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South Carolina Fraud Reporting

Definition of “False Statement or Misrepresentation” (in context of Mandatory Fraud Reporting Statute(s) discussed below)

S.C. Code § 38-55-530(D). Definitions.
As used in this article:

(D) “False statement or misrepresentation” means a statement or representation made by a person that is false, material, made with the person’s knowledge of the falsity of the statement and made with the intent of obtaining or causing another to obtain or attempting to obtain or causing another to obtain an undeserved economic advantage or benefit or made with the intent to deny or cause another to deny any benefit or payment in connection with an insurance transaction, and such shall constitute fraud. “False statement or misrepresentation” specifically includes, but is not limited to, an intentional:

(1) false report of business activities;
(2) miscount or misclassification by an employer of its employees;
(3) failure to timely reduce reserves;
(4) failure to account for Second Injury Fund reimbursements or subrogation reimbursements; or
(5) failure to provide verifiable information to public or private rating bureaus and the Department of Insurance.

An undeserved economic benefit or advantage includes, but is not limited to, a favorable insurance premium, payment schedule, insurance award, or insurance settlement.

Mandatory Fraud Reporting Statute(s)

S.C. Code Sec. 38-55-570 notification of division: (A) Any person, insurer, or authorized agency having reason to believe that another has made a false statement or misrepresentation or has knowledge of a suspected false statement or misrepresentation shall, for purposes of reporting and investigation, notify the Insurance Fraud Division of the Office of the Attorney General of the knowledge or belief and provide any additional information within his possession relative thereto.

How to Report Fraud

For reporting, go to the SC Attorney General website at:

  • www.scag.gov/insurance-fraud
  • hotline phone number, 1-888-95-FRAUD
  • and Insurance Fraud Complaint Form provided there as options for reporting.