{"id":376752,"date":"2016-04-11T01:24:12","date_gmt":"2016-04-11T06:24:12","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/state\/utah-law\/utah-insurance-fraud-laws.html"},"modified":"2016-06-20T19:51:40","modified_gmt":"2016-06-21T00:51:40","slug":"utah-insurance-fraud-laws","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/state\/utah-law\/utah-insurance-fraud-laws.html","title":{"rendered":"Utah Insurance Fraud Laws"},"content":{"rendered":"\n<div class=\"wp-container-core-columns-is-layout-9d6595d7 fl-sectionWithSidebar fl-container fl-flex fl-flex-wrap fl-gap30\">\n    \n    <div class=\"fl-page-articles fl-section-main fl-section-main-full-width\">\n        <h1 class=\"fl-no-margin-top\">Utah Insurance Fraud Laws<\/h1>\n<section class=\"fl-gutenberg-byline\">\n    <div class=\"fl-gutenberg-byline-content\">\n                    <p><i>Created by <a href=\"https:\/\/www.findlaw.com\/company\/our-team.html\">FindLaw&#8217;s team<\/a> of legal writers and editors<\/i><\/p>\n\n                | Last updated\n        <time>\n                            June 20, 2016\n                    <\/time>\n    <\/div>\n\n    \n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-legally-reviewed\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Legally Reviewed\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>This article has been written and reviewed for legal accuracy, clarity, and style by <a href=\"https:\/\/www.findlaw.com\/company\/our-team.html\">FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with <a href=\"https:\/\/www.findlaw.com\/company\/company-history\/editorial-policy.html\">our editorial standards<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n\n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-fast-checked\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Fact-Checked\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>The last updated date refers to the last time this article was reviewed by FindLaw or one of our <a href=\"https:\/\/www.findlaw.com\/company\/our-team\/contributing-authors.html\">contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please <a href=\"https:\/\/lawyers.findlaw.com\/?fli=bylinelink\" target=\"_blank\" rel=\"noopener\">contact an attorney in your area<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n<\/section>\n<p>The state of Utah specifically outlaws <a href=\"https:\/\/www.findlaw.com\/criminal\/criminal-charges\/insurance-fraud.html\">insurance fraud<\/a>. In the Beehive State, it is a crime to intentionally provide false, incomplete, or misleading information for the purpose of obtaining insurance benefits. The state also outlaws workers&#8217; compensation insurance fraud and makes it a crime to intentionally make a false or fraudulent statement or omit material information in order to obtain workers compensation benefits. The following is a quick summary of Utah insurance fraud laws.<\/p>\n<h2>Utah Insurance Fraud Laws:<\/h2>\n<p>The following table outlines insurance fraud laws in Utah.<\/p>\n<table width=\"667\" cellspacing=\"0\" cellpadding=\"2\" border=\"1\">\n<tbody><tr><td width=\"200\" valign=\"top\"><b>Code Sections<\/b><\/td>\n<td width=\"465\" valign=\"top\"><p>UTAH CODE \u00a7\u00a7 <a href=\"http:\/\/le.utah.gov\/xcode\/Title76\/Chapter6\/76-6-S521.html?v=C76-6-S521_1800010118000101\" target=\"_blank\" rel=\"noopener\">76-6-521<\/a>, <a href=\"http:\/\/le.utah.gov\/xcode\/Title31A\/Chapter31\/31A-31-S103.html\" target=\"_blank\" rel=\"noopener\">31A-31-103<\/a>, and <a href=\"http:\/\/le.utah.gov\/xcode\/Title34A\/Chapter2\/34A-2-S110.html?v=C34A-2-S110_1800010118000101\" target=\"_blank\" rel=\"noopener\">32A-2-110<\/a><\/p>\n<\/td>\n<\/tr><tr><td width=\"200\" valign=\"top\"><b>What is Prohibited?<\/b><\/td>\n<td width=\"465\" valign=\"top\"><p><u>Insurance fraud<\/u> :<\/p>\n<p>Consists of performing any of the following intentional acts:<\/p>\n<ul>\n<li><div>Providing false, incomplete, or misleading information material to an insurance application, either in writing or orally<\/div>\n<\/li>\n<li><div>Proving false, incomplete, or misleading information in order to obtain insurance benefits or damages related to a civil claim for personal or bodily injury or property damage<\/div>\n<\/li>\n<li><div>Accepting a benefit from insurance fraud proceeds<\/div>\n<\/li>\n<li><div>Intentionally or recklessly devising a scheme or device to obtain professional service fees or anything of value through false or fraudulent pretenses, representations, promises, or material omissions<\/div>\n<\/li>\n<li><div>Aiding, soliciting, or conspiring with another person to commit insurance fraud<\/div>\n<\/li>\n<li><div>Supplying false or fraudulent material information in a document or statement required by the insurance department<\/div>\n<\/li>\n<li><div>Failing to forward a premium to an insurer<\/div>\n<\/li>\n<li><div>Employing, using, or acting as a &quot;<a href=\"http:\/\/le.utah.gov\/xcode\/Title31A\/Chapter31\/31A-31-S102.html\" target=\"_blank\" rel=\"noopener\">runner<\/a>&quot; for the purpose of committing insurance fraud<\/div>\n<\/li>\n<\/ul>\n<p>Service providers such as doctors can also commit insurance fraud if they intentionally perform any of the following acts:<\/p>\n<ul>\n<li><div>Submitting a bill for an item or service that is substantially more than the customary charge or containing itemized fees for what is customarily a single procedure or service<\/div>\n<\/li>\n<li><div>Providing an item or service to a person that is substantially in excess of the person&#8217;s needs or of a poor quality<\/div>\n<\/li>\n<\/ul>\n<p>Insurers also commit insurance fraud if they intentionally withhold information or provide false or misleading information regarding an application, coverage, benefits, or claims.<\/p>\n<p><u>Workers&#8217; compensation insurance fraud<\/u> :<\/p>\n<p>Knowingly or recklessly making a false or fraudulent statement, promise, or omission of material information in order to do any of the following:<\/p>\n<ul>\n<li>Obtain workers compensation benefits<\/li>\n<li>Avoid paying for a workers compensation insurance premium<\/li>\n<li>Deprive an employee of workers compensation benefits<\/li>\n<\/ul>\n<\/td>\n<\/tr><tr><td width=\"200\" valign=\"top\"><b>Penalties<\/b><\/td>\n<td width=\"465\" valign=\"top\"><p>Intentionally providing false, incomplete, or misleading information material to an insurance application is a class B <a href=\"https:\/\/www.findlaw.com\/criminal\/criminal-law-basics\/misdemeanors.html\">misdemeanor<\/a> punishable by up to 6 months in prison and up to $1,000 in fines.<\/p>\n<p>Intentionally or recklessly devising a scheme or device to obtain professional service fees or anything of value through false or fraudulent pretenses, representations, promises, or material omissions is:<\/p>\n<ul>\n<li><div>A class B misdemeanor if the value of the benefits sought or obtained is less than $500<\/div>\n<\/li>\n<li><div>A class A misdemeanor punishable by up to 1 year in prison and up to $2,500 in fines if the benefits sought or obtained is more than $500 but less than $1,500<\/div>\n<\/li>\n<li><div>A third-degree <a href=\"https:\/\/www.findlaw.com\/criminal\/criminal-law-basics\/felonies.html\">felony<\/a> punishable by up to 5 years in prison and up to $5,000 in fines if the value of the benefits sought or obtained is $1,500 or more but less than $5,000<\/div>\n<\/li>\n<li><div>A second-degree felony punishable up to 15 years in prison and up to $10,000 in fines if the value of the benefits sought or obtained is $5,000 or more<\/div>\n<\/li>\n<\/ul>\n<p>The perpetrator is also subject to restitution and other costs such as attorney&#8217;s fees. The court may also order a civil penalty up to 3 times the value of that which was sought or received from the insurance fraud. A service provider who commits insurance fraud can also have their license suspended or revoked.<\/p>\n<p>Workers compensation fraud is a class A misdemeanor if the value of the benefits sought or obtained is less than $1,000 or the number of employees deprived of benefits is less than 5. It is a third-degree felony if benefits sought or obtained is $1,000 or more, but less than $5,000 or<br>\nthe number of employees deprived of benefits is 5 or more, but less than 50. It is a second degree-felony if the benefits sought or obtained is $5,000 or more or the number of employees deprived of benefits is 50 or more.<\/p>\n<\/td>\n<\/tr><tr><td width=\"200\" valign=\"top\"><b>Defenses<\/b><\/td>\n<td width=\"465\" valign=\"top\">The insurer or service provider had no knowledge of the insurance fraud and the fraudulent act was committed by an employee who was acting without authority.<\/td>\n<\/tr><tr><td width=\"200\" valign=\"top\"><b>How do I File a Complaint Against a Utah Insurance Company?<\/b><\/td>\n<td width=\"465\" valign=\"top\"><p>If you&#8217;re having problems with an insurance company or agent, a <a href=\"https:\/\/insurance.utah.gov\/complaint\/\" target=\"_blank\" rel=\"noopener\">complaint<\/a> may be filed with the <a href=\"https:\/\/insurance.utah.gov\/\" target=\"_blank\" rel=\"noopener\">Utah Insurance Department<\/a>.<\/p>\n<\/td>\n<\/tr><\/tbody><\/table>\n<h2>Utah Insurance Fraud Law: Related Resources<\/h2>\n<p>Insurance fraud laws can sometimes be confusing. If you have been charged with insurance fraud, you may want to consult an experienced <a href=\"https:\/\/lawyers.findlaw.com\/criminal-law\/utah\/\" target=\"_blank\" rel=\"noopener\">Utah criminal defense attorney<\/a> for questions about your specific situation. You can also visit Findlaw&#8217;s section on <a href=\"https:\/\/www.findlaw.com\/criminal\/criminal-charges\/insurance-fraud.html\">insurance fraud<\/a> for more information on this topic.<\/p>\n<div class=\"was-this-helpful\">\n    <div\n            class=\"was-this-helpful__question-container\"\n            aria-labelledby=\"was-this-helpful__question\"\n            role=\"group\"\n    >\n        <span\n                id=\"was-this-helpful__question\"\n                class=\"was-this-helpful__question fl-text-lg-bold\"\n        >Was this helpful?<\/span>\n        <button\n                class=\"was-this-helpful__button fl-text-sm\"\n                aria-label=\"Yes\"\n                value=\"yes\"\n        >\n            <span class=\"was-this-helpful__button-text fl-text-bold\">Yes<\/span>\n            <i class=\"was-this-helpful__button-icon\">\n                <svg width=\"22\" height=\"22\" viewBox=\"0 0 22 22\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n       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<h3>Popular Directory Searches<\/h3>\n            <\/div>\n            <ul>\n                                    <li><a href=\"https:\/\/lawyers.findlaw.com\/insurance-law\/\" target=\"_blank\" rel=\"noopener\">Insurance Lawyers<\/a><\/li>\n                                    <li><a href=\"https:\/\/lawyers.findlaw.com\/bad-faith-insurance\/\" target=\"_blank\" rel=\"noopener\">Bad Faith Insurance Lawyers<\/a><\/li>\n                                    <li><a href=\"https:\/\/lawyers.findlaw.com\/insurance-defense\/\" target=\"_blank\" rel=\"noopener\">Insurance Defense Lawyers<\/a><\/li>\n                                    <li><a href=\"https:\/\/lawyers.findlaw.com\/litigation-appeals\/\" target=\"_blank\" rel=\"noopener\">Litigation and Appeals Lawyers<\/a><\/li>\n                                    <li><a href=\"https:\/\/lawyers.findlaw.com\/consumer-protection\/\" target=\"_blank\" rel=\"noopener\">Consumer Protection Lawyers<\/a><\/li>\n                                    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In the Beehive State, it is a crime to intentionally provide false, incomplete, or misleading information for the purpose of obtaining insurance benefits. <\/p>\n","protected":false},"author":41135,"featured_media":0,"parent":376701,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"app\/Http\/Controllers\/Templates\/ArticleWithBreadcrumbsController.php","meta":{"_acf_changed":false,"_stopmodifiedupdate":true,"_modified_date":"","_autodraft_ids":[],"_cloudinary_featured_overwrite":false,"_sb_is_suggestion_mode":false,"_sb_show_suggestion_boards":false,"_sb_show_comment_boards":false,"_sb_suggestion_history":"","_sb_update_block_changes":"","_is_real_time_mode":false,"_realtime_collaborators":"","footnotes":"","cf_checklist_status":[]},"categories":[2743],"tags":[],"state_laws_tags":[3474,3472],"flmsa":[],"class_list":["post-376752","page","type-page","status-publish","hentry","category-state","state_laws_tags-statelaws_45_11","state_laws_tags-statelaws_45_1"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/pages\/376752","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/users\/41135"}],"replies":[{"embeddable":true,"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/comments?post=376752"}],"version-history":[{"count":0,"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/pages\/376752\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/pages\/376701"}],"wp:attachment":[{"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/media?parent=376752"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/categories?post=376752"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/tags?post=376752"},{"taxonomy":"state_laws_tags","embeddable":true,"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/state_laws_tags?post=376752"},{"taxonomy":"flmsa","embeddable":true,"href":"https:\/\/www.findlaw.com\/law-api\/wp-json\/wp\/v2\/flmsa?post=376752"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}