§ 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.)