SENATE CORPORATIONS AND TRANSPORTATION COMMITTEE SUBSTITUTE FOR

SENATE BILL 33

50th legislature - STATE OF NEW MEXICO - first session, 2011

AN ACT

RELATING TO INSURANCE FRAUD; ALLOWING THE AGGREGATION OF CERTAIN FALSE INSURANCE CLAIMS TO DETERMINE PENALTY; PROVIDING THAT THE TIME LIMITATION FOR COMMENCING PROSECUTION BEGIN WHEN THE LAST VIOLATION IS COMMITTED; PROVIDING A KNOWLEDGE REQUIREMENT BEFORE A STATEMENT UNDER OATH CAN CONSTITUTE PERJURY.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     SECTION 1. Section 59A-16-23 NMSA 1978 (being Laws 1984, Chapter 127, Section 290, as amended) is amended to read:

     "59A-16-23. FALSE APPLICATIONS, CLAIMS, PROOFS OF LOSS.--

          A. An agent, broker, solicitor, [examining physician] health care professional, health care provider, applicant or other person shall not knowingly or willfully:

                (1) make a false or fraudulent statement or representation as to a material fact in or with reference to an application for insurance or other coverage;

                (2) for the purpose of obtaining money or benefit, present or cause to be presented a false or fraudulent claim or proof in support of such a claim for payment [of loss] under a policy of insurance;

                (3) prepare, make or subscribe a false or fraudulent account, certificate, affidavit or proof of loss or other document with intent that the same may be presented or used in support of such a claim; or

                (4) make a false or fraudulent statement or representation on or relative to an application for a policy of insurance for the purpose of obtaining a fee, commission or benefit from an insurer, agent, broker or individual.

          B. A [false] statement or representation known to be false and made under oath shall constitute and be punishable as perjury.

          C. A violation of the provisions of this section when the purported loss or potential loss to the victim insurer is: 

                (1) two hundred fifty dollars ($250) or less is a petty misdemeanor;

                (2) over two hundred fifty dollars ($250) but not more than five hundred dollars ($500) is a misdemeanor;

                (3) over five hundred dollars ($500) but not more than two thousand five hundred dollars ($2,500) is a fourth degree felony;

                (4) over two thousand five hundred dollars ($2,500) but not more than twenty thousand dollars ($20,000) is a third degree felony; or

                (5) over twenty thousand dollars ($20,000) is a second degree felony.

          D. If six or more violations of Paragraph (2) or (3) of Subsection A of this section occur within any consecutive eighteen-month period, the amounts of the purported or potential losses resulting from those violations may be aggregated to determine the penalty pursuant to Subsection C of this section and the time limitation for commencing prosecution pursuant to Section 30-1-8 NMSA 1978 shall begin when the last violation is committed."

     SECTION 2. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2011.

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