Utah Code 31A-31-110. Mandatory reporting of fraudulent insurance acts
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Terms Used In Utah Code 31A-31-110
- Agency: means :(6)(a) a person other than an individual, including a sole proprietorship by which an individual does business under an assumed name; and(6)(b) an insurance organization licensed or required to be licensed under Section
31A-23a-301 ,31A-25-207 , or31A-26-209 . See Utah Code 31A-1-301- Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
- Department: means the Insurance Department. See Utah Code 31A-1-301
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Fraud: Intentional deception resulting in injury to another.
- Insurance: includes :
(96)(b)(i) a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;(96)(b)(ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and(96)(b)(iii) a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301- Insurer: means any person or aggregation of persons:
(3)(a) doing insurance business, as defined in Section 31A-1-301; or(3)(b) subject to the supervision of the commissioner under:(3)(b)(i) this title; or(3)(b)(ii) any equivalent insurance supervisory official of another state. See Utah Code 31A-31-102- NAIC: means the National Association of Insurance Commissioners. See Utah Code 31A-1-301
- Person: means an individual, firm, company, corporation, association, limited liability company, partnership, organization, society, business trust, service provider, or any other legal entity. See Utah Code 31A-31-102
- Process: means a writ or summons issued in the course of a judicial proceeding. See Utah Code 68-3-12.5
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
- Title insurance: means the insuring, guaranteeing, or indemnifying of an owner of real or personal property or the holder of liens or encumbrances on that property, or others interested in the property against loss or damage suffered by reason of liens or encumbrances upon, defects in, or the unmarketability of the title to the property, or invalidity or unenforceability of any liens or encumbrances on the property. See Utah Code 31A-1-301
- United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5
- Writing: includes :
(48)(a) printing;(48)(b) handwriting; and(48)(c) information stored in an electronic or other medium if the information is retrievable in a perceivable format. See Utah Code 68-3-12.5(1)(a) A person shall report a fraudulent insurance act to the department if:(1)(a)(i) the person has a good faith belief on the basis of a preponderance of the evidence that a fraudulent insurance act is being, will be, or has been committed by a person other than the person making the report; and(1)(a)(ii) the person is:(1)(a)(ii)(A) an insurer; or(1)(a)(ii)(B) in relation to the business of title insurance, an auditor that is employed by a title insurer.(1)(b) The report required by this Subsection (1) shall:(1)(b)(i) be in writing;(1)(b)(ii) be submitted through:(1)(b)(ii)(A) the National Insurance Crime Bureau fraud reporting system;(1)(b)(ii)(B) the NAIC‘s online fraud reporting system; or(1)(b)(ii)(C) email using an email address established by the department for the purpose of submitting the report required by this Subsection (1);(1)(b)(iii) provide information in detail relating to:(1)(b)(iii)(A) the fraudulent insurance act; and(1)(b)(iii)(B) the perpetrator of the fraudulent insurance act; and(1)(b)(iv)(1)(b)(iv)(A) state whether the person required to report under Subsection (1)(a) also reported the fraudulent insurance act in writing to:(1)(b)(iv)(A)(I) the attorney general;(1)(b)(iv)(A)(II) a state law enforcement agency;(1)(b)(iv)(A)(III) a criminal investigative department or agency of the United States;(1)(b)(iv)(A)(IV) a district attorney; or(1)(b)(iv)(A)(V) the prosecuting attorney of a municipality or county; and(1)(b)(iv)(B) if the person reported the fraudulent insurance act as provided in Subsection (1)(b)(iv)(A), state the agency to which the person reported the fraudulent insurance act.(1)(c) A person required to submit a written report under this Subsection (1) shall submit the written report to the department by no later than 90 days from the day on which the person required to report the fraudulent insurance act has a good faith belief on the basis of a preponderance of the evidence that the fraudulent insurance act is being, will be, or has been committed.(2) An action brought under Section 31A-2-201, 31A-2-308, or 31A-31-109, for failure to comply with Subsection (1) shall be commenced within four years from the date on which a person described in Subsection (1):(2)(a) has a good faith belief on the basis of a preponderance of the evidence that a fraudulent insurance act is being, will be, or has been committed; and(2)(b) willfully fails to report the fraudulent insurance act.(3) The department may by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, provide a process by which a person described in Subsection (1)(a)(ii)(B) may comply with the requirements of Subsection (1) by reporting a fraudulent insurance act to the insurer with whom the person is employed, except that the rule shall provide that if the person reports the fraudulent insurance act to the insurer, the insurer is required to report the fraudulent insurance act to the department.(4) A person described in Subsection (1)(a)(ii) who in good faith makes a report under this section, in accordance with Section 31A-31-105, is immune from civil action, civil penalty, or damages for making that report.