[§431:10A-131] 
Insurance fraud; penalties.  (a)  A person commits the offense of insurance
fraud if the person acts or omits to act with intent to obtain benefits or
recovery or compensation for services provided, or provides legal assistance or
counsel with intent to obtain benefits or recovery, through the following
means:



(1)  Knowingly presenting, or causing or permitting to
be presented, with the intent to defraud, any false information on a claim;



(2)  Knowingly presenting, or causing or permitting to
be presented, any false claim for the payment of a loss;



(3)  Knowingly presenting, or causing or permitting to
be presented, multiple claims for the same loss or injury, including presenting
multiple claims to more than one insurer, except when these multiple claims are
appropriate;



(4)  Knowingly making, or causing or permitting to be
made, any false claim for payment of a health care benefit;



(5)  Knowingly submitting, or causing or permitting to
be submitted, a claim for a health care benefit that was not used by, or
provided on behalf of, the claimant;



(6)  Knowingly presenting, or causing or permitting to
be presented, multiple claims for payment of the same health care benefit
except when these multiple claims are appropriate;



(7)  Knowingly presenting, or causing or permitting to
be presented, for payment any undercharges for benefits on behalf of a specific
claimant unless any known overcharges for benefits under this article for that
claimant are presented for reconciliation at the same time;



(8)  Aiding, or agreeing or attempting to aid,
soliciting, or conspiring with any person who engages in an unlawful act as
defined under this section; or



(9)  Knowingly making, or causing or permitting to be
made, any false statements or claims by, or on behalf of, any person or persons
during an official proceeding as defined by section 710-1000.



(b)  Violation of subsection (a) is a criminal
offense and shall constitute a:



(1)  Class B felony if the value of the benefits,
recovery, or compensation obtained or attempted to be obtained is more than
$20,000;



(2)  Class C felony if the value of the benefits,
recovery, or compensation obtained or attempted to be obtained is more than
$300; or



(3)  Misdemeanor if the value of the benefits,
recovery, or compensation obtained or attempted to be obtained is $300 or less.



(c)  Where the ability to make restitution can
be demonstrated, any person convicted under this section shall be ordered by a
court to make restitution to an insurer or any other person for any financial
loss sustained by the insurer or other person caused by the act or acts for
which the person was convicted.



(d)  A person, if acting without malice, shall
not be subject to civil liability for providing information, including filing a
report, furnishing oral or written evidence, providing documents, or giving
testimony concerning suspected, anticipated, or completed public or private
insurance fraud to a court, the commissioner, the insurance fraud
investigations unit, the National Association of Insurance Commissioners, any
federal, state, or county law enforcement or regulatory agency, or another
insurer if the information is provided only for the purpose of preventing,
investigating, or prosecuting insurance fraud, except if the person commits perjury.



(e)  This section shall not supersede any other
law relating to theft, fraud, or deception.  Insurance fraud may be prosecuted
under this section, or any other applicable section, and may be enjoined by a
court of competent jurisdiction.



(f)  An insurer shall have a civil cause of
action to recover payments or benefits from any person who has intentionally
obtained payments or benefits in violation of this section; provided that no
recovery shall be allowed if the person has made restitution under subsection
(c). [L 2003, c 125, §2]