CHAPTER 194

FORMERLY

HOUSE BILL NO. 338

AS AMENDED BY HOUSE AMENDMENT NO. 1

AN ACT TO AMEND CHAPTER 5, TITLE 11 OF THE DELAWARE CODE RELATING TO INSURANCE FRAUD.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

AMEND Chapter 5, Title 11 of the Delaware Code, by adding a new Section 913 to read as follows:

"§913. Insurance Fraud; Class E Felony

(1) A person is guilty of insurance fraud when, with the intent to injure, defraud, or deceive any insurer he:

(a) presents or causes to be presented to any insurer, any written or oral statement including computer-generated documents as part of, or in support of, a claim for payment or other benefit pursuant to an insurance policy, knowing that such statement contains false, incomplete, or misleading information concerning any fact or thing material to such claim; or

assists, abets, solicits, or conspires with another to prepare or make any written or oral statement that is intended to be presented to any insurer in connection with, or in support of, any claim for payment or other benefit pursuant to an insurance policy, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim. Insurance fraud is a Class E felony.

(2) All insurance claims forms shall contain a statement that clearly states in substance the following: Any person who knowingly, and with intent to injure, defraud, or deceive any insurer, files a statement of claim containing any false, incomplete, or misleading information is guilty of a felony.' The lack of such a statement shall not constitute a defense against prosecution under this Section.

(3) For the purposes of this Section, 'statement' includes, but is not limited to, a police report, any notice, statement, proof of loss, bill of lading, receipt for payment, invoice, account, estimate of property damages, bill for services, diagnosis, prescription, hospital or doctor records, x-rays, test result, or other evidence of loss, injury, or expense; 'insurer' shall include, but is not limited to, a health service corporation or health maintenance organization; and 'insurance policy' shall include, but is not limited to, the subscriber and members contracts of health service corporations and health maintenance organizations."

Approved July 19, 1983.