Fraud Requirements for Insurance Companies
June 15, 2015
In order to control insurance fraud, states require certain actions by companies. This chart shows which states require carriers to have statements disclaiming fraud on claim submission forms, which states require the submission of formal fraud plans to the state, which states require the existence of fraud plans and which require an annual summary of actions and results of fraud plans.
| Fraud statement required on claim form | Company must submit fraud plan to state | Company must have fraud plan in place | Annual summary of action of fraud plans required |
Alabama Code of Ala. 27-12A-1 through 27-12A-42 | x |
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Alaska Alaska Stat. §§21.36.360 through 21.36.410 | x |
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Arizona A.R.S. §§20-466.01, 20-466, 20-452.04 |
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Arkansas A.C.A. §§23-66-501 through 23-66-513, 23-100-101 | x- not reinsurance | x- if have plan, submit | x- or other initiative; hire investigators, etc. |
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California doesn't apply to reins. Cal Ins Code §§1872.8, 1879.1 through 1879.8 | x | x | x | x |
Colorado doesn't apply to reins. CRS 10-1-128,10-1-129, 10-4-1001 through 10-4-1009 | x- apps, or pol or claim forms |
| x | x |
Connecticut Conn. Gen. Stat. §§53-440 through 53-445 |
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Delaware 18 Del. C. §§2401 through 2415 |
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| Fraud statement required on claim form | Company must submit fraud plan to state | Company must have fraud plan in place | Annual summary of action of fraud plans required |
District of Columbia Not to reinsurers D.C. Code §§22-3225.01 through 22-3225.13 | x & app | x | x | x |
Florida Fla. Stat. §§626.989, 626.9891, 633.126, 817.234 |
| x- less than 10 mil dwp, or can opt to set up unit | x | w/c only |
Georgia O.C.G.A. §§33-1-9, 33-1-16, 33-1-17 |
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Hawaii HRS §§431:2-401 through 431:2-410 |
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Idaho Idaho Code §§41-268, 41-290 through 41-298 |
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Indiana Ind. Code Ann. §§27-1-3-22; 27-2-19-7; 35-43-5-4.5 |
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Iowa Iowa Code §§507E.1 through 507E.8 |
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Kansas K.S.A. §§40-2,118a and 40-2,119 |
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| x |
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Kentucky includes w/c KRS §§304.47-010 through 304.47-080 | x- & apps, does not apply to reins |
| x |
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Louisiana La. R.S. 22:1921 through 22:1929; 40:1425 |
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Maine 24-A M.R.S. §§2186 and 2187 | x & app |
| x | x |
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