Section 48.30A.050. Insurance antifraud plan—Specific procedures.  


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  • 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.