{"id":372882,"date":"2016-04-11T01:22:14","date_gmt":"2016-04-11T06:22:14","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/state\/hawaii-law\/hawaii-insurance-fraud-laws.html"},"modified":"2016-06-20T19:51:40","modified_gmt":"2016-06-21T00:51:40","slug":"hawaii-insurance-fraud-laws","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/state\/hawaii-law\/hawaii-insurance-fraud-laws.html","title":{"rendered":"Hawaii Insurance Fraud Laws"},"content":{"rendered":"\n
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Hawaii Insurance Fraud Laws<\/h1>\n
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Created by FindLaw’s team<\/a> of legal writers and editors<\/i><\/p>\n\n | Last updated\n

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The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n<\/section>\n

In Hawaii, the crime of insurance fraud<\/a> is committed when someone tries to deceive an insurance company in order to fraudulently obtain payments or benefits that he or she isn’t entitled to. Generally the offender makes false or exaggerated claims for injuries or losses that they didn’t actually suffer. However, insurance fraud comes in many shapes and sizes and can also be committed against consumers. The table below outlines Hawaii’s main insurance fraud law.<\/p>\n\n

Code Section <\/b><\/p>\n<\/td>\n

Hawaii Revised Statutes section 431:2-403: Insurance Fraud<\/b><\/td>\n<\/tr>

What’s Prohibited? <\/b><\/p>\n<\/td>\n

Insurance fraud can be committed in any of the following three ways:<\/p>\n

(1) Intentionally or knowingly misrepresenting or concealing material facts, opinions, intentions, or laws in order to obtain (or attempt to obtain) coverage, benefits, recovery, or compensation when presenting:<\/p>\n

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  • An insurance policy application<\/li>\n
  • False information regarding a claim for payment<\/li>\n
  • A claim for the payment of a loss<\/li>\n
  • Multiple claims for the same loss or injury, including presenting duplicative claims to more than one insurer<\/li>\n
  • A claim for payment of a health care benefit<\/li>\n
  • A claim for a health care benefit that wasn’t used by, or provided on behalf of, the claimant<\/li>\n
  • Improper multiple or duplicative claims for payment of the same health care benefit<\/li>\n
  • A fabricated or altered document, or making an entry in or destroying a document<\/li>\n
  • To a person, insurer, or other licensee false, incomplete, or misleading information in order to obtain coverage or payment<\/li>\n
  • Information about a person’s status as a licensee that induces a person or insurer to purchases an insurance policy, or<\/li>\n
  • Any statement or claim on behalf of a person regarding obtaining legal recovery or benefits<\/li>\n<\/ul>\n

    (2) Intentionally or knowingly aiding, agreeing, or attempting to aid, solicit, or conspire with any person who engages in any of the unlawful acts outlined above.<\/p>\n

    (3) Intentionally or knowingly making, causing, or permitting to be presented, any false statements or claims on behalf of any person during an official proceeding.<\/p>\n<\/td>\n<\/tr>

Criminal Offenses <\/b><\/p>\n<\/td>\n

Insurance fraud is:
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  • A class B felony if the value obtained (or attempted to be obtained) is more than $20,000<\/li>\n
  • A class C felony if the value obtained (or attempted to be obtained) is more than $300, or<\/li>\n
  • A misdemeanor if the value obtained (or attempted to be obtained) is $300 or less<\/li>\n<\/ul>\n<\/td>\n<\/tr>

Penalties <\/b><\/p>\n<\/td>\n

Class B felony<\/u>: Punishable by up to 10 years in prison, and\/or a fine of up to $25,000.<\/p>\n

Class C felony<\/u>: Punishable by up to five years in prison, and\/or a fine of up to $10,000.<\/p>\n

Misdemeanor offense<\/u>: Punishable by up to one year in jail, and\/or a fine of up to $2,000.<\/p>\n<\/td>\n<\/tr><\/tbody><\/table>\n

Reporting Insurance Fraud<\/h2>\n

Suspected insurance fraud in Hawaii should be reported to the Insurance Fraud Investigation Branch hotline at (808) 587-7416, or by completing a Suspected Fraudulent Claim Referral Form<\/a>. Insurers who suspect insurance fraud are required by law to report the fraud within 60 days of discovering credible information indicating a violation.<\/p>\n

Additional Resources<\/h2>\n

State laws change frequently. For case specific information about Hawaii’s insurance fraud laws contact a local consumer protection lawyer<\/a> or criminal defense attorney<\/a>.<\/p>\n

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