States Treatment of Insurance Fraud

 

June 15, 2015

 

Insurance fraud costs the industry billions each year. States are working with carriers to try to combat fraud, and have developed statutes making fraud a felony in certain jurisdictions. This chart shows which states have fraud departments, which assess carriers to support state fraud actions, use standardized forms and classify insurance fraud as a felony.

 

 

Classiï¬cation of Ins fraud

as a felony

Uses NAIC

Uniform fraud

reporting form

Has own fraud

referral form

State has fraud department/ bureau/unit

Assess carriers to

fund/support

fraud

division

Alabama

Code of Ala. §§ 27-12A-1 through 27-12A-42

x

x

 

x

$200 annually

Alaska

Alaska Stat. §§21.36.360 through 21.36.410

x ≥ $500

x

 

 

 

Arizona

A.R.S. §§20-466 through 20-466.04

x

 

x

x

x

Arkansas

A.C.A. §§23-66-501 through 23-66-513, 23-100-101

x

x

 

x

x- fee based on written premium amount-$400 min., $1000 max

California

Cal Ins Code §§1170(h); 1872.8, 1872.86, 1879.1 through 1879.8

 

x

 

x

x

x- annual assessment to be determined by the commissioner, not to exceed $5,100

Colorado

CRS 10-1-128,10-1-129, 10-4-1001 through 10-4-1009, 24-31-104.5; 18-5-211; 3 Colo. Code Regs. § 702-6:6-5-1

x

x

 

 

x- tiered fee schedule, maximum $3000 annual fee

Connecticut

Conn. Gen. Stat.

§§53-440 through 53-445

x- health ins.

 

x

x

x

 

Delaware

18 Del. C. §§2401 through 2415

x

x

 

x

$750 annually

District of Columbia

D.C. Code §§22-3225.01 through 22-3225.13

x ≥ $1,000

x

x

x

 

Florida

Fla. Stat. §§626.989, 626.9891, 633.126, 817.234

x

x

 

x

 

 

Classiï¬cation of Ins fraud

as a felony

Uses NAIC

Uniform fraud

reporting form

Has own fraud

referral form

State has fraud department/ bureau/unit

Assess carriers to

fund/support

fraud

division

Georgia

O.C.G.A. §§33-1-9, 33-1-16, 33-1-17

x

x

 

x

x-

formula based on the kind of company, insurance,

income, volume, and other factors the Commissioner determines important

Hawaii

HRS §§431:2-401 through 431:2-410

x > $300

 

x

x

 

Idaho

Idaho Code §§41-268, 41-290 through 41-298

x

x

x

x

x- portion of the annual continuation fee

Illinois

215 ILCS 5/155.23; 740 ILCS 92/1 through 92/45; 820 ILCS 305/25.5

x ≥ $300 felony w/c

 

x- email

w/c

percentage of funds not awarded to private party

Indiana

Ind. Code Ann. §§27-1-3-22; 27-2-19-7; 35-43-5-4.5

x

x

 

 

 

Iowa

Iowa Code Ann. §§507E.1 through 507E.8

x

x

 

x

 

Kansas

K.S.A. §§40-2,118a and 40-2,119

x ≥ $1,000

x-

x

x

 

Kentucky

includes w/c

KRS §§304.47-010 through 304.47-080

x > $500

x

 

x

 

Louisiana

La. R.S. 22:1921 through 22:1929; 40:1425

x

x

 

x

x- based on premium

Maine

24-A M.R.S. §§2186 and 2187

 

x

x

 

 

 

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