Legislation
SECTION 403
Prohibitions
Insurance (ISC) CHAPTER 28, ARTICLE 4
§ 403. Prohibitions. (a) In this article, "fraudulent insurance act"
means insurance fraud as defined in section 176.05 of the penal law; and
the terms "personal insurance" and "commercial insurance" shall have the
same meaning ascribed to them by section 176.00 of such law.
(b) For the purpose of section one hundred nine of this chapter, it is
a violation of this chapter for any individual, firm, association or
corporation subject to the provisions of this chapter to commit a
fraudulent insurance act or a fraudulent life settlement act.
(c) In addition to any criminal liability arising under the provisions
of this section, the superintendent shall be empowered to levy a civil
penalty not exceeding five thousand dollars and the amount of the claim
for each violation upon any person, including those persons and their
employees licensed pursuant to this chapter, who is found to have: (i)
committed a fraudulent insurance act, fraudulent life settlement act or
otherwise violates the provisions of this section; or (ii) knowingly and
with intent to defraud files, makes, or assists, solicits or conspires
with another to file or make an application for a premium reduction,
pursuant to subsection (a) of section two thousand three hundred
thirty-six of this chapter, containing any materially false information
or which, for the purpose of misleading, conceals information concerning
any fact material thereto.
(d) All applications for commercial insurance, individual, group or
blanket accident and health insurance and all claim forms, except as
provided for in subsection (e) of this section, shall contain a notice
in a form approved by the superintendent that clearly states in
substance the following:
"Any person who knowingly and with intent to defraud any insurance
company or other person files an application for insurance or statement
of claim containing any materially false information, or conceals for
the purpose of misleading, information concerning any fact material
thereto, commits a fraudulent insurance act, which is a crime, and shall
also be subject to a civil penalty not to exceed five thousand dollars
and the stated value of the claim for each such violation."
(e) All applications for automobile insurance and all claim forms
shall contain a notice, in a form approved by the superintendent, that
clearly states in substance the following:
"Any person who knowingly makes or knowingly assists, abets, solicits
or conspires with another to make a false report of the theft,
destruction, damage or conversion of any motor vehicle to a law
enforcement agency, the department of motor vehicles or an insurance
company, commits a fraudulent insurance act, which is a crime, and shall
also be subject to a civil penalty not to exceed five thousand dollars
and the value of the subject motor vehicle or stated claim for each
violation."
(f) In this article, "fraudulent life settlement act" means a fraud as
defined in section 176.40 of the penal law.
means insurance fraud as defined in section 176.05 of the penal law; and
the terms "personal insurance" and "commercial insurance" shall have the
same meaning ascribed to them by section 176.00 of such law.
(b) For the purpose of section one hundred nine of this chapter, it is
a violation of this chapter for any individual, firm, association or
corporation subject to the provisions of this chapter to commit a
fraudulent insurance act or a fraudulent life settlement act.
(c) In addition to any criminal liability arising under the provisions
of this section, the superintendent shall be empowered to levy a civil
penalty not exceeding five thousand dollars and the amount of the claim
for each violation upon any person, including those persons and their
employees licensed pursuant to this chapter, who is found to have: (i)
committed a fraudulent insurance act, fraudulent life settlement act or
otherwise violates the provisions of this section; or (ii) knowingly and
with intent to defraud files, makes, or assists, solicits or conspires
with another to file or make an application for a premium reduction,
pursuant to subsection (a) of section two thousand three hundred
thirty-six of this chapter, containing any materially false information
or which, for the purpose of misleading, conceals information concerning
any fact material thereto.
(d) All applications for commercial insurance, individual, group or
blanket accident and health insurance and all claim forms, except as
provided for in subsection (e) of this section, shall contain a notice
in a form approved by the superintendent that clearly states in
substance the following:
"Any person who knowingly and with intent to defraud any insurance
company or other person files an application for insurance or statement
of claim containing any materially false information, or conceals for
the purpose of misleading, information concerning any fact material
thereto, commits a fraudulent insurance act, which is a crime, and shall
also be subject to a civil penalty not to exceed five thousand dollars
and the stated value of the claim for each such violation."
(e) All applications for automobile insurance and all claim forms
shall contain a notice, in a form approved by the superintendent, that
clearly states in substance the following:
"Any person who knowingly makes or knowingly assists, abets, solicits
or conspires with another to make a false report of the theft,
destruction, damage or conversion of any motor vehicle to a law
enforcement agency, the department of motor vehicles or an insurance
company, commits a fraudulent insurance act, which is a crime, and shall
also be subject to a civil penalty not to exceed five thousand dollars
and the value of the subject motor vehicle or stated claim for each
violation."
(f) In this article, "fraudulent life settlement act" means a fraud as
defined in section 176.40 of the penal law.