48.30A.045  <<  48.30A.050 >>   48.30A.055

Insurance antifraud planSpecific procedures.

An insurer's antifraud plan must establish specific procedures to:
(1) Prevent insurance fraud, including internal fraud involving employees or company representatives, fraud resulting from misrepresentation on applications for insurance coverage, and claims fraud;
(2) Review claims in order to detect evidence of possible insurance fraud and to investigate claims where fraud is suspected;
(3) Report fraud to appropriate law enforcement agencies and cooperate with those agencies in their prosecution of fraud cases;
(4) Undertake civil actions against persons who have engaged in fraudulent activities;
(5) Train company employees and agents in the detection and prevention of fraud.
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