N.C.P.I.—Crim. 228.35A

NOTE WELL: Use this instruction when the defendant is not the

presenter of the false statement and the insurance claimant is the

one injured.

NOTE WELL: For situations involving an alleged fraudulent

procurement of insurance benefits use N.C.P.I.—Crim. 228.35.

The defendant has been charged with [assisting] [abetting] [soliciting]

[conspiring with]1 another person to [prepare] [make] a false [written] [oral]

statement2 that is intended to be presented to an [insurer] [insurance

claimant] [in connection with] [in opposition to] a claim for [payment] [a

benefit] pursuant to the policy.

For you to find the defendant guilty of this offense, the State must prove

seven things beyond a reasonable doubt:

First, that an insurance [policy] [coverage] existed between (name

[insured] [insurance claimant]) (and) (name insurer).

Second, that the defendant [assisted] [abetted] [solicited] [conspired

with] another person to [prepare] [make] a [written] [oral] statement.

Third, that this statement was intended to be presented to (name

[insurer] [insurance claimant]) [in connection with] [in opposition to] a claim

for [payment] [a benefit] pursuant to the policy.

Fourth, that this statement contained false or misleading information

concerning a fact or a matter material to the claim.

Fifth, that the defendant knew that this statement contained false or

misleading information concerning a fact or matter material to the claim.

Sixth, that the defendant acted with the intent3 to [injure] [defraud]

[deceive] (name insurance claimant).

And Seventh, the amount of the claim for payment or other benefit was

$100,000 or more.

If you find from the evidence beyond a reasonable doubt that on or

about the alleged date an insurance [policy] [coverage] existed between

(name [insured] [insurance claimant]) and (name insurer), and that the

defendant [assisted] [abetted] [solicited] [conspired with] another person to

[prepare] [make] a [written] [oral] statement, this statement was intended

to be presented to (name [insurer] [insurance claimant]) [in connection with]

[in opposition to] a claim for [payment] [a benefit] pursuant to the policy, this

statement contained false or misleading information concerning a fact or a

matter material to the claim, that the defendant acted with the intent to

[injure] [defraud] [deceive] (name insurance claimant), and the amount of

the claim for payment or other benefit was $100,000 or more, it would be

your duty to return a verdict of guilty of [assisting] [abetting] [soliciting]

[conspiring with] another person to [make] [prepare] a false statement to

deny benefit of an insurance policy with a claim of $100,000 or more.

However, if you do not so find, or have a reasonable doubt as to one or more

of these things, you will not return a verdict of guilty of [assisting] [abetting]

[soliciting] [conspiring with] another person to [make] [prepare] a false

statement to deny benefit of insurance policy with a claim of $100,000 or

more, but must determine whether the defendant is guilty of [assisting]

[abetting] [soliciting] [conspiring with] another person to [make] [prepare] a

false statement to deny benefit of an insurance policy.

[Assisting] [abetting] [soliciting] [conspiring with] another person to

[make] [prepare] a false statement to deny benefit of an insurance policy

differs from [assisting] [abetting] [soliciting] [conspiring with] another person

to [make] [prepare] a false statement to deny benefit of an insurance policy

with a claim of $100,000 or more in that the amount of the claim for payment

or other benefit need not be $100,000 or more.

If you find from the evidence beyond a reasonable doubt that on or

about the alleged date an insurance [policy] [coverage] existed between

(name [insured] [insurance claimant]) and (name insurer), and that the

defendant [assisted] [abetted] [solicited] [conspired with] another person to

[prepare] [make] a [written] [oral] statement, this statement was intended

to be presented to (name [insurer] [insurance claimant]) [in connection with]

[in opposition to] a claim for [payment] [a benefit] pursuant to the policy, this

statement contained false or misleading information concerning a fact or a

matter material to the claim, and that the defendant acted with the intent to

[injure] [defraud] [deceive] (name insurance claimant), it would be your duty

to return a verdict of guilty of [assisting] [abetting] [soliciting] [conspiring

with] another person to [make] [prepare] a false statement to deny benefit

of an insurance policy. However, if you do not so find, or have a reasonable

doubt as to one or more of these things, it would be your duty to return a

verdict of not guilty.