Fraud Warning: 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. Please see state specific fraud language below:
STATE FRAUD STATEMENTS
Applicable in AL, AR, DC, LA, MD, NM, RI, and WV: Any person who knowingly (or willfully)* presents a false or fraudulent claim for payment of a loss or benefit or 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. *Applies in MD Only.
Applicable in CO: 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.
Applicable in FL and OK: 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)*. *Applies in FL Only.
Applicable in KS: 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, purported insurer, broker or any agent thereof, any written statement as part of, or in support of, an application for the issuance of, or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or other benefit pursuant to an insurance policy for commercial or personal insurance which such person knows to contain materially false information concerning any fact material thereto; or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act.
Applicable in KY, NY, OH, and PA: 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 (not to exceed five thousand dollars and the stated value of the claim for each such violation)*. *Applies in NY Only.
Applicable in ME, TN, VA, and WA: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties (may)* include imprisonment, fines and denial of insurance benefits. *Applies in ME Only.
Applicable in NJ: Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.
Applicable in OR: Any person who knowingly and with intent to defraud or solicit another to defraud the insurer by submitting an application containing a false statement as to any material fact may be violating state law.
Applicable in PR: Any person who knowingly and with the intention of defrauding presents false information in an insurance application, or presents, helps, or causes the presentation of a fraudulent claim for the payment of a loss or any other benefit, or presents more than one claim for the same damage or loss, shall incur a felony and, upon conviction, shall be sanctioned for each violation by a fine of not less than five thousand dollars ($5,000) and not more than ten thousand dollars ($10,000), or a fixed term of imprisonment for three (3) years, or both penalties. Should aggravating circumstances [be] present, the penalty thus established may be increased to a maximum of five (5) years, if extenuating circumstances are present, it may be reduced to a minimum of two (2) years.
2019 Source: ACORD 125/88 Forms
Markel® Electronic Delivery and Signature Consent Disclosure
Markel Corporation affiliated insurance companies along with its underwriting and service manager, Markel Service Incorporated, known collectively as “Company,” is providing You with the opportunity to receive electronic delivery of any available insurance related documents, notices, billing and policies relating to coverage You now have, may apply for or may later have.
For the purposes of this Consent, “You or Your” shall mean the Named Insured, Prospective Named Insured, Customer or Client and refers to the person, legal entity or authorized representative of the Named Insured. Insurance Producers authorized by You, must be licensed and appointed by the Company to complete this form on Your behalf.
The purpose of this consent is to ensure that You are fully aware of the consequences of agreeing to receive and sign documents electronically. “Electronic documents” include all electronic documents we may send to You, including documents You may complete via web page and save on Your computer or attach to e-mail. An “Electronic Signature” includes any mark, symbol, sound or process that is written, stamped, engraved, attached to or logically associated with an electronic document and executed by a person with the intent to sign.
You have the following rights:
- Right to Receive Paper Documents: You have the right to receive any document provided in paper or non-electronic form. If You want a paper copy of any document, please contact the Company. There is not a fee.
- Right to Withdraw Consent. You have the right to withdraw Your consent to receive documents electronically by contacting the Company. The legal validity and enforceability of the electronic documents, signatures and deliveries used prior to withdrawal of consent will not be affected. In other words, all prior electronic deliveries shall be fully valid and enforceable.
- Changes to Your E-Mail Address. You should keep the Company informed of any change in Your electronic or e-mail address. Please contact the Company as soon as possible if there are any changes.
- Your Ability to Access Disclosures. By agreeing to this consent, You acknowledge that You can access and retain the electronic documents. The hardware and software required is an email address, a document reader and access to a computer or a device that can access the internet. To retain the notices or documents, you must have the ability to retain the notices or documents delivered by electronic means, which means access to a printer and/or the ability to download the notices or documents to a hard drive or an external media storage device1.
- You may contact us at: Markel® P.O. Box 3009 Omaha, NE 68103; phone: 888-500-3344; or by email: firstname.lastname@example.org.
- Unless required by law, all notices, disclosures, authorizations, acknowledgements and other documents relating to coverages You may have with us may be provided to You in electronic form. We may still send some notices to You in paper at Your regular mailing address. For this reason, it is important that You inform us of any changes to Your regular mailing address.
- Your rights relating to insurance we provide to You may be dependent on when You receive certain information from us. You are considered to have received information from us when we notify You at Your email address alerting You that the information is waiting for You at Your secure mailbox at the web portal or as posted on our website, as designated in the email we would send to You.
- If the law requires us to provide to You particular information in writing, we may provide that information instead by alerting You by email that the information is waiting for You at Your secure mailbox at the web portal or as posted on our website, as designated in the email we would send to You.
The Company may utilize the services of third-party service providers to facilitate electronic delivery of Electronic documents.