(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 in written,
verbal, or digital form an application or request for the issuance, modification, or
renewal of an insurance policy, which application or request, or documentation in
support of such application or request, 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
insurance claim, 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 an
insurance claim where the loss or damage claimed occurred outside of the period of
time that coverage was in effect for the applicable contract of insurance or policy
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,
verbal, or digital 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 material or statement contains false material information or withholds material
information.
(2) A person 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 trust or other
account without the authorization of the owner of the funds or other lawful
justification.
(3) A person commits insurance fraud if he or she with an intent to defraud
makes, alters, presents, or causes to be presented a certificate or other evidence of
the existence of insurance in any form that contains false material information or
omits material information.
(4) (a) Insurance fraud committed in violation of subsection (1)(a) of this
section is a class 2 misdemeanor.
(b) Insurance fraud committed in violation of subsections (1)(b) to (1)(e) or
subsection (3) of this section is a class 6 felony.
(c) Insurance fraud committed in violation of subsection (2) 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) No provision of this article 5 may be interpreted to supersede, limit,
abrogate, or impair the ability of the prosecuting authority to concurrently bring
charges for any other state criminal offense that is otherwise applicable in addition
to any offenses described by this section.
(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, verbal, 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.
L. 2014: Entire section added, (SB 14-092), ch. 190, p. 708, § 1, effective July 1. L. 2017: (1)(a), (1)(b), (1)(d), (1)(e), (2), (3), (6), and (7)(a) amended, (HB 17-1048), ch. 68, p. 214, § 1, effective August 9. L. 2021: (4) amended, (SB 21-271), ch. 462, p. 3186, § 239, effective March 1, 2022. L. 2023: (4) amended, (HB 23-1293), ch. 298, p. 1786, § 19, effective October 1.
