Bill Text: MS SB2649 | 2012 | Regular Session | Introduced
Bill Title: Workers' compensation; increase criminal fines for fraud/prohibit benefits if employee knowingly makes false representations.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2012-03-06 - Died In Committee [SB2649 Detail]
Download: Mississippi-2012-SB2649-Introduced.html
MISSISSIPPI LEGISLATURE
2012 Regular Session
To: Insurance
By: Senator(s) Longwitz (By Request)
Senate Bill 2649
AN ACT TO AMEND SECTION 71-3-69, MISSISSIPPI CODE OF 1972, TO INCREASE THE CRIMINAL FINES FOR MISREPRESENTATION TO OBTAIN WORKERS' COMPENSATION PAYMENTS OR BENEFITS; TO PROVIDE THAT AN EMPLOYEE SHALL NOT BE ENTITLED TO RECEIVE WORKERS' COMPENSATION PAYMENTS OR BENEFITS IF A COURT OF COMPETENT JURISDICTION OR THE COMMISSION DETERMINES THAT THE EMPLOYEE KNOWINGLY MADE FALSE REPRESENTATIONS TO SECURE BENEFITS; TO AMEND SECTION 7-5-309, MISSISSIPPI CODE OF 1972, TO INCREASE THE CRIMINAL FINES FOR INSURANCE FRAUD; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Section 71-3-69, Mississippi Code of 1972, is amended as follows:
71-3-69. (1) Any person who willfully makes any false or misleading statement or representation for the purpose of obtaining or wrongfully withholding any benefit or payment under this chapter is guilty of a felony and on conviction thereof may be punished by a fine of not to exceed Ten Thousand Dollars ($10,000.00) or double the value of the fraud, whichever is greater, or by imprisonment not to exceed three (3) years, or by both fine and imprisonment.
(2) An injured employee making a claim under this chapter shall provide his or her personal signature that he or she has reviewed, understands, and acknowledges the following statement: "Any person who, knowingly and with intent to injure, defraud, or deceive any employer or employee, insurance company, or self-insured program, files a statement or claim containing any false or misleading information commits insurance fraud, punishable as provided in Sections 71-3-69 and 7-5-309." If the injured employee refuses to sign the document attesting that he or she has reviewed, understands, and acknowledges the statement, compensation and other workers compensation benefits shall be suspended until the signature is obtained.
(3) (a) An employee shall not be entitled to compensation or benefits under this chapter if the court with competent jurisdiction determines that the employee has violated any criminal act enumerated in Section 7-5-303 of this section or the administrative law judge or commission determines that the employee knowingly or intentionally engaged in any of the following acts for the purpose of securing workers' compensation benefits:
(i) To knowingly make, or cause to be made, any false, fraudulent, or misleading oral or written statement for the purpose of obtaining any payment or other benefit under this chapter;
(ii) To present or cause to be presented any written or oral statement as part of, or in support of, a claim for payment or other benefit pursuant to any provision of this chapter, knowingly that such statement contains any false, incomplete, or misleading information concerning any material fact to such claim for payment;
(iii) To prepare or cause to be prepared any written or oral statement as part of, or in support of, a claim for payment or other benefit pursuant to any provision of this chapter, knowing that such statement contains any false, incomplete, or misleading information concerning any material fact to such claim for payment; or
(iv) To knowingly assist, conspire with, or urge any person to engage in activity prohibited by this section.
(b) An employer or carrier may suspend an employee's workers' compensation benefits based on probative evidence that the employee has engaged in conduct in violation of this section without first obtaining an order from the administrative judge. Should benefits be suspended by the employer or carrier pursuant to this subsection, the employee may file a petition for reinstatement of benefits with the commission. The commission or administrative law judge shall order the reinstatement of benefits unless the employer or carrier establishes, based on the preponderance of the credible evidence presented at hearing, that the employee engaged in conduct in violation of this section or introduces proof of a criminal violation of Section 7-5-303 as established under paragraph (c) of this subsection. If the employer or carrier fails to introduce any probative evidence at hearing of the violation of this section or Section 7-5-303, then the commission or administrative law judge shall order the payment of additional compensation as provided by Section 71-3-37.
(c) The administrative law judge and commission shall take judicial notice of any finding of a violation of Section 7-5-303 made by a court of competent jurisdiction and order the termination of benefits. Pleas of guilty or nolo contendre in criminal prosecutions of conduct prohibited by Section 7-5-303 shall conclusively establish violation of that section as a matter of law.
(d) Any employee violating this section as determined by the administrative law judge or commission or Section 7-5-303 as determined by a court of competent jurisdiction shall forfeit any right to compensation or benefits under this chapter.
SECTION 2. Section 7-5-309, Mississippi Code of 1972, is amended as follows:
7-5-309. (1) A person who violates any provision of Section 7-5-303 shall be guilty of a felony and, upon conviction thereof, shall be punished by imprisonment for not more than three (3) years, or by a fine of not more than Ten Thousand Dollars ($10,000.00) or double the value of the fraud, whichever is greater, or both. Sentences imposed for convictions of separate offenses under Sections 7-5-301 through 7-5-311 may run consecutively.
(2) If the defendant found to have violated any provisions of Section 7-5-303 is an organization, then it shall be subject to a fine of not more than One Hundred Fifty Thousand Dollars ($150,000.00) for each violation. "Organization" for purposes of this subsection means a person other than an individual. The term includes corporations, partnerships, associations, joint-stock companies, unions, trusts, pension funds, unincorporated organizations, governments and political subdivisions thereof and nonprofit organizations.
(3) In a proceeding for violations under Section 7-5-303, the court, in addition to the criminal penalties imposed under this section, shall assess against the defendant convicted of such violation double those reasonable costs that are expended by the Insurance Integrity Enforcement Bureau of the Office of Attorney General or the district attorney's office in the investigation of such case, including, but not limited to, the cost of investigators, process service, court reporters, expert witnesses and attorney's fees. A monetary penalty assessed and levied under this section shall be deposited to the credit of the State General Fund, and the Attorney General may institute and maintain proceedings in his name for enforcement of payment in the circuit court of the county of residence of the defendant and, if the defendant is a nonresident, such proceedings shall be in the Circuit Court of the First Judicial District of Hinds County, Mississippi.
SECTION 3. Sections 1 and 2 of this act shall apply to all violations occurring on or after July 1, 2012, regardless of the date of the injury.
SECTION 4. This act shall take effect and be in force from and after July 1, 2012.
