|
|
The 2024 Florida Statutes
|
|
|
|
|
F.S. 440.105440.105 Prohibited activities; reports; penalties; limitations.—(1)(a) Any insurance carrier, any individual self-insured, any commercial or group self-insurance fund, any professional practitioner licensed or regulated by the Department of Health, except as otherwise provided by law, any medical review committee as defined in s. 766.101, any private medical review committee, and any insurer, agent, or other person licensed under the insurance code, or any employee thereof, having knowledge or who believes that a fraudulent act or any other act or practice which, upon conviction, constitutes a felony or misdemeanor under this chapter is being or has been committed shall send to the Division of Investigative and Forensic Services, Bureau of Workers’ Compensation Fraud, a report or information pertinent to such knowledge or belief and such additional information relative thereto as the bureau may require. The bureau shall review such information or reports and select such information or reports as, in its judgment, may require further investigation. It shall then cause an independent examination of the facts surrounding such information or report to be made to determine the extent, if any, to which a fraudulent act or any other act or practice which, upon conviction, constitutes a felony or a misdemeanor under this chapter is being committed. The bureau shall report any alleged violations of law which its investigations disclose to the appropriate licensing agency and state attorney or other prosecuting agency having jurisdiction with respect to any such violations of this chapter. If prosecution by the state attorney or other prosecuting agency having jurisdiction with respect to such violation is not begun within 60 days of the bureau’s report, the state attorney or other prosecuting agency having jurisdiction with respect to such violation shall inform the bureau of the reasons for the lack of prosecution. (b) In the absence of fraud or bad faith, a person is not subject to civil liability for libel, slander, or any other relevant tort by virtue of filing reports, without malice, or furnishing other information, without malice, required by this section or required by the bureau, and no civil cause of action of any nature shall arise against such person:1. For any information relating to suspected fraudulent acts furnished to or received from law enforcement officials, their agents, or employees; 2. For any information relating to suspected fraudulent acts furnished to or received from other persons subject to the provisions of this chapter; or 3. For any such information relating to suspected fraudulent acts furnished in reports to the bureau, or the National Association of Insurance Commissioners. (2) Whoever violates any provision of this subsection commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.(a) It shall be unlawful for any employer to knowingly:1. Coerce or attempt to coerce, as a precondition to employment or otherwise, an employee to obtain a certificate of election of exemption pursuant to s. 440.05. 2. Discharge or refuse to hire an employee or job applicant because the employee or applicant has filed a claim for benefits under this chapter. 3. Discharge, discipline, or take any other adverse personnel action against any employee for disclosing information to the department or any law enforcement agency relating to any violation or suspected violation of any of the provisions of this chapter or rules promulgated hereunder. (b) It shall be unlawful for any insurance entity to revoke or cancel a workers’ compensation insurance policy or membership because an employer has returned an employee to work or hired an employee who has filed a workers’ compensation claim. (3) Whoever violates any provision of this subsection commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.(a) It shall be unlawful for any employer to knowingly fail to update applications for coverage as required by s. 440.381(1) and 1department rules within 7 days after the reporting date for any change in the required information, or to post notice of coverage pursuant to s. 440.40. (b) It shall be unlawful for any employer to knowingly participate in the creation of the employment relationship in which the employee has used any false, fraudulent, or misleading oral or written statement as evidence of identity. (c) It is unlawful for any attorney or other person, in his or her individual capacity or in his or her capacity as a public or private employee, or for any firm, corporation, partnership, or association to receive any fee or other consideration or any gratuity from a person on account of services rendered for a person in connection with any proceedings arising under this chapter, unless such fee, consideration, or gratuity is approved by a judge of compensation claims or by the Deputy Chief Judge of Compensation Claims. (4) Whoever violates any provision of this subsection commits insurance fraud, punishable as provided in paragraph (f).(a) It shall be unlawful for any employer to knowingly:1. Present or cause to be presented any false, fraudulent, or misleading oral or written statement to any person as evidence of compliance with s. 440.38. 2. Make a deduction from the pay of any employee entitled to the benefits of this chapter for the purpose of requiring the employee to pay any portion of premium paid by the employer to a carrier or to contribute to a benefit fund or department maintained by such employer for the purpose of providing compensation or medical services and supplies as required by this chapter. 3. Fail to secure workers’ compensation insurance coverage if required to do so by this chapter. (b) It shall be unlawful for any person:1. To knowingly make, or cause to be made, any false, fraudulent, or misleading oral or written statement for the purpose of obtaining or denying any benefit or payment under this chapter. 2. 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, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim. 3. To prepare or cause to be prepared any written or oral statement that is intended to be presented to any employer, insurance company, or self-insured program in connection with, or in support of, any 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 fact or thing material to such claim. 4. To knowingly assist, conspire with, or urge any person to engage in activity prohibited by this section. 5. To knowingly make any false, fraudulent, or misleading oral or written statement, or to knowingly omit or conceal material information, required by s. 440.185 or s. 440.381, for the purpose of obtaining workers’ compensation coverage or for the purpose of avoiding, delaying, or diminishing the amount of payment of any workers’ compensation premiums. 6. To knowingly misrepresent or conceal payroll, classification of workers, or information regarding an employer’s loss history which would be material to the computation and application of an experience rating modification factor for the purpose of avoiding or diminishing the amount of payment of any workers’ compensation premiums. 7. To knowingly present or cause to be presented any false, fraudulent, or misleading oral or written statement to any person as evidence of compliance with s. 440.38, as evidence of eligibility for a certificate of exemption under s. 440.05. 8. To knowingly violate a stop-work order issued by the department pursuant to s. 440.107. 9. To knowingly present or cause to be presented any false, fraudulent, or misleading oral or written statement to any person as evidence of identity for the purpose of obtaining employment or filing or supporting a claim for workers’ compensation benefits. (c) It shall be unlawful for any physician licensed under chapter 458, osteopathic physician licensed under chapter 459, chiropractic physician licensed under chapter 460, podiatric physician licensed under chapter 461, optometric physician licensed under chapter 463, or any other practitioner licensed under the laws of this state to knowingly and willfully assist, conspire with, or urge any person to fraudulently violate any of the provisions of this chapter. (d) It shall be unlawful for any person or governmental entity licensed under chapter 395 to maintain or operate a hospital in such a manner so that such person or governmental entity knowingly and willfully allows the use of the facilities of such hospital by any person, in a scheme or conspiracy to fraudulently violate any of the provisions of this chapter. (e) It shall be unlawful for any attorney or other person, in his or her individual capacity or in his or her capacity as a public or private employee, or any firm, corporation, partnership, or association, to knowingly assist, conspire with, or urge any person to fraudulently violate any of the provisions of this chapter. (f) If the monetary value of any violation of this subsection:1. Is less than $20,000, the offender commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Is $20,000 or more, but less than $100,000, the offender commits a felony of the second degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 3. Is $100,000 or more, the offender commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (5) It shall be unlawful for any attorney or other person, in his or her individual capacity or in his or her capacity as a public or private employee or for any firm, corporation, partnership, or association, to unlawfully solicit any business in and about city or county hospitals, courts, or any public institution or public place; in and about private hospitals or sanitariums; in and about any private institution; or upon private property of any character whatsoever for the purpose of making workers’ compensation claims. Whoever violates any provision of this subsection commits a felony of the second degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (6) This section shall not be construed to preclude the applicability of any other provision of criminal law that applies or may apply to any transaction. (7) An injured employee or any other party making a claim under this chapter shall provide his or her personal signature attesting 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 of claim containing any false or misleading information commits insurance fraud, punishable as provided in s. 817.234.” If the injured employee or other party refuses to sign the document attesting that he or she has reviewed, understands, and acknowledges the statement, benefits, or payments under this chapter shall be suspended until such signature is obtained. History.—s. 12, ch. 93-415; s. 105, ch. 97-103; s. 7, ch. 98-174; s. 10, ch. 2001-91; s. 87, ch. 2001-277; s. 19, ch. 2002-194; s. 473, ch. 2003-261; s. 11, ch. 2003-412; s. 5, ch. 2006-305; s. 99, ch. 2010-5; s. 10, ch. 2016-165. 1Note.—As amended by s. 11, ch. 2003-412. The amendment by s. 473, ch. 2003-261, substituted a reference to the Financial Services Commission instead of referencing the department (defined as the Department of Financial Services in s. 440.02) in place of the former Department of Insurance.
| |
Arrestable Offenses / Crimes under Fla. Stat. 440.105
Level: DegreeMisdemeanor/Felony: First/Second/Third
S440.105 2a1 - PUBLIC ORDER CRIMES - COERCE EMPL TO OBT CERTIF OF WORK COMP EXEMPT - M: F
S440.105 2a2 - PUBLIC ORDER CRIMES - FIRE NOT HIRE EMP APP BC FILED WORK COMP CLAIM - M: F
S440.105 2a3 - PUBLIC ORDER CRIMES - ADVER EMP ACTION BC REP VIOL OF WORK COMP REGS - M: F
S440.105 2a4 - PUBLIC ORDER CRIMES - REPEALED 7/1/06. 2006-305 - M: F
S440.105 2b - PUBLIC ORDER CRIMES - INS CO CANCEL INS BC EMP FILED WORK COMP CLAIM - M: F
S440.105 3a - PUBLIC ORDER CRIMES - FAIL UPDTE APP POST NOT RE WORK COMP COVERAGE - M: F
S440.105 3b - PUBLIC ORDER CRIMES - EMPLOYER HIRE EMPLOYEE WHO USED FALSE ID - M: F
S440.105 3c - PUBLIC ORDER CRIMES - ATTY OTHERS RECEIVE UNAPPROVED WORK COMP FEE - M: F
S440.105 4 - FRAUD - REMOVED - F: T
S440.105 4a1 - FRAUD-FALSE STATEMENT - EVID BY EMP COMPLY CLAIM/INS LESS 20K DOLS - F: T
S440.105 4a1 - FRAUD-FALSE STATEMENT - EVID EMP CMPLY COMP CLAIM 20K LESS 100K DOLS - F: S
S440.105 4a1 - FRAUD-FALSE STATEMENT - EVID BY EMP COMPLY COMP CLAIM 100K DOLS MORE - F: F
S440.105 4a2 - FRAUD - EMPE PAY EMPR W/C CONTRIB CLAIM LESS 20K DOLS - F: T
S440.105 4a2 - FRAUD - EMP PAY EMPR W/C CONTR CLAIM 20K LESS 100K DOL - F: S
S440.105 4a2 - FRAUD - EMPE PAY EMPR CONTRIB CLAIM 100KDOLS MORE - F: F
S440.105 4a3 - FRAUD - EMP NOT GET WORK COMP INS UNDER 20K DOLS - F: T
S440.105 4a3 - FRAUD - EMP NOT GET WORK COMP INS 20K LESS 100K DOLS - F: S
S440.105 4a3 - FRAUD - EMP NOT GET WORK COMP INS 100K DOLS OR MORE - F: F
S440.105 4b - FRAUD-FALSE STATEMENT - RENUMBERED. SEE REC # 8482 - F: T
S440.105 4b - FRAUD-FALSE STATEMENT - RENUMBERED. SEE REC # 8483 - F: S
S440.105 4b - FRAUD-FALSE STATEMENT - RENUMBERED. SEE REC # 8484 - F: F
S440.105 4b1 - FRAUD-FALSE STATEMENT - MISREP OMIT INF RE W/C CLAIM LESS 20K DOLS - F: T
S440.105 4b1 - FRAUD-FALSE STATEMENT - MISREP OMIT INFO W/C CLAIM 20K LESS 100K DOLS - F: S
S440.105 4b1 - FRAUD-FALSE STATEMENT - MISREP OMIT INF RE W/C CLAIM 100K DOLS MORE - F: F
S440.105 4b2 - FRAUD-FALSE STATEMENT - PRESENT FALSE WC CLAIM PAYMENT BENEFIT LT 20K - F: T
S440.105 4b2 - FRAUD-FALSE STATEMENT - PRESNT FALSE WC CLAIM PYMT BENEFIT 20K LT 100K - F: S
S440.105 4b2 - FRAUD-FALSE STATEMENT - PRESENT FALSE WC CLAIM PAYMENT BENEFIT MT 100K - F: F
S440.105 4b3 - FRAUD-FALSE STATEMENT - PRESENT EMPLOYER INS CO FALSE WC STATE LT 20K - F: T
S440.105 4b3 - FRAUD-FALSE STATEMENT - PRESNT EMPLYR INS CO FLSE WC STATE 20K LT 100K - F: S
S440.105 4b3 - FRAUD-FALSE STATEMENT - PRESENT EMPLOYER INS CO FALSE WC STATE MT 100K - F: F
S440.105 4b4 - FRAUD - ASSIST CONSPIRE ENGAGE IN FALSE WC ACT LT 20K - F: T
S440.105 4b4 - FRAUD - ASSIST CONSPIRE ENGAG FALSE WC ACT 20K LT 100K - F: S
S440.105 4b4 - FRAUD - ASSIST CONSPIRE ENGAGE IN FALSE WC ACT MT 100K - F: F
S440.105 4b5 - FRAUD-FALSE STATEMENT - OMIT CONCEAL MAT INFO OBT WC PYMT PREM LT 20K - F: T
S440.105 4b5 - FRAUD-FALSE STATEMENT - OMIT CNCEAL MAT INF OBT WC PAY PREM 20K LT100K - F: S
S440.105 4b5 - FRAUD-FALSE STATEMENT - OMIT CONCEAL MATER INF OBT WC PAY PREM MT 100K - F: F
S440.105 4b6 - FRAUD - MISREP PAY CLAS INF EMPLYR LOSS HISTRY LT 20 K - F: T
S440.105 4b6 - FRAUD - MISREP PAY CLAS INF EMPLY LOS HSTRY 20K LT100K - F: S
S440.105 4b6 - FRAUD - MISREP PAY CLAS INF EMPLYR LOSS HISTRY MT 100K - F: F
S440.105 4b7 - FRAUD-FALSE STATEMENT - EVID COMPLIANCE ELIGIB FOR CERT EXEMPT LT 20K - F: T
S440.105 4b7 - FRAUD-FALSE STATEMENT - EVID COMPLIAN ELIGIB FOR CERT EXEMP 20K LT100K - F: S
S440.105 4b7 - FRAUD-FALSE STATEMENT - EVID COMPLIANCE ELIGIB FOR CERT EXEMPT MT 100K - F: F
S440.105 4b8 - FRAUD - VIOL WORK COMP STOP WORK ORDER 100K DOLS OR MO - F: F
S440.105 4b8 - FRAUD - VIOL WORK COMP STOP WORK ORDER 20K TO 100K DOL - F: S
S440.105 4b8 - FRAUD - VIOL WORK COMP STOP WORK ORDER LESS THAN 20K - F: T
S440.105 4b9 - FRAUD - USE FALSE ID FOR WC CLAIM 100K DOLS OR MORE - F: F
S440.105 4b9 - FRAUD - USE FALSE ID FOR WC CLAIM 20K TO 100K DOLS - F: S
S440.105 4b9 - FRAUD - USE FALSE ID FOR WC CLAIM LESS THAN 20K DOLS - F: T
S440.105 4c - FRAUD - PHYS ASSIST WORK COMP FRAUD CLAIM LESS 20K DOL - F: T
S440.105 4c - FRAUD - PHYS ASSIST W/C FRAUD CLAIM 20K LESS 100K DOLS - F: S
S440.105 4c - FRAUD - PHYS ASST CONSP W/C FRAUD CLAIM 100K DOLS MORE - F: F
S440.105 4d - FRAUD - OPR HOSP ALLW W/C FRAUD CLAIM LESS 20K DOLS - F: T
S440.105 4d - FRAUD - HOSPTL ALLW W/C FRAUD CLAIM 20K LESS 100K DOLS - F: S
S440.105 4d - FRAUD - HOSP ALLOW W/C FRAUD CLAIM 100K DOLS MORE - F: F
S440.105 4e - FRAUD - ATTY OTHER AST VIOL W/C LAW CLM LESS 20K DOLS - F: T
S440.105 4e - FRAUD - ATTY OTHER ASST VIOL W/C CLM 20K LESS 100K DOL - F: S
S440.105 4e - FRAUD - ATTY OTHER ASST VIOL W/C CLAIM 100K DOLS MORE - F: F
S440.105 4f1 - FRAUD - DELETED - F: T
S440.105 4f2 - FRAUD - DELETED - F: S
S440.105 4f3 - FRAUD - DELETED - F: F
S440.105 4f4 - FRAUD - DELETED - F: T
S440.105 5 - PUBLIC ORDER CRIMES - ATTORNEY OR OTHER SOLICIT WORK COMP CLAIM - F: S
S440.105 7 - FRAUD-FALSE STATEMENT - REMOVED - F: T
Annotations, Discussions, Cases:
Cases Citing Statute 440.105
Total Results: 20
Court: District Court of Appeal of Florida | Date Filed: 2024-04-03
Snippet: commit that fraud, in violation of section 440.105(4)(f)3.,
Florida Statutes (2022);
Court: District Court of Appeal of Florida | Date Filed: 2019-10-30
Snippet: he or she commits
any act described in section 440.105, Florida Statutes, “for the
purpose of securing
Court: District Court of Appeal of Florida | Date Filed: 2019-02-11
Citation: 263 So. 3d 294
Snippet: fraud
defense pursuant to sections 440.09(4) and 440.105(4)(b), Florida
Statutes.
Court: District Court of Appeal of Florida | Date Filed: 2017-12-18
Snippet: defense raised pursuant
to Sections 440.09(4)(a) and 440.105, F.S., and any affirmative defense, must be
raised
Court: District Court of Appeal of Florida | Date Filed: 2017-07-26
Citation: 225 So. 3d 898, 2017 Fla. App. LEXIS 10681, 2017 WL 3160125
Snippet: 365 (Fla. 1st DCA 2005).
Sectioris 440.09(4) and 440.105, Florida Statutes, are often referred to as the
Court: District Court of Appeal of Florida | Date Filed: 2017-06-14
Citation: 220 So. 3d 1251, 2017 Fla. App. LEXIS 8663
Snippet: misrepresentation under paragraphs 440.09(4)(a) and 440.105(4)(b), Florida Statutes (2014). Because the record
Court: District Court of Appeal of Florida | Date Filed: 2017-06-06
Citation: 220 So. 3d 529, 2017 WL 2438332, 2017 Fla. App. LEXIS 8148
Snippet: engaged in collusion to commit fraud under section 440.105(4), Florida Statutes. Although the JCC’s order
Court: District Court of Appeal of Florida | Date Filed: 2017-01-19
Citation: 207 So. 3d 1030, 2017 Fla. App. LEXIS 498
Snippet: misrepresentation under sections 440.09(4) and 440.105(4), Florida Statutes, and awarding benefits to
Court: District Court of Appeal of Florida | Date Filed: 2016-12-21
Citation: 211 So. 3d 176, 2016 Fla. App. LEXIS 18676
Snippet: (11) A prosecution for a felony violation of ss. 440.105 and 817.234 must be commenced within 5 years after
Court: District Court of Appeal of Florida | Date Filed: 2016-07-06
Citation: 196 So. 3d 485
Snippet: requirement is not found in the law.
Section 440.105, Florida Statutes, makes it illegal for any person
Court: District Court of Appeal of Florida | Date Filed: 2016-05-25
Citation: 192 So. 3d 596, 2016 WL 3001809, 2016 Fla. App. LEXIS 7984
Snippet: considerations that attach to’ medical information. See § 440.105(b), Fla. Stat. (2013) (making unlawful any statement
Court: Supreme Court of Florida | Date Filed: 2016-04-28
Citation: 192 So. 3d 431, 41 Fla. L. Weekly Supp. 197, 2016 WL 1700521, 2016 Fla. LEXIS 885
Snippet: based on sections 440.09(4) (intentional acts) and 440.105(4)(b)9. (fraud), Florida Statutes (2009), ultimately
Court: District Court of Appeal of Florida | Date Filed: 2016-04-20
Citation: 190 So. 3d 171, 2016 WL 1578434, 2016 Fla. App. LEXIS 5990
Snippet: Claimant challenges the constitutionality of sections 440.105 and 440.34, Florida Statutes, which limit attorney’s
Court: District Court of Appeal of Florida | Date Filed: 2016-03-20
Snippet: requirement is not found in the law.
Section 440.105, Florida Statutes, makes it illegal for any person
Court: District Court of Appeal of Florida | Date Filed: 2015-07-07
Citation: 171 So. 3d 135
Snippet: petition for benefits. Similarly, sub-subsection 440.105(2)(b), Florida Statutes (2014), makes it unlawful
Court: District Court of Appeal of Florida | Date Filed: 2015-06-03
Citation: 167 So. 3d 480
Snippet: forfeiting benefits under sections 440.09 and 440.105, Florida Statutes (2012). We affirm.
I.
Court: District Court of Appeal of Florida | Date Filed: 2015-06-01
Citation: 165 So. 3d 812, 2015 WL 3464110
Snippet: in the JCC’s opinion, a violation of section 440.105(3)(c), Florida Statutes (2014), which is a misdemeanor
Court: District Court of Appeal of Florida | Date Filed: 2015-04-16
Citation: 160 So. 3d 941, 2015 WL 1578254
Snippet: approval of the E/SA-paid fee.
See
§ 440.105(3)(c), Fla. Stat. (2013) (requiring JCC approve
Court: District Court of Appeal of Florida | Date Filed: 2015-03-09
Citation: 159 So. 3d 934, 2015 WL 1021122
Snippet: prohibition on claimant-paid attorney’s fees in section 440.105(3)(e) and 440.34 [is] unconstitutional, and thus
Court: District Court of Appeal of Florida | Date Filed: 2014-12-23
Citation: 151 So. 3d 1291, 2014 Fla. App. LEXIS 20806, 2014 WL 7273933
Snippet: knowingly or intentionally violates subsections 440.105(4)(b)1.-3., Florida Statutes (2012), is not entitled
