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Searching 2019-2020 Session

The Vermont Statutes Online

 

Title 13 : Crimes and Criminal Procedure

Chapter 047 : FRAUDS

(Cite as: 13 V.S.A. § 2031)
  • § 2031. Insurance fraud

    (a) Definitions. As used in this section:

    (1) "Conceal" means to take affirmative action intended to prevent others from discovering information. Mere failure to disclose information does not constitute concealment.

    (2) "Insurance policy" has the same meaning as in 8 V.S.A. § 4722(3) and includes a workers' compensation policy issued pursuant to 21 V.S.A. chapter 9.

    (3) "Insurer" has the same meaning as in 8 V.S.A. § 4901(2) and includes a workers' compensation insurer pursuant to 21 V.S.A. chapter 9.

    (b) Fraudulent insurance act. No person shall, with intent to defraud:

    (1) present or cause to be presented a claim for payment or benefit, pursuant to any insurance policy, that contains false representations as to any material fact or which conceals a material fact; or

    (2) present or cause to be presented any information that contains false representations as to any material fact or that conceals a material fact concerning the solicitation for sale of any insurance policy or purported insurance policy, an application for certificate of authority, or the financial condition of any insurer.

    (c) Penalties. A person who violates subsection (b) of this section shall:

    (1) if the benefit wrongfully obtained or the loss suffered by any person as a result of the violation has a value of less than $900.00, be imprisoned for not more than six months or fined not more than $5,000.00, or both; or

    (2) if the benefit wrongfully obtained or the loss suffered by any person as a result of the violation has a value of more than $900.00, be imprisoned for not more than five years or fined not more than $10,000.00, or both; or

    (3) for a second or subsequent offense, regardless of the value of the benefit wrongfully obtained, be imprisoned not more than five years or fined not more than $20,000.00, or both.

    (d) Administrative action. Upon the conviction of a practitioner for a violation of subsection (b) of this section, the prosecutor shall inform the appropriate licensing authority. Any victim may notify the appropriate licensing authorities in this State and any other jurisdiction in which the practitioner is licensed of the conviction.

    (e) This section shall not be construed to limit or restrict prosecution under any other applicable law.

    (f) Immunity. No insurer or insurance professional acting in good faith and furnishing or disclosing information to the appropriate law enforcement official shall be subject to civil liability for libel, slander, or any other cause of action arising from the furnishing or disclosing of such information, except if the information is furnished solely to obtain an advantage in connection with a claim that will be, is being, or has been filed.

    (g) The public policy of this State is that the standards of this section shall not apply or be introduced into evidence in any civil or administrative proceeding, whether to argue public policy, materiality, or for any other purpose. (Added 2005, No. 179 (Adj. Sess.), § 1, eff. July 1, 2006; amended 2007, No. 208 (Adj. Sess.), § 4.)