40-2,118.Fraudulent insurance act defined;penalty; notification of commissioner, when; antifraud plan.(a) For purposes of this act a "fraudulent insurance act" meansan act committed by any person who, knowingly and with intent to defraud,presents, causes to be presented or prepares with knowledge or belief thatit will be presented to or by an insurer, purported insurer, broker or anyagent thereof, any written statement as part of, or in support of, anapplication for the issuance of, or the rating of an insurance policy forpersonal or commercial insurance, or a claim for payment or other benefitpursuant to an insurance policy for commercial or personal insurance whichsuch person knows to contain materially false information concerning anyfact material thereto; or conceals, for the purpose of misleading,information concerning any fact material thereto.
(b) An insurer that has knowledge or a good faith belief that afraudulent insurance act is being or has been committed shallprovide to the commissioner, on a form prescribed by thecommissioner, any and all information and such additionalinformation relating to such fraudulent insurance act as the commissioner mayrequire.
(c) Any other person that has knowledge or a good faith belief thata fraudulent insurance act is being or has been committed mayprovide to the commissioner, on a form prescribed by thecommissioner, any and all information and such additionalinformation relating to such fraudulent insurance act as the commissioner mayrequest.
(d) (1) Each insurer shall have antifraud initiatives reasonablycalculated to detect fraudulent insurance acts. Antifraud initiativesmay include: fraud investigators, who may be insurer employees orindependent contractors; or an antifraud plan submitted to thecommissioner no later than July 1, 2007. Each insurer that submitsan antifraud plan shall notify the commissioner of any materialchange in the information contained in the antifraud plan within 30days after such change occurs. Such insurer shall submit to thecommissioner in writing the amended antifraud plan.
The requirement for submitting anyantifraud plan, or any amendment thereof, to the commissioner shall expire onthe date specified in paragraph (2) of this subsection unless the legislaturereviews and reenacts the provisions of paragraph (2) pursuant to K.S.A. 45-229and amendments thereto.
(2) Any antifraud plan, or any amendment thereof,submitted to the commissionerfor informational purposes only shall beconfidential and not be a public record and shall notbe subject to discovery or subpoena in a civil actionunless following an in camera review, the court determines that the antifraudplan is relevant and otherwise admissible under the rules of evidence setforth in article 4, chapter 60 of the Kansas Statutes Annotated, and amendmentsthereto. The provisions of this paragraph shall expire on July 1, 2011, unlessthe legislature reviews and reenacts this provision pursuant toK.S.A. 45-229, and amendments thereto, prior to July 1, 2011.
(e) Except as otherwise specifically provided in K.S.A. 21-3718 andamendments thereto and K.S.A. 44-5,125 and amendments thereto, a fraudulentinsurance act shall constitute a severity level 6, nonperson felony if theamount involved is $25,000 or more; a severity level 7, nonperson felony if theamount is at least $5,000 but less than $25,000; a severity level 8, nonpersonfelony if the amount is at least $1,000 but less than $5,000; and a class Cnonperson misdemeanor if the amount is less than$1,000.Any combination of fraudulent acts as defined in subsection (a) which occurin a period of six consecutive months which involves$25,000 or more shall have a presumptive sentence of imprisonment regardless ofits location on the sentencing grid block.
(f) In addition to any other penalty, a person who violates this statuteshall be ordered to make restitution to the insurer or any other person orentity for any financial loss sustained as a result of such violation. Aninsurer shall not be required to provide coverage or pay any claim involving afraudulent insurance act.
(g) This act shall apply to all insurance applications, ratings, claims andother benefits made pursuant to any insurance policy.
40-2,118.Fraudulent insurance act defined;penalty; notification of commissioner, when; antifraud plan.(a) For purposes of this act a "fraudulent insurance act" meansan act committed by any person who, knowingly and with intent to defraud,presents, causes to be presented or prepares with knowledge or belief thatit will be presented to or by an insurer, purported insurer, broker or anyagent thereof, any written statement as part of, or in support of, anapplication for the issuance of, or the rating of an insurance policy forpersonal or commercial insurance, or a claim for payment or other benefitpursuant to an insurance policy for commercial or personal insurance whichsuch person knows to contain materially false information concerning anyfact material thereto; or conceals, for the purpose of misleading,information concerning any fact material thereto.
(b) An insurer that has knowledge or a good faith belief that afraudulent insurance act is being or has been committed shallprovide to the commissioner, on a form prescribed by thecommissioner, any and all information and such additionalinformation relating to such fraudulent insurance act as the commissioner mayrequire.
(c) Any other person that has knowledge or a good faith belief thata fraudulent insurance act is being or has been committed mayprovide to the commissioner, on a form prescribed by thecommissioner, any and all information and such additionalinformation relating to such fraudulent insurance act as the commissioner mayrequest.
(d) (1) Each insurer shall have antifraud initiatives reasonablycalculated to detect fraudulent insurance acts. Antifraud initiativesmay include: fraud investigators, who may be insurer employees orindependent contractors; or an antifraud plan submitted to thecommissioner no later than July 1, 2007. Each insurer that submitsan antifraud plan shall notify the commissioner of any materialchange in the information contained in the antifraud plan within 30days after such change occurs. Such insurer shall submit to thecommissioner in writing the amended antifraud plan.
The requirement for submitting anyantifraud plan, or any amendment thereof, to the commissioner shall expire onthe date specified in paragraph (2) of this subsection unless the legislaturereviews and reenacts the provisions of paragraph (2) pursuant to K.S.A. 45-229and amendments thereto.
(2) Any antifraud plan, or any amendment thereof,submitted to the commissionerfor informational purposes only shall beconfidential and not be a public record and shall notbe subject to discovery or subpoena in a civil actionunless following an in camera review, the court determines that the antifraudplan is relevant and otherwise admissible under the rules of evidence setforth in article 4, chapter 60 of the Kansas Statutes Annotated, and amendmentsthereto. The provisions of this paragraph shall expire on July 1, 2011, unlessthe legislature reviews and reenacts this provision pursuant toK.S.A. 45-229, and amendments thereto, prior to July 1, 2011.
(e) Except as otherwise specifically provided in K.S.A. 21-3718 andamendments thereto and K.S.A. 44-5,125 and amendments thereto, a fraudulentinsurance act shall constitute a severity level 6, nonperson felony if theamount involved is $25,000 or more; a severity level 7, nonperson felony if theamount is at least $5,000 but less than $25,000; a severity level 8, nonpersonfelony if the amount is at least $1,000 but less than $5,000; and a class Cnonperson misdemeanor if the amount is less than$1,000.Any combination of fraudulent acts as defined in subsection (a) which occurin a period of six consecutive months which involves$25,000 or more shall have a presumptive sentence of imprisonment regardless ofits location on the sentencing grid block.
(f) In addition to any other penalty, a person who violates this statuteshall be ordered to make restitution to the insurer or any other person orentity for any financial loss sustained as a result of such violation. Aninsurer shall not be required to provide coverage or pay any claim involving afraudulent insurance act.
(g) This act shall apply to all insurance applications, ratings, claims andother benefits made pursuant to any insurance policy.
40-2,118.Fraudulent insurance act defined;penalty; notification of commissioner, when; antifraud plan.(a) For purposes of this act a "fraudulent insurance act" meansan act committed by any person who, knowingly and with intent to defraud,presents, causes to be presented or prepares with knowledge or belief thatit will be presented to or by an insurer, purported insurer, broker or anyagent thereof, any written statement as part of, or in support of, anapplication for the issuance of, or the rating of an insurance policy forpersonal or commercial insurance, or a claim for payment or other benefitpursuant to an insurance policy for commercial or personal insurance whichsuch person knows to contain materially false information concerning anyfact material thereto; or conceals, for the purpose of misleading,information concerning any fact material thereto.
(b) An insurer that has knowledge or a good faith belief that afraudulent insurance act is being or has been committed shallprovide to the commissioner, on a form prescribed by thecommissioner, any and all information and such additionalinformation relating to such fraudulent insurance act as the commissioner mayrequire.
(c) Any other person that has knowledge or a good faith belief thata fraudulent insurance act is being or has been committed mayprovide to the commissioner, on a form prescribed by thecommissioner, any and all information and such additionalinformation relating to such fraudulent insurance act as the commissioner mayrequest.
(d) (1) Each insurer shall have antifraud initiatives reasonablycalculated to detect fraudulent insurance acts. Antifraud initiativesmay include: fraud investigators, who may be insurer employees orindependent contractors; or an antifraud plan submitted to thecommissioner no later than July 1, 2007. Each insurer that submitsan antifraud plan shall notify the commissioner of any materialchange in the information contained in the antifraud plan within 30days after such change occurs. Such insurer shall submit to thecommissioner in writing the amended antifraud plan.
The requirement for submitting anyantifraud plan, or any amendment thereof, to the commissioner shall expire onthe date specified in paragraph (2) of this subsection unless the legislaturereviews and reenacts the provisions of paragraph (2) pursuant to K.S.A. 45-229and amendments thereto.
(2) Any antifraud plan, or any amendment thereof,submitted to the commissionerfor informational purposes only shall beconfidential and not be a public record and shall notbe subject to discovery or subpoena in a civil actionunless following an in camera review, the court determines that the antifraudplan is relevant and otherwise admissible under the rules of evidence setforth in article 4, chapter 60 of the Kansas Statutes Annotated, and amendmentsthereto. The provisions of this paragraph shall expire on July 1, 2011, unlessthe legislature reviews and reenacts this provision pursuant toK.S.A. 45-229, and amendments thereto, prior to July 1, 2011.
(e) Except as otherwise specifically provided in K.S.A. 21-3718 andamendments thereto and K.S.A. 44-5,125 and amendments thereto, a fraudulentinsurance act shall constitute a severity level 6, nonperson felony if theamount involved is $25,000 or more; a severity level 7, nonperson felony if theamount is at least $5,000 but less than $25,000; a severity level 8, nonpersonfelony if the amount is at least $1,000 but less than $5,000; and a class Cnonperson misdemeanor if the amount is less than$1,000.Any combination of fraudulent acts as defined in subsection (a) which occurin a period of six consecutive months which involves$25,000 or more shall have a presumptive sentence of imprisonment regardless ofits location on the sentencing grid block.
(f) In addition to any other penalty, a person who violates this statuteshall be ordered to make restitution to the insurer or any other person orentity for any financial loss sustained as a result of such violation. Aninsurer shall not be required to provide coverage or pay any claim involving afraudulent insurance act.
(g) This act shall apply to all insurance applications, ratings, claims andother benefits made pursuant to any insurance policy.
