2016 Tennessee Code
Title 56 - Insurance
Chapter 47 - Workers' Compensation Fraud Act
§ 56-47-104. Unlawful insurance acts.

(a) Any person who commits, or participates in, or permits its employees or its agents to commit any of the following acts with an intent to induce reliance, has committed an unlawful insurance act:

(1) Presents, causes to be presented or prepares with knowledge or belief that it will be presented, by or on behalf of an insured, insurer, claimant or applicant to an insurer or insurance professional in connection with an insurance transaction, any information that the person knows to contain false representations, or representations, the falsity of which the person has recklessly disregarded, as to any material fact, or that withholds or conceals a material fact, concerning any of the following:

(i) The application for, rating of or renewal of, any insurance policy;

(ii) A claim for payment or benefit pursuant to any insurance policy; or

(iii) Payments made in accordance with the terms of any insurance policy;

(2) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented, to or by an insurer, insurance professional in connection with an insurance transaction, any information that the person knows to contain false representations, or representations, the falsity of which the person has recklessly disregarded, as to any material fact, or that withholds or conceals a material fact, concerning any of the following:

(i) The solicitation for sale of any insurance policy or purported insurance policy;

(ii) An application for certificate of authority; or

(iii) The financial condition of any insurer;

(3) Solicits or accepts new or renewal insurance risks by or for an insurer that the person knows was insolvent or the insolvency of which the person recklessly disregards;

(4) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented, by or on behalf of an insured or insurer, or insurance professional or any other person to a claimant in connection with an insurance transaction, any information that the person knows to contain false representations, or representations, the falsity of which the person has recklessly disregarded, as to any material fact, or that withholds or conceals a material fact, concerning any of the following:

(i) A claim for payment for benefit pursuant to any insurance policy; or

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

(b) It is unlawful for any person to commit, or to attempt to commit, or to aid, assist, abet or solicit another to commit, or to conspire to commit an unlawful insurance act.

(c) A practitioner violates this section only if the practitioner has been engaged in conduct that constitutes a pattern or practice of violation of this section.