(a) A person convicted of a violation of ¤ 56-53-102 shall be ordered to make monetary restitution for any financial loss or damages sustained by any other person as a result of the violation. Financial loss or damage shall include, but is not necessarily limited to, loss of earnings, out-of-pocket and other expenses, paid deductible amounts under an insurance policy, insurer claim payments, cost reasonably attributed to investigations and recovery efforts by owners, insurers, insurance professionals, law enforcement and other public authorities, and cost of prosecution. (b) When restitution is ordered, the court shall determine its extent and methods. Restitution may be imposed in addition to a fine and, if ordered, any other penalty, but not in lieu thereof. The court shall determine whether restitution, if ordered, shall be paid in a single payment or installments and shall fix a period of time, not in excess of three (3) years, within which payment of restitution is to be made in full.
(a) Any person who commits, participates in, or aids, abets, or conspires to commit, or solicits another person to commit, or permits its employees or its agents to commit any of the following acts with an intent to induce reliance, has committed an unlawful insurance act: (3) Solicits or accepts new or renewal insurance risks by or for an insurer that the person knows was insolvent or the insolvency of which the person recklessly disregards.
(a)(1) Any practitioner determined by the court to have violated ¤ 56-53-102 shall be deemed to have committed an act involving moral turpitude that is inimical to the public well being. The court or prosecutor shall notify the appropriate licensing authority in this state of the judgment for appropriate disciplinary action, including revocation of the professional license, and may notify appropriate licensing authorities in any other jurisdictions where the practitioner is licensed. Any victim may notify the appropriate licensing authorities in this state and any other jurisdiction where the practitioner is licensed, of the conviction. (2) Upon notification of a conviction of the crimes enumerated in ¤ 56-53-102 or a substantially similar crime under the laws of another state or the United States, this state’s appropriate licensing authority may hold an administrative hearing, or take other appropriate administrative action authorized by state law, to consider the imposition of the administrative sanctions as provided by law against the practitioner. Where the practitioner has been convicted of a felony violation of ¤ 56-53-102 or a substantially similar crime under the laws of another state or of the United States, this state’s appropriate licensing authority may hold an administrative hearing, or take other appropriate administrative action authorized by state law, and may summarily and permanently revoke the license or take other action against the licensee as deemed appropriate. It is recommended by the legislature that the supreme court shall summarily and permanently disbar any attorney found guilty of such felony. (3) The referrals to the appropriate licensing or other agencies, and all dispositive actions of the referral, shall be a matter of public record. (b)(1) A person convicted of a felony involving dishonesty or breach of trust shall not participate in the business of insurance unless a waiver is granted by the commissioner. (2) A person in the business of insurance shall not knowingly or intentionally permit a person convicted of a felony involving dishonesty or breach of trust to participate in the business of insurance unless a waiver has been granted by the commissioner pursuant to subdivision (b)(1).
(a) Any person who, knowingly and with intent to defraud, and for the purpose of depriving another of property or for pecuniary gain, commits, participates in or aids, abets, or conspires to commit or solicits another person to commit, or intentionally permits its employees or its agents to commit any of the following acts, has committed a fraudulent insurance act: (1) Presents, causes to be presented, or prepares with knowledge or belief that it will be presented, by or on behalf of an insured, claimant or applicant to an insurer, insurance professional or premium finance company in connection with an insurance transaction or premium finance transaction, any information that contains false representations as to any material fact, or that withholds or conceals a material fact concerning any of the following: (D) The application used in any premium finance transaction;
Any person who intentionally presents or causes to be presented a false or fraudulent claim, or any proof in support of such claim, for the payment of a loss, or other benefits, upon any contract of insurance coverage, or automobile comprehensive or collision insurance, or certificate of such insurance or prepares, makes or subscribes to a false or fraudulent account, certificate, affidavit or proof of loss, or other documents or writing, with intent that the same may be presented or used in support of such claim, is punished as in the case of theft.
(a)(1) Any person injured in the person’s business or property by reason of a violation of ¤ 56-53-103 may recover for the injury from the person or persons violating ¤ 56-53-103, in any appropriate court having jurisdiction, the following: (A) Return of any profit, benefit, compensation or payment received by the person violating ¤ 56-53-103 directly resulting from the violation; and (B) Reasonable attorneys’ fees, related legal expenses, including internal legal expenses and court costs. (2) An action maintained under subdivision (a)(1) may neither be certified as a class action nor be made part of a class action. (b)(1) Any person injured in the person’s business or property by reason of a violation of ¤ 56-53-102 may recover for the injury from the person or persons violating ¤ 56-53-102, in any appropriate court having jurisdiction, the following: (A) Return of any profit, benefit, compensation or payment received by the person violating ¤ 56-53-102 directly resulting from the violation; (B) Reasonable attorneys’ fees, related legal expenses, including internal legal expenses and court costs; (C) All other economic damages directly resulting from the violation of ¤ 56-53-102; (D) Reasonable investigative fees based on a reasonable estimate of the time and expense incurred in the investigation of the violation or violations of ¤ 56-53-102 proved at trial; and (E) A penalty of no less than one hundred dollars ($100) and no greater than ten thousand dollars ($10,000). (2) An action maintained under subdivision (b)(1) may neither be certified as a class action nor be made part of a class action. (c) Any person injured in the person’s business or property by a person violating ¤ 56-53-102, upon a showing of clear and convincing evidence that the violation was part of a pattern or practice of such violations, shall be entitled to recover threefold the injured person’s economic damages. An action for treble damages must be brought within three (3) years of the violation. One third ( ÉÒ ) of the treble damages awarded shall be payable to the state to be used solely for the purpose of investigation and prosecution of violations of this chapter or other fraudulent behavior relating to insurance transactions, or for public education relating to insurance fraud. An action maintained under this subsection (c) may neither be certified as class action nor be made part of a class action, unless the violations of ¤ 56-53-102 giving rise to the action resulted in criminal conviction of the violator or violators under ¤ 56-53-104. (d)(1) The attorney general and reporter, district attorney general or other prosecutorial agency shall have authority to maintain civil proceedings on behalf of the department of commerce and insurance and any victims of violations of ¤ 56-53-102. In the action, the court shall proceed as soon as practicable to the hearing and determination of the hearing. Pending final determination, the court may at any time enter restraining orders or prohibitions, or take other actions, including the acceptance of satisfactory performance bonds, as it deems proper. (A) The circuit and chancery courts of the state shall have jurisdiction to prevent and restrain violations of ¤ 56-53-102 by issuing appropriate orders. (B) In any action commenced under this subsection (d), the court, upon finding that any person has violated ¤ 56-53-102, shall levy a fine of up to five thousand dollars ($5,000) for each violation. (2) Any court in which a prosecution for violation of ¤ 56-53-102 is pending shall have authority to stay or limit proceedings in any civil action regarding the same or related conduct. Any court in which is pending a civil action brought pursuant to this subsection (d) may stay or limit proceedings in actions brought pursuant to subsections (a)-(c) regarding the same or related conduct or may transfer the actions or consolidate them before itself or allow the plaintiffs in the actions to participate in the action brought pursuant to this subsection (d), as it shall prescribe. (e) Any cause of action under this section for violation of ¤ 56-53-102 or ¤ 56-53-103 must be brought within five (5) years of the commission of the acts constituting the violation, or within five (5) years of the time the plaintiff discovered, or with reasonable diligence could have discovered, the acts, whichever is later. (f) An insurer shall not pay damages awarded under this section, or provide a defense or money for a defense, on behalf of an insured under a contract of insurance or indemnification. A third party who has asserted a claim against an insured shall have no cause of action under this section against the insurer of the insured arising out of the insurer’s processing or settlement of the third party’s claim. An obligee under a surety bond shall not have a cause of action under this section against the surety arising out of the surety’s processing or settlement of the obligee’s claim against the bond. (g) Any person injured in the person’s business or property by reason of a violation of ¤ 56-53-102 or ¤ 56-53-103 may recover under only one (1) of the subsections of this section.
(a) GENERAL. Rates: (1) Shall not be excessive, inadequate or unfairly discriminatory; or (2) In the case of an advisory prospective loss costs filing, shall reasonably reflect projected losses and loss adjustment expenses. (b) EXCESSIVENESS. A rate is excessive if it is likely to produce a profit that is unreasonably high for the insurance provided or if the expense provision included in the rate is unreasonably high in relation to the services rendered. (c) INADEQUACY. A rate is not inadequate unless the rate is clearly insufficient to sustain projected losses and expenses in the class of business to which it applies and the use of the rate has or, if continued, will have the effect of substantially lessening competition or the tendency to create a monopoly. (d) UNFAIR DISCRIMINATION. Unfair discrimination exists if, after allowing for practical limitations, price differentials fail to reflect equitably the differences in expected losses and expenses. A rate is not unfairly discriminatory because different premiums result for policyholders with like loss exposures with different expenses, or like expenses but different loss exposures, so long as the rate reflects the differences with reasonable accuracy.