§ 5-37-505 — Insurance fraud by use of a procurer

(a) As used in this section and § 5-37-506 : (1) (A) "Procurer" means a person or entity that for pecuniary benefit procures or attempts to procure a client, patient, or customer by directly contacting the client, patient, or customer in person, by telephone, or by electronic means at the direction of, request of, employment of, or in cooperation with a provider. (B) "Procurer" does not include a provider or a person that procures or attempts to procure a client, patient, or customer for a provider through public media or a person that refers a client, patient, or customer to a provider as otherwise authorized by law; (2) "Provider" means: (A) An attorney; (B) A healthcare provider; or (C) An employee of a provider; and (3) "Public media" means telephone directories, professional directories, newspapers and other periodicals, radio and television, billboards, and mailed or electronically transmitted written or visual communications that do not involve in-person or direct contact with a specific prospective client, patient, or customer. (b) A person commits the offense of insurance fraud by use of a procurer if: (1) He or she is a procurer or provider; and (2) For the purpose of defrauding an insured person or an insurance carrier, he or she knowingly: (A) Falsely represents the services to be provided to an actual or prospective client, patient, or customer; (B) Makes a misrepresentation, including without limitation affiliation with an insurance company, a law enforcement agency, or a governing board of a healthcare provider while procuring or attempting to procure a client, patient, or customer; or (C) Uses, solicits, directs, hires, or employs another person to act as a procurer to falsely represent the services to be provided to an actual or prospective client, patient, or customer. (c) Insurance fraud by use of a procurer or provider is a Class D felony.

Legislative History

Added by Act 2013, No. 513,§ 1, eff. 8/16/2013.