Chapter Definitions
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Law
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Tennessee Code
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Insurance
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Insurance Fraud
- Chapter Definitions
As used in this chapter, unless the context otherwise requires:
- “Actual malice” means knowledge that information is false, or reckless disregard of whether it is false;
- “Conceal” means to take affirmative action to prevent others from discovering information. Mere failure to disclose information does not constitute concealment. Action by the holder of a legal privilege, or one who has a reasonable belief that a privilege exists, to prevent discovery of privileged information, does not constitute concealment;
- “Insurance policy” means the written instrument in which are set forth the terms of any certificate of insurance, binder of coverage or contract of insurance, including a certificate, binder or contract issued by a state-assigned risk plan, benefit plan, nonprofit hospital service plan, health maintenance organization, motor club service plan, or surety bond, cash bond or any other alternative to insurance authorized by a state's financial responsibility act. “Insurance policy” also means any other instruments authorized or regulated by the department of commerce and insurance;
- “Insurance professional” means sales agents, managing general agents, brokers, producers, adjusters and third-party administrators;
- “Insurance transaction” means a transaction by, between or among:
- An insurer or a person who acts on behalf of an insurer; and
- An insured, claimant, applicant for insurance, public adjuster, insurance professional, practitioner, or any person who acts on behalf of an insured, claimant, applicant for insurance, public adjuster, insurance professional, or practitioner;for the purpose of obtaining insurance or reinsurance, calculating insurance premiums, submitting a claim, negotiating or adjusting a claim, or otherwise obtaining insurance, self-insurance, or reinsurance or obtaining the benefits of insurance, self-insurance, or reinsurance or from insurance, self-insurance, or reinsurance;
- “Insurer” means any person purporting to engage in the business of insurance or authorized to do business in this state or subject to regulation by the state, who undertakes to indemnify another against loss, damage or liability arising from a contingent or unknown event. “Insurer” includes, but is not limited to, an insurance company, self-insurer, reinsurer, reciprocal exchange, interinsurer, risk retention group, Lloyd's insurer, fraternal benefit society, surety, medical service, health maintenance organization, dental, optometric or any other similar health service plan, and any other legal entity engaged or purportedly engaged in the business of insurance, including any person or entity that falls within the definition of “insurer” found within this title;
- “Pattern or practice” means repeated, routine or generalized in nature, and not merely isolated or sporadic;
- “Person” means a natural person, company, corporation, unincorporated association, partnership, professional corporation, agency of government and any other entity;
- “Practitioner” means a licensee of this state authorized to practice medicine and surgery, psychology, chiropractic or law or any other licensee of the state or person required to be licensed in the state whose services are compensated either in whole or in part, directly or indirectly, by insurance proceeds, including, but not limited to, automotive repair shops, building contractors and insurance adjusters, or a licensee similarly licensed in other states and nations or the licensed practitioner of any nonmedical treatment rendered in accordance with a recognized religious method of healing;
- “Premium” means consideration paid or payable for coverage under an insurance policy. “Premium” includes any payments, whether due within the insurance policy term or otherwise, and deductible payments, whether advanced by the insurer or insurance professional and subject to reimbursement by the insured or otherwise, any self-insured retention or payments, whether advanced by the insurer or insurance professional and subject to reimbursement by the insured or otherwise, and any collateral or security to be provided to collateralize obligations to pay any of the above;
- “Premium finance company” means a person engaged or purporting to engage in the business of advancing money, directly or indirectly, to an insurer or producer at the request of an insured pursuant to the terms of a premium finance agreement, including but not limited to loan contracts, notes, agreements or obligations, wherein the insured has assigned the unearned premiums, accrued dividends, or loss payments as security for the advancement in payment of premiums on insurance policies only, and does not include the financing of insurance premiums purchased in connection with the financing of goods and services;
- “Premium finance transaction” means a transaction by, between or among an insured, a producer or other party claiming to act on behalf of an insured and a third-party premium finance company, for the purposes of purportedly or actually advancing money directly or indirectly to an insurer or producer at the request of an insured pursuant to the terms of a premium finance agreement, wherein the insured has assigned the unearned premiums, accrued dividends or loan payments as security for the advancement in payment of premiums on insurance policies only, and does not include the financing of insurance premiums purchased in connection with the financing of goods and services;
- “Reckless” means without reasonable belief of the truth, or, for the purposes of § 56-53-103(a)(3), with a high degree of awareness of probable insolvency; and
- “Withhold” means to fail to disclose facts or information that any law, other than this chapter, requires to be disclosed. Mere failure to disclose information does not constitute “withholding” if the one failing to disclose reasonably believes that there is no duty to disclose.
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