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Article 176 - NY Penal Law

INSURANCE FRAUD
176.00 Insurance fraud; definition of terms.
176.05 Insurance fraud; defined.
176.10 Insurance fraud in the fifth degree. A MISD
176.15 Insurance fraud in the fourth degree. E FELONY
176.20 Insurance fraud in the third degree. D FELONY
176.25 Insurance fraud in the second degree. C FELONY
176.30 Insurance fraud in the first degree. B FELONY
176.35 Aggravated insurance fraud. D FELONY
176.40 Fraudulent life settlement act; defined.
176.45 Life settlement fraud in the fifth degree. A MISD
176.50 Life settlement fraud in the fourth degree. E FELONY
176.55 Life settlement fraud in the third degree. D FELONY
176.60 Life settlement fraud in the second degree. C FELONY
176.65 Life settlement fraud in the first degree. B FELONY
176.70 Aggravated life settlement fraud. D FELONY

S 176.00 Insurance fraud; definition of terms.
  The following definitions are applicable to this article:
  1. "Insurance policy" has the meaning assigned to insurance contract
by subsection (a) of section one thousand one hundred one of the
insurance law except it shall include reinsurance contracts, purported
insurance policies and purported reinsurance contracts.
  2. "Statement" includes, but is not limited to, any notice, proof of
loss, bill of lading, invoice, account, estimate of property damages,
bill for services, diagnosis, prescription, hospital or doctor records,
x-ray, test result, and other evidence of loss, injury or expense.
  3. "Person" includes any individual, firm, association or corporation.
  4. "Personal insurance" means a policy of insurance insuring a natural
person against any of the following contingencies:
  (a) loss of or damage to real property used predominantly for
residential purposes and which consists of not more than four dwelling
units, other than hotels, motels and rooming houses;
  (b) loss of or damage to personal property which is not used in the
conduct of a business;
  (c) losses or liabilities arising out of the ownership, operation, or
use of a motor vehicle, predominantly used for non-business purposes;
  (d) other liabilities for loss of, damage to, or injury to persons or
property, not arising from the conduct of a business;
  (e) death, including death by personal injury, or the continuation of
life, or personal injury by accident, or sickness, disease or ailment,
excluding insurance providing disability benefits pursuant to article
nine of the workers` compensation law.
  A policy of insurance which insures any of the contingencies listed in
paragraphs (a) through (e) of this subdivision as well as other
contingencies shall be personal insurance if that portion of the annual
premium attributable to the listed contingencies exceeds that portion
attributable to other contingencies.
  5. "Commercial insurance" means insurance other than personal
insurance, and shall also include insurance providing disability
benefits pursuant to article nine of the workers` compensation law,
insurance providing workers` compensation benefits pursuant to the
provisions of the workers` compensation law and any program of self
insurance providing similar benefits.

S 176.05 Insurance fraud; defined.
  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 an  insurer,
self  insurer,  or  purported insurer, or purported self insurer, or any
agent thereof:
  1. any written statement as part of, or in support of, an  application
for  the issuance of, or the rating of a commercial insurance policy, or
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 insurance that he or she knows to:
  (a) contain materially false information concerning any fact  material
thereto; or
  (b) conceal, for the purpose of misleading, information concerning any
fact material thereto; or
  2.  any written statement or other physical evidence as part of, or in
support of, an application  for  the  issuance  of  a  health  insurance
policy,  or a policy or contract or other authorization that provides or
allows coverage for, membership or enrollment in, or other services of a
public or private health plan, or a claim for payment, services or other
benefit pursuant to such policy, contract or plan that he or  she  knows
to:
  (a)  contain materially false information concerning any material fact
thereto; or
  (b) conceal, for the purpose of misleading, information concerning any
fact material thereto.
  Such policy or contract or plan or authorization  shall  include,  but
not  be  limited to, those issued or operating pursuant to any public or
governmentally-sponsored or supported plan for health care  coverage  or
services  or  those  otherwise issued or operated by entities authorized
pursuant to the public health law. For purposes of this  subdivision  an
"application  for  the  issuance of a health insurance policy" shall not
include (i) any application for a health insurance  policy  or  contract
approved  by  the  superintendent  of financial services pursuant to the
provisions of sections three thousand two hundred sixteen, four thousand
three hundred four, four  thousand  three  hundred  twenty-one  or  four
thousand  three  hundred  twenty-two  of  the insurance law or any other
application for a health insurance policy or contract  approved  by  the
superintendent of financial services in the individual or direct payment
market;  or  (ii)  any application for a certificate evidencing coverage
under a self-insured plan or under a  group  contract  approved  by  the
superintendent of financial services.

S 176.10 Insurance fraud in the fifth degree.
  A person is guilty of insurance fraud in the fifth degree when he
commits a fraudulent insurance act.
  Insurance fraud in the fifth degree is a class A misdemeanor.

S 176.15 Insurance fraud in the fourth degree.
  A person is guilty of insurance fraud in the fourth degree when he
commits a fraudulent insurance act and thereby wrongfully takes, obtains
or withholds, or attempts to wrongfully take, obtain or withhold
property with a value in excess of one thousand dollars.
  Insurance fraud in the fourth degree is a class E felony.

S 176.20 Insurance fraud in the third degree.
  A person is guilty of insurance fraud in the third degree when he
commits a fraudulent insurance act and thereby wrongfully takes, obtains
or withholds, or attempts to wrongfully take, obtain or withhold
property with a value in excess of three thousand dollars.
  Insurance fraud in the third degree is a class D felony.

S 176.25 Insurance fraud in the second degree.
  A person is guilty of insurance fraud in the second degree when he
commits a fraudulent insurance act and thereby wrongfully takes, obtains
or withholds, or attempts to wrongfully take, obtain or withhold
property with a value in excess of fifty thousand dollars.
  Insurance fraud in the second degree is a class C felony.

S 176.30 Insurance fraud in the first degree.
  A person is guilty of insurance fraud in the first degree when he
commits a fraudulent insurance act and thereby wrongfully takes, obtains
or withholds, or attempts to wrongfully take, obtain or withhold
property with a value in excess of one million dollars.
  Insurance fraud in the first degree is a class B felony.

S 176.35 Aggravated insurance fraud.
  A person is guilty of aggravated insurance fraud in the fourth degree
when he commits a fraudulent insurance act, and has been previously
convicted within the preceding five years of any offense, an essential
element of which is the commission of a fraudulent insurance act.
  Aggravated insurance fraud in the fourth degree is a class D felony.

S 176.40 Fraudulent life settlement act; defined.
  A fraudulent life settlement 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, a life settlement provider, life settlement broker, life  settlement
intermediary,  or  any  agent  thereof,  or  to  any  owner  any written
statement or other physical evidence as part of, or in  support  of,  an
application for a life settlement contract, a claim for payment or other
benefit under a life settlement contract, which the person knows to:
  (1)  contain materially false information concerning any material fact
thereto; or
  (2) conceal, for the purpose of misleading, information concerning any
fact material thereto.

S 176.45 Life settlement fraud in the fifth degree.
  A  person is guilty of life settlement fraud in the fifth degree when
he or she commits a fraudulent life settlement act.
  Life settlement fraud in the fifth degree is a class A misdemeanor.

S 176.50  Life settlement fraud in the fourth degree.
  A  person is guilty of life settlement fraud in the fourth degree when
he or she commits a fraudulent  life  settlement  act  and  thereby
wrongfully  takes, obtains or withholds, or attempts to wrongfully take,
obtain or withhold property with a value in excess of twenty-five
thousand dollars.
  Life settlement fraud in the fourth degree is a class E felony.

S 176.55  Life settlement fraud in the third degree.
  A person is guilty of life settlement fraud in the third degree when
he or she commits a fraudulent life settlement act and thereby
wrongfully takes, obtains or withholds, or attempts to wrongfully take,
obtain or withhold property with a value in excess of fifty thousand dollars.
  Life settlement fraud in the third degree is a class D felony.

S 176.60 Life settlement fraud in the second degree.
  A person is guilty of life settlement fraud in the second degree when
he or she commits a fraudulent life settlement act and thereby wrongfully
takes, obtains or withholds, or attempts to wrongfully take, obtain or
withhold property with a value in excess of one hundred thousand dollars.
  Life settlement fraud in the second degree is a class C felony.

S 176.65 Life settlement fraud in the first degree.
  A person is guilty of life settlement fraud in the first degree when
he or she commits a fraudulent life settlement act and thereby wrongfully
takes, obtains or withholds, or attempts to wrongfully take, obtain or
withhold property with a value in excess of one million dollars.
  Life settlement fraud in the first degree is a class B felony.

S 176.70 Aggravated life settlement fraud.
 A  person is guilty of aggravated life settlement fraud when he or she
commits a fraudulent life settlement act, and has been previously convicted
within the preceding five years of any offense, an essential element of
which is the commission of a fraudulent life settlement act.
  Aggravated life settlement fraud is a class D felony.

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