New York statute
N.Y. Penal Law § 176.05 — Insurance fraud; defined
Current through 2026 legislative session (LBDC text via OpenLegislation as of 2026-07-17)
Part of Article 176: Insurance Fraud, New York Penal Law.
Full text of N.Y. Penal Law § 176.05
Statutory text current through the 2026 legislative session (LBDC text via OpenLegislation as of 2026-07-17). This publication reproduces the text of the Consolidated Laws of New York as provided by the New York State Senate's Open Legislation service (Legislative Bill Drafting Commission statutory text); it is not the official statutes of the State of New York.
176.05 Insurance fraud; defined.
1. A fraudulent insurance act is committed by any person who,
knowingly and with intent to defraud presents, causes to be presented,
or prepares with knowledge or belief that it will be presented to or by
an insurer, self insurer, or purported insurer, or purported self
insurer, or any agent thereof:
(a) any written statement as part of, or in support of, an application
for the issuance of, or the rating of a commercial insurance policy, or
certificate or evidence of self insurance for commercial insurance or
commercial self insurance, or a claim for payment or other benefit
pursuant to an insurance policy or self insurance program for commercial
or personal insurance that such person knows to:
(i) contain materially false information concerning any fact material
thereto; or
(ii) conceal, for the purpose of misleading, information concerning
any fact material thereto; or
(b) any written statement or other physical evidence as part of, or in
support of, an application for the issuance of a health insurance
policy, or a policy or contract or other authorization that provides or
allows coverage for, membership or enrollment in, or other services of a
public or private health plan, or a claim for payment, services or other
benefit pursuant to such policy, contract or plan that such person knows
to:
(i) contain materially false information concerning any material fact
thereto; or
(ii) conceal, for the purpose of misleading, information concerning
any fact material thereto.
Such policy or contract or plan or authorization shall include, but
not be limited to, those issued or operating pursuant to any public or
governmentally-sponsored or supported plan for health care coverage or
services or those otherwise issued or operated by entities authorized
pursuant to the public health law. For purposes of this subdivision an
"application for the issuance of a health insurance policy" shall not
include (i) any application for a health insurance policy or contract
approved by the superintendent of financial services pursuant to the
provisions of sections three thousand two hundred sixteen, four thousand
three hundred four, four thousand three hundred twenty-one or four
thousand three hundred twenty-two of the insurance law or any other
application for a health insurance policy or contract approved by the
superintendent of financial services in the individual or direct payment
market; or (ii) any application for a certificate evidencing coverage
under a self-insured plan or under a group contract approved by the
superintendent of financial services.
2. A person who hires, requests, encourages, orchestrates, or invites
another individual to stage a motor vehicle accident, as that term is
defined in section 176.75 of this article, commits a fraudulent
insurance act, and the person who hired, requested, encouraged,
orchestrated, or invited the other to stage a motor vehicle accident
shall be deemed to have wrongfully taken, obtained, or withheld the full
amount of loss to the victim or victims of the fraudulent insurance act.
Official sources
Legal terms used in this section
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