An applicant for health benefits submits fabricated invoices to persuade an insurer to pay a claim it does not owe. In addition to insurance regulatory action, criminal prosecution for obtaining property by false pretenses proceeds under which North Carolina statute?

Why A is correct

Insurance fraud in North Carolina is prosecuted under the general false pretenses statute, G.S. 14-100, which criminalizes obtaining property by false pretenses; the felony classification depends on the amount obtained. Regulatory provisions of Chapter 58 operate alongside, but this general criminal statute is the vehicle for the fraud itself.

Why the other options are wrong

• B) G.S. 58-33-105 covers false or fraudulent statements made in insurance applications, a Class 1 misdemeanor; this scenario is about obtaining a claim payment by fraud.
• C) G.S. 58-2-180 addresses willful false statements in required filings made under oath or by subscription, not claim-submitting fraud.
• D) G.S. 58-63-50 is the civil forfeiture for willfully violating a cease-and-desist order; it is not a criminal fraud statute.

Memory hook

Claim fraud is old-fashioned false pretenses: G.S. 14-100.