By Smithee H.B. No. 2457
75R8253 GWK-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the prosecution and punishment of insurance fraud and
1-3 engaging in organized criminal activity for which the underlying
1-4 offense is insurance fraud.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Section 35.01, Penal Code, is amended by amending
1-7 Subdivision (4) and by adding Subdivision (6) to read as follows:
1-8 (4) "Insurer" means a person who engages in the
1-9 business of insurance in this state, including:
1-10 (A) an insurer that is not authorized to do
1-11 business in this state;
1-12 (B) a health maintenance organization;
1-13 (C) a group hospital service corporation
1-14 regulated under Chapter 20, Insurance Code; [and]
1-15 (D) any person who self-insures; and
1-16 (E) any entity doing insurance business under
1-17 the Insurance Code [and provides health care benefits to the
1-18 person's employees].
1-19 (6) "Claim" means a written or oral communication made
1-20 to an insurer under the terms of a health or property and casualty
1-21 insurance policy that may reasonably be:
1-22 (A) construed as a demand for payment by an
1-23 insurer to another; or
1-24 (B) expected to result in the payment by an
2-1 insurer to another.
2-2 SECTION 2. Chapter 35, Penal Code, is amended by adding
2-3 Sections 35.021 and 35.022 to read as follows:
2-4 Sec. 35.021. PENALTY FOR FRAUDULENTLY OBTAINING OR DENYING
2-5 BENEFITS. (a) A person commits an offense if the person, with the
2-6 intent to obtain or deny payment of benefits, including medical
2-7 benefits, under Subtitle A or Subtitle C, Labor Code, for himself
2-8 or another, knowingly or intentionally:
2-9 (1) makes a false or misleading statement;
2-10 (2) misrepresents or conceals a material fact; or
2-11 (3) fabricates, alters, conceals, or destroys a
2-12 document other than a governmental record.
2-13 (b) An offense under Subsection (a) is:
2-14 (1) a Class A misdemeanor if the value of the benefits
2-15 is less than $1,500; and
2-16 (2) a state jail felony if the value of the benefits
2-17 is $1,500 or more.
2-18 Sec. 35.022. PENALTY FOR FRAUDULENTLY OBTAINING WORKERS'
2-19 COMPENSATION INSURANCE COVERAGE. (a) A person commits an offense
2-20 if the person, with the intent to obtain workers' compensation
2-21 insurance coverage under the workers' compensation insurance laws
2-22 of this state or to avoid payment of premiums due for that
2-23 coverage, for himself or another, knowingly or intentionally:
2-24 (1) makes a false statement;
2-25 (2) misrepresents or conceals a material fact; or
2-26 (3) makes a false entry in, fabricates, alters,
2-27 conceals, or destroys a document other than a governmental record.
3-1 (b) An offense under Subsection (a) is:
3-2 (1) a Class A misdemeanor if the amount of premium
3-3 avoided is less than $1,500; and
3-4 (2) a state jail felony if the amount of the premium
3-5 avoided is $1,500 or more.
3-6 (c) The court may order a person to pay restitution to an
3-7 insurance company, the Texas workers' compensation insurance
3-8 facility, or the Texas Workers' Compensation Insurance Fund if the
3-9 person commits an offense under this section.
3-10 SECTION 3. Section 71.02(a), Penal Code, is amended to read
3-11 as follows:
3-12 (a) A person commits an offense if, with the intent to
3-13 establish, maintain, or participate in a combination or in the
3-14 profits of a combination or as a member of a criminal street gang,
3-15 he commits or conspires to commit one or more of the following:
3-16 (1) murder, capital murder, arson, aggravated robbery,
3-17 robbery, burglary, theft, aggravated kidnapping, kidnapping,
3-18 aggravated assault, aggravated sexual assault, sexual assault,
3-19 forgery, deadly conduct, assault punishable as a Class A
3-20 misdemeanor, burglary of a motor vehicle, or unauthorized use of a
3-21 motor vehicle;
3-22 (2) any gambling offense punishable as a Class A
3-23 misdemeanor;
3-24 (3) promotion of prostitution, aggravated promotion of
3-25 prostitution, or compelling prostitution;
3-26 (4) unlawful manufacture, transportation, repair, or
3-27 sale of firearms or prohibited weapons;
4-1 (5) unlawful manufacture, delivery, dispensation, or
4-2 distribution of a controlled substance or dangerous drug, or
4-3 unlawful possession of a controlled substance or dangerous drug
4-4 through forgery, fraud, misrepresentation, or deception;
4-5 (6) any unlawful wholesale promotion or possession of
4-6 any obscene material or obscene device with the intent to wholesale
4-7 promote the same;
4-8 (7) any unlawful employment, authorization, or
4-9 inducing of a child younger than 17 years of age in an obscene
4-10 sexual performance;
4-11 (8) any felony offense under Chapter 32, Penal Code;
4-12 (9) any offense under Chapter 36, Penal Code; [or]
4-13 (10) any offense under Chapter 34, Penal Code; or
4-14 (11) any offense under Chapter 35, Penal Code.
4-15 SECTION 4. Sections 418.001 and 418.002, Labor Code, are
4-16 repealed.
4-17 SECTION 5. (a) The change in law made by this Act applies
4-18 only to an offense committed on or after the effective date of this
4-19 Act. For purposes of this section, an offense is committed before
4-20 the effective date of this Act if any element of the offense occurs
4-21 before the effective date.
4-22 (b) An offense committed before the effective date of this
4-23 Act is covered by the law in effect when the offense was committed,
4-24 and the former law is continued in effect for that purpose.
4-25 SECTION 6. This Act takes effect September 1, 1997.
4-26 SECTION 7. The importance of this legislation and the
4-27 crowded condition of the calendars in both houses create an
5-1 emergency and an imperative public necessity that the
5-2 constitutional rule requiring bills to be read on three several
5-3 days in each house be suspended, and this rule is hereby suspended.