2006 Louisiana Laws - RS 22:1242 — Definitions

§1242.  Definitions

As used in this Part the following terms shall have the meanings indicated herein:

(1)  "Fraudulent insurance act" shall include but not be limited to acts or omissions committed by any person who, knowingly and with intent to defraud:

(a)  Presents, causes to be presented, or prepares with knowledge or belief that it will be presented to or by an insurer, reinsurer, purported insurer or reinsurer, broker, or any agent thereof, any oral or written statement which he knows to contain materially false information as part of, or in support of, or denial of, or concerning any fact material to or conceals any information concerning any fact material to the following:

(i)  An application for the issuance of any insurance policy.

(ii)  The rating of any insurance policy.

(iii)  A claim for payment or benefit pursuant to any insurance policy.

(iv)  Premiums paid on any insurance policy.

(v)  Payments made in accordance with the terms of any insurance policy.

(vi)  An application for certificate of authority or the application for a certificate of authority by a health insurer that has ceased writing health and accident insurance in the state within the prior five years.

(vii)  The financial condition of any insurer, reinsurer, purported insurer or reinsurer.

(viii)  The acquisition of any insurer or reinsurer.

(b)  Solicits or accepts new or renewal insurance risks by or for an insolvent insurer, reinsurer, or other entity regulated under the insurance laws of this state.

(c)  Removes or attempts to remove the assets or record of assets, transactions, and affairs of such material part thereof, from the home office or other place of business of the insurer, reinsurer, or other entity regulated under the insurance laws of this state, or from the place of safekeeping of the insurer, reinsurer, or other entity regulated under the laws of this state, or who conceals or attempts to conceal the same from the department.

(d)  Diverts, attempts to divert, or conspires to divert funds of an insurer, reinsurer, or other entity regulated under the laws of this state, or other persons in connection with:

(i)  The transaction of insurance or reinsurance.

(ii)  The conduct of business activities by an insurer, reinsurer, or other entity regulated by the insurance laws of this state.

(iii)  The formation, acquisition, or dissolution of an insurer, reinsurer, or other entity regulated under the insurance laws of this state.

(e)  Supplies false or fraudulent material information pertaining to any document or statement required by the Department of Insurance.

(f)  Commits any fraudulent viatical settlement act, as defined by R.S. 22:191.

(g)  Solicits or accepts new or renewal insurance risks by or for an unauthorized insurer, except as provided by Part XXVII of this Chapter.

(2)  "Statement" includes but is not limited to any notice, statement, proof of loss, bill of lading, receipt for payment, invoice, account, estimate of property damages, bill for services, diagnosis, prescription, hospital or doctor records, test results, x-rays, or other evidence of loss, injury, or expense.

Acts 1992, No. 707, §2; Acts 1993, No. 663, §2, eff. June 16, 1993; Acts 2004, No. 498, §1.