Important Notice
For your protection Arizona law requires the following statement
to appear on this form. Any person who knowingly presents a false or
fraudulent claim for payment of a loss is subject to criminal and civil
penalties.
Any person who knowingly and with intent to defraud
any insurance company or other person files a statement of claim containing
any materially false, incomplete or misleading information or conceals,
for the purpose of misleading, information concerning any fact material
thereto commits a fraudulent insurance act, which is a crime and may be
prosecuted under state law.
Any person who knowingly and with intent to defraud
any insurance company or other person files a statement of claim containing
any materially false, incomplete or misleading information or conceals,
for the purpose of misleading, information concerning any fact material
thereto commits a fraudulent insurance act, which is a crime and may be
prosecuted under state law.
For your protection California law requires the following to
appear on this form: Any person who knowingly presents a false or fraudulent
claim for the payment of a loss is guilty of a crime and may be subject to
fines and confinement in state prison.
It is unlawful to knowingly provide false, incomplete, or
misleading facts or information to an insurance company for the purpose of
defrauding or attempting to defraud the company. Penalties may include
imprisonment, fines, denial of insurance and civil damages. Any insurance
company or agent of an insurance company who knowingly provides false,
incomplete, or misleading facts or information to a policyholder or claimant
for the purpose of defrauding or attempting to defraud the policyholder or
claimant with regard to a settlement or award payable from insurance
proceeds shall be reported to the Colorado division of insurance within
the department of regulatory agencies.
WARNING :Any person who knowingly and with intent to injure,
defraud, or deceive any insurer files a statement of claim or an application
containing any false, incomplete, or misleading information is guilty of a
felony of the third degree.
Any person who knowingly, and with intent to defraud or deceive any
insurance company, files a statement of claim containing any false,
incomplete, or misleading information is guilty of a felony.
Any person who knowingly or willfully presents a false or
fraudulent claim for payment of a loss or benefit or who knowingly or
willfully presents false information in an application for insurance is
guilty of a crime and may be subject to fines and confinement in prison.
Any person who, with a purpose to injure, defraud, or
deceive any insurance company, files a statement of claim containing any
false, incomplete, or misleading information is subject to prosecution and
punishment for insurance fraud, as provided in RSA 638:20.
Any person who knowingly files a statement of claim containing
any false or misleading information is subject to criminal and civil
penalties.
Any person who knowingly and with intent to
defraud any insurance company or other person files an application for
insurance or statement of claim containing any materially false information
or conceals for the purpose of misleading, information concerning any fact
material thereto commits a fraudulent insurance act, which is a crime and
subjects such person to criminal and civil penalties.
Any person who knowingly and with intent to
defraud any insurance company or other person files an application for
insurance or statement of claim containing any materially false information
or conceals for the purpose of misleading, information concerning any fact
material thereto commits a fraudulent insurance act, which is a crime and
subjects such person to criminal and civil penalties.
Any person who knowingly, and with intent to injure, defraud
or deceive any insurer, makes any claim for the proceeds of an insurance
policy containing any false, incomplete or misleading information is guilty
of a felony.
It is a crime to knowingly provide false,
incomplete or misleading information to an insurance company for the
purpose of defrauding the company. Penalties include imprisonment, fines
and denial of insurance benefits.
It is a crime to knowingly provide false,
incomplete or misleading information to an insurance company for the
purpose of defrauding the company. Penalties include imprisonment, fines
and denial of insurance benefits.
Any person who knowingly presents a false or fraudulent claim for
payment of a loss is guilty of a crime and may be subject to fines and
confinement in state prison.
Any person who knowingly and with intent to defraud any insurance
company or other person files an application for insurance or statement of
claim containing any materially false information, or conceals for the
purpose of misleading, information concerning any fact material thereto,
commits a fraudulent insurance act, which is a crime, and shall also be
subject to a civil penalty not to exceed five thousand dollars and the
stated value of the claim for each such violation.
Any person who knowingly presents a false or fraudulent claim for payment
of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines
and confinement in prison.
