Effective 5/14/2019 31A-31-103. Fraudulent insurance act. (1) A person commits a fraudulent insurance act if that person with intent to deceive or defraud: (a) knowingly presents or causes to be presented to an insurer any oral or written statement or representation knowing that the statement or representation contains false, incomplete, or misleading information concerning any […]
31A-31-104. Disclosure of information. (1) (a) Subject to Subsection (2), upon written request by an insurer to an authorized agency, the authorized agency may release to the insurer information or evidence that is relevant to any suspected insurance fraud. (b) Upon written request by an authorized agency to an insurer, the insurer or an agent […]
31A-31-105. Immunity. (1) (a) A person, insurer, or authorized agency is immune from civil action, civil penalty, or damages when in good faith that person, insurer, or authorized agency: (i) cooperates with an agency described in Subsection (1)(b); (ii) furnishes evidence to an agency described in Subsection (1)(b); (iii) provides information regarding a suspected fraudulent […]
31A-31-106. Disciplinary action. (1) If, after giving notice and a hearing conducted pursuant to Title 63G, Chapter 4, Administrative Procedures Act, the commissioner finds by a preponderance of the evidence that a person licensed under Title 31A, Insurance Code, has committed a fraudulent insurance act, the commissioner may suspend or revoke the license issued under […]
Effective 5/14/2019 31A-31-107. Workers’ compensation insurance fraud. (1) In any action involving workers’ compensation insurance, Section 34A-2-110 supersedes this chapter. (2) Nothing in this section prohibits the department from investigating and pursuing civil or criminal penalties in accordance with Section 31A-31-109 and Title 34A, Utah Labor Code, for violations of Section 34A-2-110. Amended by Chapter […]
31A-31-108. Assessment of insurers. (1) For purposes of this section: (a) The commissioner shall by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, define: (i) “annuity consideration”; (ii) “membership fees”; (iii) “other fees”; (iv) “deposit-type contract funds”; and (v) “other considerations in Utah.” (b) “Insurance fraud provisions” means: (i) this […]
31A-31-108.5. Insurance Fraud Victim Restitution Fund. (1) There is created an expendable special revenue fund known as the “Insurance Fraud Victim Restitution Fund.” (2) The Insurance Fraud Victim Restitution Fund shall consist of money ordered paid under Subsections 31A-31-109(1)(a)(i) and (2)(a). (3) The commissioner shall administer the Insurance Fraud Victim Restitution Fund for the sole […]
31A-31-109. Civil penalties. (1) In addition to other penalties provided by law, a person who violates this chapter: (a) is subject to the following civil penalties: (i) the person shall make full restitution; and (ii) the person shall pay the costs of enforcement of this chapter for the case in which the person is found […]
31A-31-110. Mandatory reporting of fraudulent insurance acts. (1) (a) A person shall report a fraudulent insurance act to the department if: (i) the person has a good faith belief on the basis of a preponderance of the evidence that a fraudulent insurance act is being, will be, or has been committed by a person other […]
31A-31-111. Health discount program fraud. (1) In addition to any other fraudulent acts prohibited by this chapter, a person commits a fraudulent insurance act if that person with intent to deceive or defraud: (a) accepts fees, dues, charges, or other consideration for providing a health discount program as defined in Section 31A-8a-102 without having health […]
Effective 5/10/2016 31A-31-112. Insurance antifraud plan. (1) An insurer, as defined in Section 31A-31-102, shall prepare, implement, and maintain an insurance antifraud plan for its operations in this state. (2) The insurance antifraud plan required by Subsection (1) shall outline specific procedures, actions, and safeguards that include how the authorized insurer or health maintenance organization […]
