Disclosures

GENERAL NOTICE TO ALL APPLICANTS:  States in the United States, and other jurisdictions outside of the United States, generally consider it a crime or violation to withhold and/or misappropriate payments of insurance premiums collected and held in trust, file false claims, and/or knowingly provide false, incomplete or misleading information to an insurance company or its delegated representatives for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits.

Each local jurisdiction has its own specific insurance compliance statutes and regulations.  Applicants are responsible for compliance with statutory and regulatory requirements in all applicable jurisdictions.  The following disclosures were accurate at the time of their publishing, may have changed since then as a result of local jurisdiction action, and as such are for representation only:  Consult with your local statutory and regulatory authorities to know your specific obligations.

NOTICE TO ALABAMA APPLICANTS: “A person commits the crime of insurance fraud if, knowingly and with intent to defraud, he or she commits, or conceals any material information concerning… (4) Presenting, causing to be presented, or preparing with knowledge or belief that it will be presented to or by an insurer, reinsurer, producer, or any of their respective agents, false information as part of, in support of, or concerning a fact material to, one or more of the following: a. An application for the issuance or renewal of an insurance policy or reinsurance agreement; b. The rating of an insurance policy or reinsurance agreement; c. A claim for payment or benefit pursuant to an insurance policy or reinsurance agreement.”

NOTICE TO ARKANSAS APPLICANTS: “Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit, or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.”

NOTICE TO CALIFORNIA APPLICANTS: “Section 550 of the California Penal Code outlaws insurance fraud. Any misrepresentation on the insurance application or any claims made under this policy of insurance that is fraudulent can result in you being sued and/or having criminal charges filed against you. Pursuant to California Insurance Code Section 1879.2, you are hereby notified that any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fine and confinement in state prison.”

NOTICE TO COLORADO APPLICANTS: “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, and 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 Authorities.”

NOTICE TO DISTRICT OF COLUMBIA APPLICANTS: “Warning: it is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant.”

NOTICE TO FLORIDA APPLICANTS: “Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete or misleading information is guilty of a felony in the third degree.”

NOTICE TO GEORGIA APPLICANTS: (a) Any natural person who knowingly or willfully: (1) Makes or aids in the making of any false or fraudulent statement or representation of any material fact or thing: (A) In any written statement or certificate; (B) In the filing of a claim; (C) In the making of an application for a policy of insurance; (D) In the receiving of such an application for a policy of insurance; or (E) In the receiving of money for such application for a policy of insurance, for the purpose of procuring or attempting to procure the payment of any false or fraudulent claim or other benefit by an insurer; (2) Receives money for the purpose of purchasing insurance and converts such money to such person’s own benefit; (3) Issues fake or counterfeit insurance policies, certificates of insurance, insurance identification cards, or insurance binders; or (4) Makes any false or fraudulent representation as to the death or disability of a policy or certificate holder in any written statement or certificate for the purpose of fraudulently obtaining money or benefit from an insurer, commits the crime of insurance fraud. (Georgia Code § 33-1-9)

NOTICE TO KENTUCKY APPLICANTS: “Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime.”

NOTICE TO LOUISIANA APPLICANTS: “Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.”

NOTICE TO MAINE APPLICANTS: “It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.”

NOTICE TO MINNESOTA APPLICANTS: “A person who submits an application or files claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime.”

NOTICE TO NEW JERSEY APPLICANTS: “Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.”

NOTICE TO NEW MEXICO APPLICANTS: “Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to civil fines and criminal penalties.”

NOTICE TO NEW YORK APPLICANTS: “Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.”

NOTICE TO NORTH CAROLINA APPLICANTS: “Any person who, with the intent to injure, defraud, or deceive an insurer or insurance claimant: (1) Presents or causes to be presented a written or oral statement, including computer-generated documents 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 or misleading information concerning any fact or matter material to the claim, or (2) Assists, abets, solicits, or conspires with another person to prepare or make any written or oral statement that is intended to be presented to an insurer or insurance claimant in connection with, 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 or misleading information concerning a fact or matter material to the claim is guilty of a Class H felony.”

NOTICE TO OHIO APPLICANTS: “Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.”

NOTICE TO OKLAHOMA APPLICANTS: “Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony” (365:15-1-10, 36 §3613.1).

NOTICE TO PENNSYLVANIA APPLICANTS: “Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.”

NOTICE TO TENNESSEE APPLICANTS: “It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits.”

NOTICE TO TEXAS APPLICANTS: “A person commits an offense if the person, with intent to defraud or deceive an insurer and in support of an application for an insurance policy: (1) prepares or causes to be prepared a statement that: (A) the person knows contains false or misleading material information; and (B) is presented to an insurer; or (2) presents or causes to be presented to an insurer a statement that the person knows contains false or misleading material information.”

NOTICE TO VIRGINIA APPLICANTS: “It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits.”

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