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SENATE BILL NO. 1391

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Daily Data Tracking History

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S1391.......................................by COMMERCE AND HUMAN RESOURCES
INSURANCE FRAUD - Amends existing law to clarify that insurance fraud
constitutes a submission which is altered rather than incomplete.

02/04    Senate intro - 1st rdg - to printing
02/05    Rpt prt - to Com/HuRes

Bill Text

S1391


                                                                        
 ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
Fifty-fourth Legislature                 Second Regular Session - 1998
                                                                        

                                      IN THE SENATE

                                   SENATE BILL NO. 1391

                        BY COMMERCE AND HUMAN RESOURCES COMMITTEE

 1                                        AN ACT
 2    RELATING TO INSURANCE FRAUD; AMENDING SECTION 41-293, IDAHO CODE,  TO  CLARIFY
 3        THAT IT CONSTITUTES INSURANCE FRAUD TO SUBMIT AN ALTERED CLAIM.

 4    Be It Enacted by the Legislature of the State of Idaho:

 5        SECTION  1.  That  Section  41-293, Idaho Code, be, and the same is hereby
 6    amended to read as follows:

 7        41-293.  INSURANCE FRAUD. Insurance fraud includes:
 8        (1)  (a)  Any person who, with the intent to defraud or deceive an insurer
 9        for the purpose of obtaining any money or benefit presents or causes to be
10        presented to any insurer, a purported insurer, broker or agent, any  writ-
11        ten  or  oral statement including computer-generated documents as part of,
12        or in support of, a claim for payment or other benefit, knowing that  such
13        statement contains false,  incomplete   altered , or
14        misleading  information  concerning  any  fact   or thing material to such
15        claim; or
16        (b)  Any person who, with intent to defraud or deceive an insurer assists,
17        abets, solicits, or conspires with another to prepare or make any  written
18        or  oral  statement  that is intended to be presented to any insurer, pur-
19        ported insurer, broker or agent, in connection with, or in support of, any
20        claim for payment or other benefit, knowing that such  statement  contains
21        false,   incomplete   altered , or misleading infor-
22        mation concerning any fact or thing material to such claim;
23        (c)  Any insurance agent or other person who with  intent  to  defraud  or
24        deceive an insurer presents or causes to be presented to or by an insurer,
25        a purported insurer or agent, a materially false or altered application of
26        insurance;
27        (d)  Any  insurance  agent  or  other person who with intent to defraud or
28        deceive willfully takes premium money knowing that coverage  will  not  be
29        affected;
30        (e)  Any  medical  practitioner  who  willfully submits a false or altered
31        bill, with the intent of deceiving an insurer;
32        (f)  Anyone willfully making a false statement or material  misrepresenta-
33        tion,  with  the  intent  of  deceiving  an  insurer,  to obtain or extend
34        worker's compensation benefits;
35        (g)  Anyone who offers or accepts a direct or indirect inducement to  file
36        a  false statement of claim, with intent of deceiving an insurer.
37        (2)  Any  offense committed by use of a telephone, any means of electronic
38    communication or mail as provided by this chapter may be deemed to  have  been
39    committed  at the place from which the telephone call or electronic communica-
40    tion was made, or mail was sent, or the offense may be  deemed  to  have  been
41    committed  at  the place at which the telephone call, electronic communication
42    or mail was received.
43        (3)  Any violator of this section is guilty of a felony and shall be  sub-


                                          2

 1    ject to a term of imprisonment not to exceed fifteen (15) years, or a fine not
 2    to  exceed fifteen thousand dollars ($15,000), or both and shall be ordered to
 3    make restitution to the insurer or any other person  for  any  financial  loss
 4    sustained  as a result of a violation of this section. Each instance of viola-
 5    tion may be considered a separate offense.

Statement of Purpose / Fiscal Impact

                           STATEMENT OF PURPOSE
    
                                  RS 07802
    
    The proposed amendment to Idaho Code, §41-293 clarifies the 
    intent of the original legislation and will avoid a potential 
    indictment or criminal complaint against an Idaho citizen or 
    his attorney who has intentionally withheld a document or 
    documents from submission to an insurance adjuster based upon 
    the existence of privilege as recognized by Idaho law or for 
    other good reason. The word "altered" its substituted for the 
    word "incomplete" to establish if, in fact, an affirmative act 
    of fraudulent intent takes place, prosecution is still 
    appropriate.
    
                               FISCAL NOTE
    
    None.
    
	
	
    CONTACT: Kay Shields, Executive Director
             David E. Kerrick, Legislative Affairs Counsel
             Idaho Trial Lawyers Association
             P. O. Box 1777
             Boise, ID 83707
    
    itla@primenet. com
    (208) 345-1890
    (208) 345-1894 (fax)
    
    
    STATEMENT OF PURPOSE/FISCAL NOTE               Bill No S1391