H. B. 2650


(By Delegates H. White, Phillips, L. White, Fealy,
Johnson, P. White and Hendricks)

[Introduced March 19, 1993; referred to the
Committee on Banking and Insurance.]



A BILL to amend chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, by adding thereto a new article, designated article twelve- c, relating to establishing the West Virginia Insurance Fraud Act; criminal penalties.

 Be it enacted by the Legislature of West Virginia:
That chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended by adding thereto a new article, designated article twelve-c, to read as follows:
ARTICLE 12C. WEST VIRGINIA INSURANCE FRAUD ACT.

§33-12C-1. Short title.

This article may be known and cited as the "West Virginia Insurance Fraud Act."
§33-12C-2. Definitions.

For the purposes of this section, "statement" includes, but is not limited to, a police report, notice or proof of loss,assignment of title, bill of sale, release of lien, bill of lading, receipt for payment, invoice, account, estimate of property damages, bill for services, diagnosis, prescriptions, hospital or doctor records, X rays, test results or other evidence of loss, injury, expense, condition or title.
§33-12C-3. Penalties.

Any person who, with the intent to injure, defraud or deceive any insurer:
(1) Presents or causes to be presented to any insurer, any written or oral statement including computer-generated documents as part of, or in support of, a claim for payment or other benefit pursuant to an insurance policy, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim; or
(2) Assists, abets, solicits or conspires with another to prepare or make any written or oral statement that is intended to be presented to any insurer in connection with, or in support of, any claim for payment or other benefit pursuant to an insurance policy, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim; is guilty of a felony, and, upon conviction thereof, shall be fined not more than five thousand dollars, or confined in the penitentiary not less than one year nor more than five years or both fined and imprisoned.
§33-12C-4. Claims form notice.

All claims forms submitted to the claimant or insured shall contain a statement that clearly states in substance the following: "Any person who knowingly, and with intent to injure, defraud, or deceive any insurer, files a statement of claim containing any false, incomplete or misleading information is guilty of a felony." The lack of such a statement shall not constitute a defense against prosecution under this section.



NOTE: The purpose of this bill is to establish the West Virginia Insurance Fraud Act. This bill provides for penalties for persons who present, or aid and abet another who presents a fraudulent claim to an insurer. The bill further provides that the claim form submitted to the insured contain language putting the insured on notice that the furnishing of information with intent to defraud an insurer is a felony.

This article is new; therefore, strike-throughs and underscoring have been omitted.