COMMITTEE SUBSTITUTE

FOR

Senate Bill No. 167

(By Senators Wiedebusch and Kimble)

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[Originating in the Committee on the Judiciary;

reported March 2, 1995.]

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A BILL to amend article three, chapter sixty-one of the code of West Virginia, one thousand nine hundred thirty-one, as amended, by adding thereto a new section, designated section twenty-four-e, relating to insurance fraud; creating felony offenses for the filing of fraudulent insurance forms and other such documents; establishing penalties; and creating exceptions and immunities.

Be it enacted by the Legislature of West Virginia:
That article three, chapter sixty-one of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended by adding thereto a new section, designated section twenty-four-e, to read as follows:
ARTICLE 3. CRIMES AGAINST PROPERTY.
ยง61-3-24e. Fraudulent acts involving insurance; penalties; exceptions.

(a) Any person who, with the intent to defraud any insurer, presents or causes to be presented to any insurer or insurance representative, any written statement as part of or in support of a claim for payment or other benefit pursuant to an insurance policy, knowing that such statement contains materially false information, is guilty of a felony if the amount of the claim exceeds one thousand dollars, and, upon conviction thereof, such person shall be fined not more than five thousand dollars, or confined in the penitentiary not less than one, nor more than five years, or both.
(b) Any insurer or an agent of an insurer who submits or causes to be submitted to any person or entity, with intent to defraud, any written statement as part of or in support of any application, claim, audit, report, valuation, statement, appraisal, estimation of loss, publication, certificate, actuarial report or study, filing, financial statement, tax return, rate request, petition or any other such document knowing that such statement contains any materially false information concerning any fact or issue relating thereto, 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: Provided, That the commissioner shall, after notice and hearing, refuse to renew or revoke or suspend the license of any insurer convicted of a violation of this subsection as provided by article three, chapter thirty-three of this code.
(c) The provisions of this section are not applicable to an accused in any criminal case who, under the provisions of article three, section five of the Constitution of the state of West Virginia, could not be compelled to be a witness against himself, unless such accused shall have voluntarily and intelligently waived the right to remain silent prior to making or giving such statement or representation.
(d) The provisions of this section are not applicable to a person in the relation of husband and wife, parent or grandparent, child or grandchild, brother or sister, by consanguinity or affinity, of an accused in any criminal case, when such person, after the commission of an offense shall aid or assist the accused to avoid or escape from prosecution or punishment.