Wisconsin Statutes 895.486 – Civil immunity exemption; reports of insurance fraud
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Terms Used In Wisconsin Statutes 895.486
- Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
- Following: when used by way of reference to any statute section, means the section next following that in which the reference is made. See Wisconsin Statutes 990.01
- Fraud: Intentional deception resulting in injury to another.
- Person: includes all partnerships, associations and bodies politic or corporate. See Wisconsin Statutes 990.01
(1) In this section, “insurance fraud” means the presentation of any statement, document or claim, or the preparation of a statement, document or claim with the knowledge that the statement, document or claim will be presented, that the person knew or should have known contained materially false, incomplete or misleading information concerning any of the following:
(a) An application for the issuance of an insurance policy.
(b) A claim for payment, reimbursement or benefits payable under an insurance policy.
(c) A payment made in accordance with the terms of an insurance policy.
(d) A premium on an insurance policy.
(e) The rating of an insurance policy.
(2) Any person who, absent malice, files a report with or furnishes information concerning suspected, anticipated, or completed insurance fraud is immune from civil liability for his or her acts or omissions in filing the report or furnishing the information to any of the following or to their agents, employees or designees:
(a) The office of the commissioner of insurance.
(b) A law enforcement officer.
(c) The National Association of Insurance Commissioners.
(d) Any governmental agency established to detect and prevent insurance fraud.
(e) Any nonprofit organization established to detect and prevent insurance fraud.
(f) Any insurer or authorized representative of an insurer.
(3) Any information furnished by an insurer in response to a report or information furnished under sub. (2) is confidential and may be made public only if required in a civil or criminal action.
(4) If a civil action is commenced against a person for damages related to the filing of a report or the furnishing of information under sub. (2) and the court determines that the person is immune from civil liability for his or her acts or omissions in filing the report or furnishing the information, the person filing the report or furnishing the information shall recover costs under ch. 814 and, notwithstanding s. 814.04 (1), reasonable attorney fees.