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First Substitute H.B. 126
This document includes House Committee Amendments incorporated into the bill on Thu, Feb 8, 2007 at 4:58 PM by jeyring. -->
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8 LONG TITLE
9 General Description:
10 This bill modifies the Insurance Code to address reporting of fraudulent insurance acts.
11 Highlighted Provisions:
12 This bill:
13 . expands required reporting of fraudulent insurance acts;
14 . modifies the requirements of that report;
15 . modifies penalties; and
16 . makes technical changes.
17 Monies Appropriated in this Bill:
18 None
19 Other Special Clauses:
20 None
21 Utah Code Sections Affected:
22 AMENDS:
23 31A-31-105, as enacted by Chapter 243, Laws of Utah 1994
24 31A-31-110, as enacted by Chapter 104, Laws of Utah 2004
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26 Be it enacted by the Legislature of the state of Utah:
27 Section 1. Section 31A-31-105 is amended to read:
28 31A-31-105. Immunity.
29 (1) (a) A person, insurer, or authorized agency is immune from civil action, civil
30 penalty, or damages when in good faith that person, insurer, or authorized agency:
31 (i) cooperates with[
32 (ii) furnishes evidence[
33 (iii) provides [
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35 (iv) receives information regarding suspected insurance fraud from an agency
36 described in Subsection (1)(b); or
37 (v) submits a required report to the department under Section31A-31-110.
38 (b) The agency referred to in Subsection (1)(a) is one or more of the following:
39 [
40 [
41 insurance fraud; or
42 [
43 Subsection [
44 (2) A person, insurer, or authorized agency is immune from civil action, civil penalty,
45 or damages if that person, insurer, or authorized agency complies in good faith with a court
46 order to provide evidence or testimony requested by the entities described in [
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48 (3) This section does not abrogate or modify common law or statutory rights,
49 privileges, or immunities enjoyed by any person or entity.
50 (4) Notwithstanding any other provision in this section, a person, insurer, or service
51 provider is not immune from civil action, civil penalty or damages under this section if that
52 person commits the fraudulent insurance act that is the subject of the information.
53 Section 2. Section 31A-31-110 is amended to read:
54 31A-31-110. Mandatory reporting of fraudulent insurance acts.
55 [
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57 (1) (a) A person shall report a fraudulent insurance act to the department if:
58 (i) the person has a good faith belief on the basis of a preponderance of the evidence
59 that H. [
59a [
60
60a
61 and
62 (ii) the person is:
63 H. [
64 (B) a producer;
65 (C) a limited line producer;
66 (D) a customer service representative;
67 (E) a consultant;
68 (F) a managing general agent;
69 (G) an insurance adjuster;
70 H. [
70a employed by a title
71 insurer.
72 (b) The written report required by this Subsection (1) shall:
73 (i) provide information in detail relating to:
74 [
75 [
76 (ii) (A) state whether the person required to report under Subsection (1)(a) also
77 reported the fraudulent insurance act in writing to:
78 (I) the attorney general;
79 (II) any state law enforcement agency;
80 (III) any criminal investigative department or agency of the United States;
81 (IV) a district attorney; or
82 (V) the prosecuting attorney of any municipality or county; and
83 (B) if the person reported the fraudulent insurance act as provided in Subsection
84 (1)(b)(ii)(A), to which entity the person reported the fraudulent insurance act.
85 (c) The written report required by this Subsection (1) shall be reported to the
86 department by no later than 90 days from the day on which the person required to report the
87 fraudulent insurance act has a good faith belief on the basis of a preponderance of the evidence
88 that the act that is being, will be, or has been committed is a fraudulent insurance act.
89 [
90
91 [
92 within four years from the date on which [
93 described in Subsection (1):
94 [
95 (a) has a good faith belief on the basis of a preponderance of the evidence that an act
96 described in Subsection (1)(a) is a fraudulent insurance act; and
97 [
98 (3) The department H. [
98a Chapter 46a, Utah
99 Administrative Rulemaking Act, provide a process by which H. [
100 described in Subsection (1)(a)(ii) may comply with Subsection (1) by submitting a single report
101 of an act described in Subsection (1)(a).
101a with the requirements of Subsection (1) by reporting a fraudulent insurance act to the insurer
101b with whom the person is employed, except that the rule shall provide that if the person reports
101c the fraudulent insurance act to the insurer, the insurer is required to report the fraudulent
101d insurance act to the department. .H
102 (4) A person described in Subsection (1)(a)(ii) who in good faith makes a report under
103 this section is immune from civil action, civil penalty, or damages for making that report in
104 accordance with Section 31A-31-105 .
104a H. (5) This section does not apply to a fraudulent insurance act related to health
104b insurance. .H
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