By Holzheauser H.B. No. 1894
74R5514 GWK-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the offense of insurance claim fraud; providing
1-3 criminal penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter D, Chapter 32, Penal Code, is amended
1-6 by adding Section 32.55 to read as follows:
1-7 Sec. 32.55. INSURANCE CLAIM FRAUD. (a) A person commits an
1-8 offense if the person, with intent to injure, defraud, or deceive
1-9 an insurer, causes to be prepared or presents to an insurer in
1-10 support of a claim for payment under a contract of the insurer a
1-11 statement that the person knows:
1-12 (1) contains false or misleading information
1-13 concerning a matter that is material to the claim; or
1-14 (2) conceals or fails to disclose a material fact that
1-15 affects:
1-16 (A) a person's right to a payment; or
1-17 (B) the amount of a payment to which a person is
1-18 entitled.
1-19 (b) A person commits an offense if the person, with the
1-20 intent to injure, defraud, or deceive an insurer, solicits, offers,
1-21 pays, or receives a benefit in connection with the furnishing of
1-22 goods or services for which payment is sought under a contract of
1-23 an insurer.
1-24 (c) An offense under this section is:
2-1 (1) a Class C misdemeanor if the value of the claim is
2-2 less than $20;
2-3 (2) a Class B misdemeanor if:
2-4 (A) the value of the claim is $20 or more but
2-5 less than $500; or
2-6 (B) the value of the claim is less than $20 and
2-7 the actor has been previously convicted of a misdemeanor under this
2-8 section;
2-9 (3) a Class A misdemeanor if the value of the claim is
2-10 $500 or more but less than $1,500;
2-11 (4) a state jail felony if:
2-12 (A) the value of the claim is $1,500 or more but
2-13 less than $20,000; or
2-14 (B) the value of the claim is less than $1,500
2-15 and the actor has been previously convicted of a misdemeanor two or
2-16 more times under this section;
2-17 (5) a felony of the third degree if the value of the
2-18 claim is $20,000 or more but less than $100,000;
2-19 (6) a felony of the second degree if the value of the
2-20 claim is $100,000 or more but less than $200,000; or
2-21 (7) a felony of the first degree if:
2-22 (A) the value of the claim is $200,000 or more;
2-23 (B) the value of the claim is less than $200,000
2-24 and the actor has been previously convicted of a felony under this
2-25 section; or
2-26 (C) the value of the claim is less than $200,000
2-27 and the commission of the offense placed a person at risk of death
3-1 or serious bodily injury.
3-2 (d) In this section:
3-3 (1) "Insurer" means any person that does business as
3-4 an insurer in this state, including an insurer that is not
3-5 authorized to do business in this state. The term includes a
3-6 health maintenance organization, a company subject to Chapter 20,
3-7 Insurance Code, and an organization that is self-insured and that
3-8 provides health care benefits to its employees.
3-9 (2) "Statement" means any written representation of
3-10 fact, including a notice, proof of loss, bill of lading, receipt
3-11 for payment, invoice, account, estimate of property damages, bill
3-12 for services, or other evidence of loss, injury, or expense. A
3-13 statement may be computer-generated.
3-14 SECTION 2. The change in law made by Section 32.55, Penal
3-15 Code, as added by this Act, applies only to the punishment for an
3-16 offense committed on or after the effective date of this Act. For
3-17 the purpose of this section, an offense is committed before the
3-18 effective date of this Act if any element of the offense occurs
3-19 before the effective date. An offense committed before the
3-20 effective date of this Act is covered by the law in effect when the
3-21 offense was committed, and the former law is continued in effect
3-22 for that purpose.
3-23 SECTION 3. The importance of this legislation and the
3-24 crowded condition of the calendars in both houses create an
3-25 emergency and an imperative public necessity that the
3-26 constitutional rule requiring bills to be read on three several
3-27 days in each house be suspended, and this rule is hereby suspended,
4-1 and that this Act take effect and be in force from and after its
4-2 passage, and it is so enacted.