senate Bill S7552

2013-2014 Legislative Session

Relates to penalties for false representation and fraudulent practices; repealer

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Archive: Last Bill Status - In Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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May 15, 2014 referred to local government

S7552 - Bill Details

Current Committee:
Law Section:
Volunteer Ambulance Workers' Benefit Law
Laws Affected:
Rpld & add §55, Vol Amb Work Ben L; rpld & add §55, Vol Ffs Ben L

S7552 - Bill Texts

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Relates to penalties for false representation and fraudulent practices; makes such provisions the same as those applicable to workers' compensation provisions.

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BILL NUMBER:S7552

TITLE OF BILL: An act to amend the volunteer ambulance workers'
benefit law and the volunteer firefighters' benefit law, in relation
to penalties for false representation and to repeal certain provisions
of such laws relating thereto

PURPOSE: The purpose of the legislation is to ensure that sections 114
and 114-a of the workers compensation law is applicable to volunteer
firefighters and volunteer ambulance workers.

SUMMARY OF PROVISIONS: Section one repeals section 55 of the volunteer
firefighters benefit law and replaces it with current sections 114 and
114-a of the workers' compensation law.

Section two repeals section 55 of the volunteer ambulance workers
benefit law and replaces it with current sections 114 and 114-a of the
workers' compensation law.

Section three provides for an immediate effective date.

JUSTIFICATION: Currently, a volunteer firefighter or ambulance worker
who is injured in the line of duty is eligible for workers'
compensation benefits if he or she can demonstrate a loss of earning
capacity. Additionally, both the workers' compensation law and the
volunteer firefighters benefits law (VBFL) provide for criminal
penalties for offering fraudulent information in support of a claim.
In 1996, the legislature amended the workers' compensation law to also
include civil penalties for fraudulent claims by adding a new section
114-a.

Unfortunately, no corresponding amendment was made to either the VBFL
or the volunteer ambulance workers benefits law (VAWBL).

The issue of the applicability of section 114-a to the to the VBFL was
addressed before the New York State Workers Compensation Board and the
Board determined that section 114-a was inapplicable to the VBFL.
This issue was appealed to the Appellate Division, Third Department
and in the case of Giello v. Providence Fire District, 869 N.Y.S.2d
676 (2008) the Appellate Division affirmed the Workers' Compensation
Board's decision establishing that section 114-a which provides for a
disqualification of benefits to a claimant for making false
representations did not apply to benefits awarded pursuant to the VBFL
on the basis that section 114-a was unambiguous and limited its
application to wage replacement benefits under the workers'
compensation law.

Under the circumstances, the issue of the applicability of section
114-a to the VBFL and VAWBL should be addressed by the legislature.
It is only fair that civil penalties should be provided for fraudulent
claims involving volunteer firefighters offering fraudulent
information in support of a claim under the VBFL.

The VBFL and VAWBL provides cash benefits and/or medical care for
volunteer members who are injured or become ill in the line of duty,
and recognizes the unselfish service of volunteer firefighters and
ambulance workers. The law was designed to protect these volunteers


who are injured in the line of duty. Similarly, the law should be
amended to provide for civil penalties similar to section 114-a in
keeping with the intent of the statute which was to protect volunteer
firefighters and ambulance workers who provide unselfish service and
provide for civil penalties for those who choose to take advantage of
the statute by submitting fraudulent information in support of a claim
under the VBFL and VAWBL.

LEGISLATIVE HISTORY: New bill.

FISCAL IMPLICATIONS: To be determined.

EFFECTIVE DATE: Immediately

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                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  7552

                            I N  S E N A T E

                              May 15, 2014
                               ___________

Introduced  by  Sen.  SEWARD -- read twice and ordered printed, and when
  printed to be committed to the Committee on Local Government

AN ACT to amend the volunteer ambulance workers'  benefit  law  and  the
  volunteer  firefighters'  benefit  law,  in  relation to penalties for
  false representation and to repeal certain  provisions  of  such  laws
  relating thereto

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 55 of the volunteer ambulance workers' benefit  law
is REPEALED and a new section 55 is added to read as follows:
  S  55.  FRAUDULENT  PRACTICES.  1.  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 OR
PURPORTED INSURER, 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  COMPENSATION  INSURANCE,  OR  A  CLAIM  FOR
PAYMENT  OR  OTHER BENEFIT PURSUANT TO A COMPENSATION POLICY WHICH HE OR
SHE KNOWS TO: (I) CONTAIN A FALSE STATEMENT OR REPRESENTATION CONCERNING
ANY FACT MATERIAL THERETO; OR (II)  OMITS  ANY  FACT  MATERIAL  THERETO,
SHALL BE GUILTY OF A CLASS E FELONY. UPON CONVICTION, THE COURT IN ADDI-
TION  TO  ANY  OTHER  AUTHORIZED  SENTENCE,  MAY ORDER FORFEITURE OF ALL
RIGHTS TO COMPENSATION OR PAYMENTS OF ANY BENEFIT, AND MAY ALSO  REQUIRE
RESTITUTION  OF  ANY  AMOUNT RECEIVED AS A RESULT OF A VIOLATION OF THIS
SUBDIVISION.
  2. AN EMPLOYER OR CARRIER, OR ANY EMPLOYEE, AGENT, OR PERSON ACTING ON
BEHALF OF AN EMPLOYER OR CARRIER, WHO KNOWINGLY MAKES A FALSE  STATEMENT
OR  REPRESENTATION  AS  TO  A  MATERIAL FACT IN THE COURSE OF REPORTING,
INVESTIGATION OF, OR ADJUSTING A CLAIM FOR ANY BENEFIT OR PAYMENT  UNDER
THE  WORKERS'  COMPENSATION LAW FOR THE PURPOSE OF AVOIDING PROVISION OF
SUCH PAYMENT OR BENEFIT SHALL BE GUILTY OF A CLASS E FELONY.
  3. A PERSON WHO KNOWINGLY MAKES A FALSE STATEMENT OR REPRESENTATION AS
TO A MATERIAL FACT FOR THE PURPOSE OF OBTAINING, MAINTAINING OR RENEWING
INSURANCE UNDER THIS CHAPTER, WHETHER FOR HIMSELF OR HERSELF OR FOR  ANY
OTHER PERSON OR ENTITY OR FOR THE PURPOSE OF EVADING THE REQUIREMENTS OF

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15255-01-4

S. 7552                             2

SECTION  FIFTY  OF  THIS CHAPTER SHALL BE GUILTY OF A CLASS E FELONY. IN
ADDITION TO ANY OTHER REMEDY, THE CARRIER PROVIDING INSURANCE  SHALL  BE
ENTITLED  TO  RESTITUTION OF ANY AMOUNT OBTAINED OR WITHHELD AS A RESULT
OF A VIOLATION OF THIS SUBDIVISION.
  4.  CONSISTENT  WITH  THE PROVISIONS OF THE CRIMINAL PROCEDURE LAW, IN
ANY PROSECUTION ALLEGING A VIOLATION OF SUBDIVISION ONE, TWO OR THREE OF
THIS SECTION, OR SECTIONS FIFTY-TWO AND ONE HUNDRED  THIRTY-ONE  OF  THE
WORKERS'  COMPENSATION  LAW,  IN  WHICH THE ACT OR ACTS ALLEGED MAY ALSO
CONSTITUTE A VIOLATION OF THE PENAL OR OTHER LAW, THE PROSECUTING  OFFI-
CIAL  MAY CHARGE A PERSON PURSUANT TO THE PROVISIONS OF THIS SECTION AND
IN THE SAME ACCUSATORY INSTRUMENT WITH A VIOLATION OF SUCH OTHER LAW.
  5. A PERSON (A) WHO IS CONVICTED OF A  SECOND  OR  SUBSEQUENT  OFFENSE
UNDER  THIS SECTION WITHIN TEN YEARS OF THE PRIOR CONVICTION, OR (B) WHO
VIOLATES ANY PROVISION OF THIS SECTION CONCERNING TWO OR MORE CLAIMANTS,
SHALL BE GUILTY OF A CLASS D FELONY.
  6. IF FOR THE PURPOSE OF OBTAINING COMPENSATION  PURSUANT  TO  SECTION
FIFTEEN  OF  THE WORKERS' COMPENSATION LAW, OR FOR THE PURPOSE OF INFLU-
ENCING ANY DETERMINATION REGARDING ANY SUCH PAYMENT, A CLAIMANT KNOWING-
LY MAKES A FALSE STATEMENT OR REPRESENTATION AS TO A MATERIAL FACT, SUCH
PERSON SHALL BE DISQUALIFIED FROM RECEIVING  ANY  COMPENSATION  DIRECTLY
ATTRIBUTABLE  TO SUCH FALSE STATEMENT OR REPRESENTATION. IN ADDITION, AS
DETERMINED BY THE WORKERS' COMPENSATION BOARD,  THE  CLAIMANT  SHALL  BE
SUBJECT TO A DISQUALIFICATION OR AN ADDITIONAL PENALTY UP TO THE FOREGO-
ING  AMOUNT  DIRECTLY  ATTRIBUTABLE  TO THE FALSE STATEMENT OR REPRESEN-
TATION. ANY PENALTY MONIES SHALL BE PAID INTO THE STATE TREASURY.
  7. IF WITH THE KNOWLEDGE OF A CLAIMANT, ANOTHER PERSON KNOWINGLY MAKES
A FALSE STATEMENT OR REPRESENTATION  AS  TO  A  MATERIAL  FACT  FOR  THE
PURPOSE  OF ASSISTING A CLAIMANT IN EITHER OBTAINING, OR INFLUENCING ANY
DETERMINATION REGARDING COMPENSATION PURSUANT TO SECTION FIFTEEN OF  THE
WORKERS'  COMPENSATION  LAW,  SUCH  CLAIMANT  MAY  BE  DISQUALIFIED FROM
RECEIVING ANY COMPENSATION DIRECTLY ATTRIBUTABLE TO SUCH FALSE STATEMENT
OR REPRESENTATION. IN ADDITION, AS DETERMINED BY  THE  WORKERS'  COMPEN-
SATION  BOARD,  THE  CLAIMANT MAY BE SUBJECT TO A DISQUALIFICATION OR AN
ADDITIONAL PENALTY UP TO THE FOREGOING AMOUNT DIRECTLY  ATTRIBUTABLE  TO
THE  FALSE  STATEMENT  OR  REPRESENTATION.  ANY  PENALTY MONIES SHALL BE
DEPOSITED TO THE CREDIT OF THE GENERAL FUND OF THE STATE.
  8. IF THE WORKERS' COMPENSATION BOARD OR ANY COURT HAVING JURISDICTION
OVER PROCEEDINGS IN RESPECT OF ANY  CLAIM  FOR  COMPENSATION  DETERMINES
THAT  THE  PROCEEDINGS  IN RESPECT OF SUCH CLAIM, INCLUDING ANY APPEALS,
HAVE BEEN INSTITUTED OR CONTINUED WITHOUT REASONABLE GROUND:
  (I) THE COST OF SUCH PROCEEDINGS SHALL BE ASSESSED AGAINST  THE  PARTY
WHO HAS SO INSTITUTED OR CONTINUED THE PROCEEDINGS, WHICH SHALL BE PAYA-
BLE  TO  THE  BOARD  FOR ADMINISTRATIVE EXPENSES PURSUANT TO SECTION ONE
HUNDRED FIFTY-ONE OF THE WORKERS' COMPENSATION LAW;
  (II) REASONABLE ATTORNEYS' FEES SHALL BE ASSESSED AGAINST AN  ATTORNEY
OR  LICENSED  REPRESENTATIVE WHO HAS INSTITUTED OR CONTINUED PROCEEDINGS
WITHOUT REASONABLE GROUNDS, WHICH ASSESSMENT SHALL  BE  PAYABLE  TO  THE
BOARD  FOR  ADMINISTRATIVE  EXPENSES  PURSUANT  TO  SECTION  ONE HUNDRED
FIFTY-ONE OF THE WORKERS' COMPENSATION LAW.   FEES  AWARDED  UNDER  THIS
PROVISION MAY NOT BE RECOUPED FROM THE PARTY; AND
  (III)  SUCH  ASSESSMENTS  SHALL  BE  IN  ADDITION TO ANY OTHER PENALTY
PERMITTED UNDER THE WORKERS' COMPENSATION LAW.
  S 2. Section 55 of the volunteer firefighters' benefit law is REPEALED
and a new section 55 is added to read as follows:
  S 55. FRAUDULENT PRACTICES. 1. ANY  PERSON  WHO,  KNOWINGLY  AND  WITH
INTENT  TO  DEFRAUD  PRESENTS,  CAUSES TO BE PRESENTED, OR PREPARES WITH

S. 7552                             3

KNOWLEDGE OR BELIEF THAT IT WILL BE PRESENTED TO OR  BY  AN  INSURER  OR
PURPORTED  INSURER,  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  COMPENSATION  INSURANCE,  OR A CLAIM FOR
PAYMENT OR OTHER BENEFIT PURSUANT TO A COMPENSATION POLICY WHICH  HE  OR
SHE KNOWS TO: (I) CONTAIN A FALSE STATEMENT OR REPRESENTATION CONCERNING
ANY  FACT  MATERIAL  THERETO;  OR  (II) OMITS ANY FACT MATERIAL THERETO,
SHALL BE GUILTY OF A CLASS E FELONY. UPON CONVICTION, THE COURT IN ADDI-
TION TO ANY OTHER AUTHORIZED  SENTENCE,  MAY  ORDER  FORFEITURE  OF  ALL
RIGHTS  TO COMPENSATION OR PAYMENTS OF ANY BENEFIT, AND MAY ALSO REQUIRE
RESTITUTION OF ANY AMOUNT RECEIVED AS A RESULT OF A  VIOLATION  OF  THIS
SUBDIVISION.
  2. AN EMPLOYER OR CARRIER, OR ANY EMPLOYEE, AGENT, OR PERSON ACTING ON
BEHALF  OF AN EMPLOYER OR CARRIER, WHO KNOWINGLY MAKES A FALSE STATEMENT
OR REPRESENTATION AS TO A MATERIAL FACT  IN  THE  COURSE  OF  REPORTING,
INVESTIGATION  OF, OR ADJUSTING A CLAIM FOR ANY BENEFIT OR PAYMENT UNDER
THE WORKERS' COMPENSATION LAW FOR THE PURPOSE OF AVOIDING  PROVISION  OF
SUCH PAYMENT OR BENEFIT SHALL BE GUILTY OF A CLASS E FELONY.
  3. A PERSON WHO KNOWINGLY MAKES A FALSE STATEMENT OR REPRESENTATION AS
TO A MATERIAL FACT FOR THE PURPOSE OF OBTAINING, MAINTAINING OR RENEWING
INSURANCE  UNDER THIS CHAPTER, WHETHER FOR HIMSELF OR HERSELF OR FOR ANY
OTHER PERSON OR ENTITY OR FOR THE PURPOSE OF EVADING THE REQUIREMENTS OF
SECTION FIFTY OF THIS CHAPTER SHALL BE GUILTY OF A CLASS  E  FELONY.  IN
ADDITION  TO  ANY OTHER REMEDY, THE CARRIER PROVIDING INSURANCE SHALL BE
ENTITLED TO RESTITUTION OF ANY AMOUNT OBTAINED OR WITHHELD AS  A  RESULT
OF A VIOLATION OF THIS SUBDIVISION.
  4.  CONSISTENT  WITH  THE PROVISIONS OF THE CRIMINAL PROCEDURE LAW, IN
ANY PROSECUTION ALLEGING A VIOLATION OF SUBDIVISION ONE, TWO OR THREE OF
THIS SECTION, OR SECTIONS FIFTY-TWO AND ONE HUNDRED  THIRTY-ONE  OF  THE
WORKERS'  COMPENSATION  LAW,  IN  WHICH THE ACT OR ACTS ALLEGED MAY ALSO
CONSTITUTE A VIOLATION OF THE PENAL OR OTHER LAW, THE PROSECUTING  OFFI-
CIAL  MAY CHARGE A PERSON PURSUANT TO THE PROVISIONS OF THIS SECTION AND
IN THE SAME ACCUSATORY INSTRUMENT WITH A VIOLATION OF SUCH OTHER LAW.
  5. A PERSON (A) WHO IS CONVICTED OF A  SECOND  OR  SUBSEQUENT  OFFENSE
UNDER  THIS SECTION WITHIN TEN YEARS OF THE PRIOR CONVICTION, OR (B) WHO
VIOLATES ANY PROVISION OF THIS SECTION CONCERNING TWO OR MORE CLAIMANTS,
SHALL BE GUILTY OF A CLASS D FELONY.
  6. IF FOR THE PURPOSE OF OBTAINING COMPENSATION  PURSUANT  TO  SECTION
FIFTEEN  OF  THE WORKERS' COMPENSATION LAW, OR FOR THE PURPOSE OF INFLU-
ENCING ANY DETERMINATION REGARDING ANY SUCH PAYMENT, A CLAIMANT KNOWING-
LY MAKES A FALSE STATEMENT OR REPRESENTATION AS TO A MATERIAL FACT, SUCH
PERSON SHALL BE DISQUALIFIED FROM RECEIVING  ANY  COMPENSATION  DIRECTLY
ATTRIBUTABLE  TO SUCH FALSE STATEMENT OR REPRESENTATION. IN ADDITION, AS
DETERMINED BY THE WORKERS' COMPENSATION BOARD,  THE  CLAIMANT  SHALL  BE
SUBJECT TO A DISQUALIFICATION OR AN ADDITIONAL PENALTY UP TO THE FOREGO-
ING  AMOUNT  DIRECTLY  ATTRIBUTABLE  TO THE FALSE STATEMENT OR REPRESEN-
TATION. ANY PENALTY MONIES SHALL BE PAID INTO THE STATE TREASURY.
  7. IF WITH THE KNOWLEDGE OF A CLAIMANT, ANOTHER PERSON KNOWINGLY MAKES
A FALSE STATEMENT OR REPRESENTATION  AS  TO  A  MATERIAL  FACT  FOR  THE
PURPOSE  OF ASSISTING A CLAIMANT IN EITHER OBTAINING, OR INFLUENCING ANY
DETERMINATION REGARDING COMPENSATION PURSUANT TO SECTION FIFTEEN OF  THE
WORKERS'  COMPENSATION  LAW,  SUCH  CLAIMANT  MAY  BE  DISQUALIFIED FROM
RECEIVING ANY COMPENSATION DIRECTLY ATTRIBUTABLE TO SUCH FALSE STATEMENT
OR REPRESENTATION. IN ADDITION, AS DETERMINED BY  THE  WORKERS'  COMPEN-
SATION  BOARD,  THE  CLAIMANT MAY BE SUBJECT TO A DISQUALIFICATION OR AN
ADDITIONAL PENALTY UP TO THE FOREGOING AMOUNT DIRECTLY  ATTRIBUTABLE  TO

S. 7552                             4

THE  FALSE  STATEMENT  OR  REPRESENTATION.  ANY  PENALTY MONIES SHALL BE
DEPOSITED TO THE CREDIT OF THE GENERAL FUND OF THE STATE.
  8. IF THE WORKERS' COMPENSATION BOARD OR ANY COURT HAVING JURISDICTION
OVER  PROCEEDINGS  IN  RESPECT  OF ANY CLAIM FOR COMPENSATION DETERMINES
THAT THE PROCEEDINGS IN RESPECT OF SUCH CLAIM,  INCLUDING  ANY  APPEALS,
HAVE  BEEN  INSTITUTED  OR CONTINUED WITHOUT REASONABLE GROUND:  (I) THE
COST OF SUCH PROCEEDINGS SHALL BE ASSESSED AGAINST THE PARTY WHO HAS  SO
INSTITUTED  OR  CONTINUED THE PROCEEDINGS, WHICH SHALL BE PAYABLE TO THE
BOARD FOR  ADMINISTRATIVE  EXPENSES  PURSUANT  TO  SECTION  ONE  HUNDRED
FIFTY-ONE  OF  THE WORKERS' COMPENSATION LAW; (II) REASONABLE ATTORNEYS'
FEES SHALL BE ASSESSED AGAINST AN ATTORNEY  OR  LICENSED  REPRESENTATIVE
WHO  HAS INSTITUTED OR CONTINUED PROCEEDINGS WITHOUT REASONABLE GROUNDS,
WHICH ASSESSMENT SHALL  BE  PAYABLE  TO  THE  BOARD  FOR  ADMINISTRATIVE
EXPENSES  PURSUANT  TO  SECTION  ONE  HUNDRED  FIFTY-ONE OF THE WORKERS'
COMPENSATION LAW.  FEES AWARDED UNDER THIS PROVISION MAY NOT BE RECOUPED
FROM THE PARTY; AND (III) SUCH ASSESSMENTS SHALL BE IN ADDITION  TO  ANY
OTHER PENALTY PERMITTED UNDER THE WORKERS' COMPENSATION LAW.
  S 3. This act shall take effect immediately.

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