26.1-02.1 Insurance Fraud

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CHAPTER 26.1-02.1INSURANCE FRAUD26.1-02.1-01. Definitions. As used in this chapter:1."Business of insurance" means the writing of insurance or the reinsuring of risks by<br>an insurer, including acts necessary or incidental to writing insurance or reinsuring<br>risks and the activities of persons who act as or who are officers, directors, agents,<br>or employees of insurers, or who are other persons authorized to act on their behalf.<br>The term does not include the activities of the North Dakota life and health insurance<br>guaranty association or the North Dakota insurance guaranty association.2."Financial loss" includes loss of earnings, out-of-pocket and other expenses, repair<br>and replacement costs, and claims payments.3."Fraudulent insurance act" includes the following acts or omissions committed by a<br>person knowingly and with intent to defraud:a.Presenting, causing to be presented, or preparing with knowledge or belief that<br>it will be presented to or by an insurer, reinsurer, insurance producer, or any<br>agent thereof, false or misleading information as part of, in support of, or<br>concerning a fact material to one or more of the following:(1)An application for the issuance or renewal of an insurance policy or<br>reinsurance contract;(2)The rating of an insurance policy or reinsurance contract;(3)A claim for payment or benefit pursuant to an insurance policy or<br>reinsurance contract;(4)Premiums paid on an insurance policy or reinsurance contract;(5)Payments made in accordance with the terms of an insurance policy or<br>reinsurance contract;(6)A document filed with the commissioner or the chief insurance regulatory<br>official of another jurisdiction;(7)The financial condition of an insurer or reinsurer;(8)The formation, acquisition, merger, reconsolidation, dissolution, or<br>withdrawal from one or more lines of insurance or reinsurance in all or<br>part of this state by an insurer or reinsurer;(9)The issuance of written evidence of insurance;(10)The reinstatement of an insurance policy; or(11)The formation of an agency, brokerage, or insurance producer contract.b.Solicitation or acceptance of new or renewal insurance risks on behalf of an<br>insurer, reinsurer, or other person engaged in the business of insurance by a<br>person who knows or should know that the insurer or other person responsible<br>for the risk is insolvent at the time of the transaction.c.Removal, concealment, alteration, or destruction of the assets or records of an<br>insurer, reinsurer, or other person engaged in the business of insurance.Page No. 1d.Theft by deception or otherwise, or embezzlement, abstracting, purloining, or<br>conversion of moneys, funds, premiums, credits, or other property of an<br>insurer, reinsurer, or person engaged in the business of insurance.e.Attempting to commit, aiding or abetting in the commission of, or conspiring to<br>commit the acts or omissions specified in this section.4."Insurance" means a contract or arrangement in which one undertakes to pay or<br>indemnify another as to loss from certain contingencies called "risks", including<br>through reinsurance; pay or grant a specified amount or determinable benefit to<br>another in connection with ascertainable risk contingencies; pay an annuity to<br>another; or act as surety. The term does not include a debt cancellation contract<br>between a bank and debtor, between a credit union and debtor, or between a<br>savings association and debtor and does not include a debt suspension contract<br>between a bank and debtor, between a credit union and debtor, or between a<br>savings association and debtor.5."Insurer" means a person entering into arrangements or contracts of insurance or<br>reinsurance and who agrees to perform any of the acts set forth in subsection 4,<br>whether the person has or is required to have a certificate of authority or denies<br>being an insurer.The term does not include the North Dakota life and healthinsurance guaranty association, the risk management fund, a bank, credit union, or<br>savings association as a party to a debt cancellation contract or debt suspension<br>contract, or the North Dakota insurance guaranty association.6."Person" means an individual, corporation, partnership, association, joint stock<br>company, trust, unincorporated organization, or any similar entity or any combination<br>of the foregoing.7."Policy" means an individual or group policy, group certificate, contract, or<br>arrangement of insurance or reinsurance affecting the rights of a resident of this<br>state or bearing a reasonable relation to this state, regardless of whether delivered<br>or issued for delivery in this state.8."Practitioner" means a licensee of this state authorized to practice medicine and<br>surgery, psychology, chiropractic, or law or any other licensee of the state whose<br>services are compensated, directly or indirectly, by insurance proceeds, or a<br>licensee similarly licensed in other states and nations or the practitioner of any<br>nonmedical treatment rendered in accordance with a recognized religious method of<br>healing.9."Reinsurance" means a contract, binder of coverage including placement slip, or<br>arrangement under which an insurer procures insurance for itself in another insurer<br>as to all or part of an insurance risk of the originating insurer.26.1-02.1-02. Insurance fraud. 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height:815px; text-align:center;\"\u003eLoading PDF...\u003c/div\u003e\u003cscript type=\"text/javascript\"\u003e var pdf_url = 'https://law.justia.com/codes/north-dakota/2009/t261/pdf/t261c021.pdf'; $(document).ready(function() { var embedwindow = $(\"#embed_document\"); if ($.browser.msie){ embedwindow.html('\u003cembed src=\"'+pdf_url+'\" width=\"100%\" height=\"100%\"\u003e\u003c/embed\u003e'); } else { embedwindow.html('\u003ciframe style=\"width:100%; height:100%;\" src=\"https://docs.google.com/gview?url='+window.escape(pdf_url)+'\u0026embedded=true\" frameborder=\"0\"\u003e\u003c/iframe\u003e'); } });\u003c/script\u003e\u003cbr\u003e\u003cbr\u003e\u003cnoframes\u003eCHAPTER 26.1-02.1INSURANCE FRAUD26.1-02.1-01. Definitions. As used in this chapter:1.\u0026quot;Business of insurance\u0026quot; means the writing of insurance or the reinsuring of risks by\u003cbr\u003ean insurer, including acts necessary or incidental to writing insurance or reinsuring\u003cbr\u003erisks and the activities of persons who act as or who are officers, directors, agents,\u003cbr\u003eor employees of insurers, or who are other persons authorized to act on their behalf.\u003cbr\u003eThe term does not include the activities of the North Dakota life and health insurance\u003cbr\u003eguaranty association or the North Dakota insurance guaranty association.2.\u0026quot;Financial loss\u0026quot; includes loss of earnings, out-of-pocket and other expenses, repair\u003cbr\u003eand replacement costs, and claims payments.3.\u0026quot;Fraudulent insurance act\u0026quot; includes the following acts or omissions committed by a\u003cbr\u003eperson knowingly and with intent to defraud:a.Presenting, causing to be presented, or preparing with knowledge or belief that\u003cbr\u003eit will be presented to or by an insurer, reinsurer, insurance producer, or any\u003cbr\u003eagent thereof, false or misleading information as part of, in support of, or\u003cbr\u003econcerning a fact material to one or more of the following:(1)An application for the issuance or renewal of an insurance policy or\u003cbr\u003ereinsurance contract;(2)The rating of an insurance policy or reinsurance contract;(3)A claim for payment or benefit pursuant to an insurance policy or\u003cbr\u003ereinsurance contract;(4)Premiums paid on an insurance policy or reinsurance contract;(5)Payments made in accordance with the terms of an insurance policy or\u003cbr\u003ereinsurance contract;(6)A document filed with the commissioner or the chief insurance regulatory\u003cbr\u003eofficial of another jurisdiction;(7)The financial condition of an insurer or reinsurer;(8)The formation, acquisition, merger, reconsolidation, dissolution, or\u003cbr\u003ewithdrawal from one or more lines of insurance or reinsurance in all or\u003cbr\u003epart of this state by an insurer or reinsurer;(9)The issuance of written evidence of insurance;(10)The reinstatement of an insurance policy; or(11)The formation of an agency, brokerage, or insurance producer contract.b.Solicitation or acceptance of new or renewal insurance risks on behalf of an\u003cbr\u003einsurer, reinsurer, or other person engaged in the business of insurance by a\u003cbr\u003eperson who knows or should know that the insurer or other person responsible\u003cbr\u003efor the risk is insolvent at the time of the transaction.c.Removal, concealment, alteration, or destruction of the assets or records of an\u003cbr\u003einsurer, reinsurer, or other person engaged in the business of insurance.Page No. 1d.Theft by deception or otherwise, or embezzlement, abstracting, purloining, or\u003cbr\u003econversion of moneys, funds, premiums, credits, or other property of an\u003cbr\u003einsurer, reinsurer, or person engaged in the business of insurance.e.Attempting to commit, aiding or abetting in the commission of, or conspiring to\u003cbr\u003ecommit the acts or omissions specified in this section.4.\u0026quot;Insurance\u0026quot; means a contract or arrangement in which one undertakes to pay or\u003cbr\u003eindemnify another as to loss from certain contingencies called \u0026quot;risks\u0026quot;, including\u003cbr\u003ethrough reinsurance; pay or grant a specified amount or determinable benefit to\u003cbr\u003eanother in connection with ascertainable risk contingencies; pay an annuity to\u003cbr\u003eanother; or act as surety. The term does not include a debt cancellation contract\u003cbr\u003ebetween a bank and debtor, between a credit union and debtor, or between a\u003cbr\u003esavings association and debtor and does not include a debt suspension contract\u003cbr\u003ebetween a bank and debtor, between a credit union and debtor, or between a\u003cbr\u003esavings association and debtor.5.\u0026quot;Insurer\u0026quot; means a person entering into arrangements or contracts of insurance or\u003cbr\u003ereinsurance and who agrees to perform any of the acts set forth in subsection 4,\u003cbr\u003ewhether the person has or is required to have a certificate of authority or denies\u003cbr\u003ebeing an insurer.The term does not include the North Dakota life and healthinsurance guaranty association, the risk management fund, a bank, credit union, or\u003cbr\u003esavings association as a party to a debt cancellation contract or debt suspension\u003cbr\u003econtract, or the North Dakota insurance guaranty association.6.\u0026quot;Person\u0026quot; means an individual, corporation, partnership, association, joint stock\u003cbr\u003ecompany, trust, unincorporated organization, or any similar entity or any combination\u003cbr\u003eof the foregoing.7.\u0026quot;Policy\u0026quot; means an individual or group policy, group certificate, contract, or\u003cbr\u003earrangement of insurance or reinsurance affecting the rights of a resident of this\u003cbr\u003estate or bearing a reasonable relation to this state, regardless of whether delivered\u003cbr\u003eor issued for delivery in this state.8.\u0026quot;Practitioner\u0026quot; means a licensee of this state authorized to practice medicine and\u003cbr\u003esurgery, psychology, chiropractic, or law or any other licensee of the state whose\u003cbr\u003eservices are compensated, directly or indirectly, by insurance proceeds, or a\u003cbr\u003elicensee similarly licensed in other states and nations or the practitioner of any\u003cbr\u003enonmedical treatment rendered in accordance with a recognized religious method of\u003cbr\u003ehealing.9.\u0026quot;Reinsurance\u0026quot; means a contract, binder of coverage including placement slip, or\u003cbr\u003earrangement under which an insurer procures insurance for itself in another insurer\u003cbr\u003eas to all or part of an insurance risk of the originating insurer.26.1-02.1-02. Insurance fraud. Repealed by S.L. 2003, ch. 235,"])</script><script>self.__next_f.push([1,"3c:[\"$\",\"article\",null,{\"className\":\"article-content\",\"children\":[[\"$\",\"header\",null,{\"className\":\"article-header\",\"children\":[[\"$\",\"$Le\",null,{\"href\":\"/north-dakota/\",\"className\":\"article-category\",\"children\":[\"North Dakota\",\" Statutes\"]}],[\"$\",\"h1\",null,{\"className\":\"article-title\",\"children\":\"26.1-02.1 Insurance Fraud\"}]]}],[\"$\",\"div\",null,{\"className\":\"article-body statute-content\",\"dangerouslySetInnerHTML\":{\"__html\":\"$3e\"}}],false]}]\n"])</script><script>self.__next_f.push([1,"3d:[\"$\",\"aside\",null,{\"className\":\"right-sidebar\",\"children\":[\"$\",\"div\",null,{\"className\":\"related-sidebar\",\"children\":[[\"$\",\"h3\",null,{\"children\":[[\"$\",\"span\",null,{\"className\":\"emoji\",\"children\":\"⚖️\"}],\" State 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