or county; (g)  the department; or (h)  the disciplinary section of an agency licensing a service provider. See Utah Code 31A-31-102 authorized insurer: means an insurer: (i)  holding a valid certificate of authority to do an insurance business in this state; and (ii)  transacting business as authorized by a valid certificate. See Utah Code 31A-1-301 Certificate: means evidence of insurance given to: (a)  an insured under a group insurance policy; or (b)  a third party. See Utah Code 31A-1-301 Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action. Contract: A legal written agreement that becomes binding when signed. County legislative body: means :Utah Code 68-3-12.5 Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries. Department: means the Insurance Department. See Utah Code 31A-1-301 Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial. Employee: means : (a)  an individual employed by an employer; or (b)  an individual who meets the requirements of Subsection (53)(b). See Utah Code 31A-1-301 Escheat: Reversion of real or personal property to the state when 1) a person dies without leaving a will and has no heirs, or 2) when the property (such as a bank account) has been inactive for a certain period of time. 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. Financial loss: includes : (a)  out-of-pocket expenses; (b)  reasonable attorney fees; (c)  repair and replacement costs; or (d)  claims payments. See Utah Code 31A-31-102 Fraud: Intentional deception resulting in injury to another. Health care: means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment: (a)  a professional service; (b)  a personal service; (c)  a facility; (d)  equipment; (e)  a device; (f)  supplies; or (g)  medicine. See Utah Code 31A-1-301 Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies. Individual: means a natural person. See Utah Code 31A-1-301 Insurance: includes : (i)  a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind; (ii)  a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and (iii)  a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301 Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes: (i)  a policyholder; (ii)  a subscriber; (iii)  a member; and (iv)  a beneficiary. See Utah Code 31A-1-301 Insurer: means any person or aggregation of persons: (a)  doing insurance business, as defined in Section 31A-1-301; or (b)  subject to the supervision of the commissioner under: (i)  this title; or (ii)  any equivalent insurance supervisory official of another state. See Utah Code 31A-31-102 Legislative: when used to describe the powers, duties, or functions of a county commission or council, refers to: (a)  the power and duty to enact ordinances, levy taxes, and establish budgets; and (b)  those powers, duties, and functions that, under constitutional and statutory provisions and through long usage and accepted practice and custom at the federal and state level, have come to be regarded as belonging to the legislative branch of government. See Utah Code 17-50-101 License: includes a certificate of authority issued to an insurer. See Utah Code 31A-1-301 NAIC: means the National Association of Insurance Commissioners. See Utah Code 31A-1-301 nonadmitted insurer: means an insurer: (i)  not holding a valid certificate of authority to do an insurance business in this state; or (ii)  transacting business not authorized by a valid certificate. See Utah Code 31A-1-301 Order: means an order of the commissioner. See Utah Code 31A-1-301 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, firm, company, corporation, association, limited liability company, partnership, organization, society, business trust, service provider, or any other legal entity. See Utah Code 31A-31-102 Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court. Policy: includes a service contract issued by: (i)  a motor club under Chapter 11, Motor Clubs; (ii)  a service contract provided under Chapter 6a, Service Contracts; and (iii)  a corporation licensed under: (A)  Chapter 7, Nonprofit Health Service Insurance Corporations; or (B)  Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301 Premium: includes , however designated: (i)  an assessment; (ii)  a membership fee; (iii)  a required contribution; or (iv)  monetary consideration. See Utah Code 31A-1-301 Proceeding: includes an action or special statutory proceeding. See Utah Code 31A-1-301 Property: includes both real and personal property. See Utah Code 68-3-12.5 Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government. Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action. Runner: includes : (i)  a capper; or (ii)  a steerer. See Utah Code 31A-31-102 Security: means a: (i)  note; (ii)  stock; (iii)  bond; (iv)  debenture; (v)  evidence of indebtedness; (vi)  certificate of interest or participation in a profit-sharing agreement; (vii)  collateral-trust certificate; (viii)  preorganization certificate or subscription; (ix)  transferable share; (x)  investment contract; (xi)  voting trust certificate; (xii)  certificate of deposit for a security; (xiii)  certificate of interest of participation in an oil, gas, or mining title or lease or in payments out of production under such a title or lease; (xiv)  commodity contract or commodity option; (xv)  certificate of interest or participation in, temporary or interim certificate for, receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed in Subsections (171)(a)(i) through (xiv); or (xvi)  another interest or instrument commonly known as a security. See Utah Code 31A-1-301 Service provider: means : (a)  an individual licensed to practice law; (b)  an individual licensed or certified by the state under: (i)  this title; (ii)  Title 41, Chapter 3, Motor Vehicle Business Regulation Act; (iii)  Title 58, Occupations and Professions; or (iv)  Title 61, Securities Division - Real Estate Division; (c)  an individual licensed in another jurisdiction in a manner similar to a license described in Subsection (7)(a) or (b); (d)  an individual practicing any nonmedical treatment rendered in accordance with a recognized religious method of healing; or (e)  a hospital, health care facility, or person whose services are compensated directly or indirectly by insurance. See Utah Code 31A-31-102 Statement: includes any: (a)  (i)  notice; (ii)  statement; (iii)  proof of loss; (iv)  bill of lading; (v)  receipt for payment; (vi)  invoice; (vii)  account; (viii)  estimate of property damage; (ix)  bill for services; (x)  diagnosis; (xi)  prescription; (xii)  hospital or doctor record; (xiii)  x-ray; (xiv)  test result; or (xv)  other evidence of loss, injury, or expense; or (b)  item listed in Subsection (8)(a) that is a computer-generated document. See Utah Code 31A-31-102 Statute: A law passed by a legislature. Testimony: Evidence presented orally by witnesses during trials or before grand juries. Title insurance: means the insuring, guaranteeing, or indemnifying of an owner of real or personal property or the holder of liens or encumbrances on that property, or others interested in the property against loss or damage suffered by reason of liens or encumbrances upon, defects in, or the unmarketability of the title to the property, or invalidity or unenforceability of any liens or encumbrances on the property. See Utah Code 31A-1-301 United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5 Writing: includes :Utah Code 68-3-12.5