H. Michael Steinberg has over 32 years experience practicing Colorado criminal law. Mr. Steinberg strives to stay current with the ever changing aspects of criminal law issues and updates resulting in his extensive knowledge of successful criminal defense as well as appellate work. He is also an active member of the National Association of Criminal Defense Lawyers, the Colorado Criminal Defense Bar Association, the Colorado Trial Lawyer's Association, and the Colorado and Arapahoe Bar Associations.
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2014 New Colorado Law Codifies All Types Of Insurance Fraud SB 14-092 – Section 18-5-211

 

By H. Michael Steinberg Colorado Insurance Fraud – Theft Crimes Lawyer – Email the Author at hmsteinberg@hotmail.com
2014 New Colorado Law Codifies All Types Of Insurance Fraud SB 14-092 – Section 18-5-211-
The Governor of Colorado – in May of 2014 – signed a new insurance fraud law that was effective for crimes committed on or after July 1, 2014.

Here is a LINK to the law:

Senate Bill 14-092: “Concerning the Crime of Insurance Fraud,” SB 092 creates the new Title 18 crime of insurance fraud.

The law is very specific and carefully lists when a Colorado District Attorney can charge any or all players in the insurance system.

How Does One Commit The Crime Of Insurance Fraud In Colorado?

The new law applies across the board to fraud committed by insurance claimants, agents and brokers.

The most common kind of Insurance fraud in Colorado is committed when a person

…knowingly presents or causes to be presented an application for the issuance or renewal of an insurance policy, submits materially false information or fails to disclose such or fails to disclose a material event or condition that affects a person’s rights or continued right to any insurance benefit or payment.

But other obvious forms of fraud – per the statute – include multiple methods of committing the crime. What is important here is that the INTENT to commit the crime is required for guilt. Therefore – it an act is merely negligent or even reckless – there is no proof of specific intent – that is – a premeditated crime.

Arguably, the second most important sections are the definitions in the law. These include the definition of what is a “material” fact and what a “claim” is.

Here is the law – the best way to understand it – is to read it carefully:

Section 18-5-211. Insurance fraud – definitions

(1) A person commits insurance fraud if the person does any of the following:

(a) With an intent to defraud presents or causes to be presented an application for the issuance or renewal of an insurance policy, which application, or documentation in support of such application or renewal, contains false material information or withholds material information that is requested by the insurer and results in the issuance of an insurance policy or insurance coverage for the applicant or another;

(b) With an intent to defraud presents or causes to be presented any claim for a loss or injury, which claim contains false material information or withholds material information;

(c) With an intent to defraud causes or participates, or purports to be involved, in a vehicular collision, or any other vehicular accident, for the purpose of presenting any false or fraudulent insurance claim;

(d) With an intent to defraud presents or causes to be presented a claim for the payment of a loss where the loss or damage claimed preexisted the execution of the applicable contract of insurance unless otherwise permitted under the contract of insurance or policy; or
(e) With an intent to defraud presents or causes to be presented any written, oral, or electronic material or statement as part of, in support of or in opposition to, a claim for payment or other benefit pursuant to an insurance policy, knowing that the statement contains false material information or withholds material information.

(2) An insurance producer or agent of an insurance producer commits insurance fraud if he or she knowingly moves, diverts, or misappropriates premium funds belonging to an insurer or unearned premium funds belonging to an insured or applicant for insurance from a producer’s trust or other account without the authorization of the owner of the funds or other lawful justification.

(3) An insurance producer or agent of an insurance producer commits insurance fraud if he or she with an intent to defraud creates, utters, or presents a certificate or any other evidence of insurance containing false information to any person or entity.

(4) Insurance fraud committed in violation of paragraph (a) of subsection (1) of this section is a class 1 misdemeanor. Insurance fraud committed in violation of paragraphs (b) to (e) of Cite as C.R.S. Section 18-5-211 subsection (1) of this section or subsection (2) or (3) of this section is a class 5 felony.

(5) The commissioner of insurance shall revoke the license to conduct business in this state of any licensed insurance producer under article 2 of title 10, C.R.S., who is convicted of any provision under this section.

(6) Nothing in this section precludes a prosecutor from prosecuting any other offense.

(7) As used in this section, unless the context otherwise requires:

(a) “Claim” means a demand for money, property, or services pursuant to a contract of insurance as well as any documentation in support of such claim whether submitted contemporaneously with the claim or at a different time. A claim and any supporting information may be in written, oral, electronic, or digital form.

(b) “Insurance” has the same meaning as defined in section 10-1-102 (12), C.R.S.

(c) “Insurance producer” has the same meaning as defined in section 10-2-103 (6), C.R.S.

(d) “Insurer” has the same meaning as defined in section 10-1-102 (13),C.R.S.

(e) “Material information” is a statement or assertion directly pertaining to an application for insurance or an insurance claim that a reasonable person making such an assertion knows or should know will affect the action, conduct, or decision of the person who receives or is intended to receive the asserted information in a manner that would directly or indirectly benefit the person making the assertion.

The Colorado Attorney General Is Most Likely To File Charges

Typically the branch of law enforcement most likely to investigate and prosecute these cases is the Office of The Attorney General Of Colorado.

The Colorado Division of Insurance in the Department of Regulatory Agencies and the National Insurance Crime Bureau makes the referral of suspected fraud, forgery, theft and other crimes to the AG – who then investigates further and decides to reject or to file charges.. It a Colorado criminal defense lawyer has an opportunity to make a difference – that difference maybe made at this “pre-filing stage.”

Don’t Forget The Civil Version Of Insurance Fraud In Colorado

Section 10-1-128 (6A)

Requirement — “It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado division of insurance within the department of regulatory agencies.”

ABOUT THE AUTHOR: H. Michael Steinberg – Email The Author at hmsteinberg@hotmail.com – A Denver Colorado Criminal Defense Lawyer – or call his office at 303-627-7777 during business hours – or call his cell if you cannot wait and need his immediate assistance – 720-220-2277.

H. Michael Steinberg, is a Denver, Colorado criminal defense lawyer with over 30 years of day to day courtroom experience – specializing in Colorado Criminal Law along the Front Range. Call him if you have any questions about …the crime of Insurance Fraud in Colorado.