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Submitted by to the category Other Topics on 12/09/2012 02:28 PM

INSURANCE FRAUD IN THE FIFTH DEGREE

(A Misdemeanor)

PENAL LAW §176.10

(Committed on or after Nov. 1, 1998

for Commercial/Personal Insurance Policy)

(Committed on or after July 20, 2011

for Health Insurance Policy)1

The _______ count is Insurance Fraud in the Fifth Degree.

Under our law, a person is guilty of Insurance Fraud in the

Fifth Degree when he or she commits a fraudulent insurance act.

The term “fraudulent insurance act”2 has its own special

meaning in our law. I will now give you the meaning of that term.

A FRAUDULENT INSURANCE ACT is committed by any

person who, knowingly and with intent to defraud, presents,

causes to be presented, or prepares with knowledge or belief that

it will be presented, to or by:

Select appropriate alternative(s):

an insurer,

self insurer, [or]

purported insurer, [or]

purported self insurer, [or]

any agent thereof,

Select if commercial/personal insurance policy is alleged:

1

Effective July 20, 2011, Penal Law § 176.05, which defines insurance fraud

was amended. L 2011, ch 211. The amendment was made to comply with

the dictates of People v. Boothe, 16 NY3d 195 (2011). It changed the

definition of “fraudulent insurance act” to include the separate definition of

“fraudulent health care insurance act.”

2

See footnote 1.

any written statement as part of, or in support of,

Select appropriate alternative(s):

an application for the issuance of, or the rating of, a

commercial insurance policy, [or]

a certificate or evidence of self insurance for

commercial insurance or commercial self insurance,

[or]

a claim for payment or other benefit pursuant to an

insurance policy or self insurance program for

commercial or personal insurance3

Select if health insurance policy is alleged:

any written statement or other physical evidence as part of,

or in support of,

Select appropriate alternative(s):

an application for the issuance of a health insurance

3

Penal Law § 176.05 (1).

2

policy,4 [or]

a policy or contract or other authorization...

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