State Codes and Statutes

Statutes > California > Ins > 1879-1879.8

INSURANCE CODE
SECTION 1879-1879.8



1879.  The purpose of this article is to confront aggressively the
problem of insurance fraud in this state by facilitating the
detection of insurance fraud, eliminating the occurrence of fraud
through the development of fraud prevention programs, requiring the
restitution of fraudulently obtained insurance benefits, and reducing
the amount of premium dollars used to pay fraudulent claims.



1879.1.  The commissioner or his or her designated deputy
commissioner may convene meetings with representatives of insurance
companies to discuss specific information concerning suspected,
anticipated, or completed acts of insurance fraud. Information shared
at those meetings regarding specific suspected, anticipated, or
completed acts of insurance fraud shall not make a person subject to
civil liability for libel, slander, or any other relevant cause of
action provided that all of the following requirements are met:
   (a) The commissioner or his or her designated deputy commissioner
is present at the meeting or meetings.
   (b) The commissioner or his or her designated deputy commissioner
advises meeting participants, at the beginning of any meeting
convened pursuant to this section, of guidelines to ensure compliance
with federal and state antitrust laws.
   (c) There is no fraud or malice on the part of the representatives
of the insurance companies or the commissioner or his or her
designated deputy commissioner.


1879.2.  (a) Any insurer that prints, reproduces, or furnishes a
form to any person upon which that person gives notice to the insurer
of a claim under any contract of insurance or makes a claim against
the insurer for any loss, damage, liability, or other covered event
shall cause to be printed or displayed, in comparative prominence
compared to other contents, the following statement: "Any person who
knowingly presents a false or fraudulent claim for the payment of a
loss is guilty of a crime and may be subject to fines and confinement
in state prison." The statement shall be preceded by the words: "For
your protection California law requires the following to appear on
this form" or other explanatory words of similar meaning.
   (b) Any insurer that has produced or caused to be printed forms
containing the statement required by subdivision (a), as originally
added by Chapter 1008 of the Statutes of 1994, may continue to use
those forms until December 31, 1996. This subdivision is intended to
prevent any unnecessary waste of resources that might result from
insurers' efforts to comply with conflicting provisions of law.




1879.3.  The commissioner shall appoint supervisory and
investigatory personnel within the bureau. In addition, the
commissioner shall assign staff counsel who are employed by the
department and are under the supervision of the department's general
counsel to advise the department's fraud division, and to further the
purposes of this article and Article 1 (commencing with Section
1871). The attorneys' duties may include representing the
commissioner and the department in civil lawsuits pursuant to Article
1 (commencing with Section 1871). Those persons shall be qualified
by training and experience to perform the duties of their position.
   When so requested by the commissioner, the Attorney General may
assign one or more deputy attorneys general to assist the
commissioner in the performance of these duties.



1879.4.  (a) The Chief of the Fraud Division and those investigators
designated by him or her may expend funds to conduct undercover
activities, employ civilian operatives, or in any other manner not
prohibited by law to investigate insurance fraud or workers'
compensation fraud.
   (b) The money expended pursuant to subdivision (a) shall be paid
out of the funds appropriated or made available by law for the
support or use of the department.



1879.5.  (a) Any person who believes that a violation of this
article has been or is being made may notify the department
immediately after discovery of the alleged violation and may send to
the department, on a form and in a manner prescribed by the
commissioner, the information requested and any additional
information relative to the alleged violation as the department may
request. The division shall review the reports and select those
alleged violations as may require further investigation. It shall
then cause an independent examination or evaluation of the facts
surrounding the alleged violation to be made to determine the extent,
if any, to which fraud, deceit, or intentional misrepresentation of
any kind exists.
   (b) No person shall be subject to civil liability for libel,
violation of privacy, or otherwise by virtue of the filing of reports
or furnishing of other information, in good faith and without
malice, provided pursuant to this section or requested by the
department as a result of the authority conferred upon it by law.
   (c) The commissioner may, by regulation, require admitted insurers
to keep any records and other information as he or she deems
necessary for the effective enforcement of this article.



1879.6.  The commissioner may adopt administrative regulations as he
or she deems necessary for the effective implementation of this
article.


1879.7.  The commissioner shall report annually to the Legislature
as to the activities of the department and the cost-effectiveness of
the programs established pursuant to this article.



1879.8.  Nothing in this article shall be construed to preclude the
applicability of any other provision of civil or criminal law that
applies to any act committed or alleged to have been committed by any
person.

State Codes and Statutes

Statutes > California > Ins > 1879-1879.8

INSURANCE CODE
SECTION 1879-1879.8



1879.  The purpose of this article is to confront aggressively the
problem of insurance fraud in this state by facilitating the
detection of insurance fraud, eliminating the occurrence of fraud
through the development of fraud prevention programs, requiring the
restitution of fraudulently obtained insurance benefits, and reducing
the amount of premium dollars used to pay fraudulent claims.



1879.1.  The commissioner or his or her designated deputy
commissioner may convene meetings with representatives of insurance
companies to discuss specific information concerning suspected,
anticipated, or completed acts of insurance fraud. Information shared
at those meetings regarding specific suspected, anticipated, or
completed acts of insurance fraud shall not make a person subject to
civil liability for libel, slander, or any other relevant cause of
action provided that all of the following requirements are met:
   (a) The commissioner or his or her designated deputy commissioner
is present at the meeting or meetings.
   (b) The commissioner or his or her designated deputy commissioner
advises meeting participants, at the beginning of any meeting
convened pursuant to this section, of guidelines to ensure compliance
with federal and state antitrust laws.
   (c) There is no fraud or malice on the part of the representatives
of the insurance companies or the commissioner or his or her
designated deputy commissioner.


1879.2.  (a) Any insurer that prints, reproduces, or furnishes a
form to any person upon which that person gives notice to the insurer
of a claim under any contract of insurance or makes a claim against
the insurer for any loss, damage, liability, or other covered event
shall cause to be printed or displayed, in comparative prominence
compared to other contents, the following statement: "Any person who
knowingly presents a false or fraudulent claim for the payment of a
loss is guilty of a crime and may be subject to fines and confinement
in state prison." The statement shall be preceded by the words: "For
your protection California law requires the following to appear on
this form" or other explanatory words of similar meaning.
   (b) Any insurer that has produced or caused to be printed forms
containing the statement required by subdivision (a), as originally
added by Chapter 1008 of the Statutes of 1994, may continue to use
those forms until December 31, 1996. This subdivision is intended to
prevent any unnecessary waste of resources that might result from
insurers' efforts to comply with conflicting provisions of law.




1879.3.  The commissioner shall appoint supervisory and
investigatory personnel within the bureau. In addition, the
commissioner shall assign staff counsel who are employed by the
department and are under the supervision of the department's general
counsel to advise the department's fraud division, and to further the
purposes of this article and Article 1 (commencing with Section
1871). The attorneys' duties may include representing the
commissioner and the department in civil lawsuits pursuant to Article
1 (commencing with Section 1871). Those persons shall be qualified
by training and experience to perform the duties of their position.
   When so requested by the commissioner, the Attorney General may
assign one or more deputy attorneys general to assist the
commissioner in the performance of these duties.



1879.4.  (a) The Chief of the Fraud Division and those investigators
designated by him or her may expend funds to conduct undercover
activities, employ civilian operatives, or in any other manner not
prohibited by law to investigate insurance fraud or workers'
compensation fraud.
   (b) The money expended pursuant to subdivision (a) shall be paid
out of the funds appropriated or made available by law for the
support or use of the department.



1879.5.  (a) Any person who believes that a violation of this
article has been or is being made may notify the department
immediately after discovery of the alleged violation and may send to
the department, on a form and in a manner prescribed by the
commissioner, the information requested and any additional
information relative to the alleged violation as the department may
request. The division shall review the reports and select those
alleged violations as may require further investigation. It shall
then cause an independent examination or evaluation of the facts
surrounding the alleged violation to be made to determine the extent,
if any, to which fraud, deceit, or intentional misrepresentation of
any kind exists.
   (b) No person shall be subject to civil liability for libel,
violation of privacy, or otherwise by virtue of the filing of reports
or furnishing of other information, in good faith and without
malice, provided pursuant to this section or requested by the
department as a result of the authority conferred upon it by law.
   (c) The commissioner may, by regulation, require admitted insurers
to keep any records and other information as he or she deems
necessary for the effective enforcement of this article.



1879.6.  The commissioner may adopt administrative regulations as he
or she deems necessary for the effective implementation of this
article.


1879.7.  The commissioner shall report annually to the Legislature
as to the activities of the department and the cost-effectiveness of
the programs established pursuant to this article.



1879.8.  Nothing in this article shall be construed to preclude the
applicability of any other provision of civil or criminal law that
applies to any act committed or alleged to have been committed by any
person.


State Codes and Statutes

State Codes and Statutes

Statutes > California > Ins > 1879-1879.8

INSURANCE CODE
SECTION 1879-1879.8



1879.  The purpose of this article is to confront aggressively the
problem of insurance fraud in this state by facilitating the
detection of insurance fraud, eliminating the occurrence of fraud
through the development of fraud prevention programs, requiring the
restitution of fraudulently obtained insurance benefits, and reducing
the amount of premium dollars used to pay fraudulent claims.



1879.1.  The commissioner or his or her designated deputy
commissioner may convene meetings with representatives of insurance
companies to discuss specific information concerning suspected,
anticipated, or completed acts of insurance fraud. Information shared
at those meetings regarding specific suspected, anticipated, or
completed acts of insurance fraud shall not make a person subject to
civil liability for libel, slander, or any other relevant cause of
action provided that all of the following requirements are met:
   (a) The commissioner or his or her designated deputy commissioner
is present at the meeting or meetings.
   (b) The commissioner or his or her designated deputy commissioner
advises meeting participants, at the beginning of any meeting
convened pursuant to this section, of guidelines to ensure compliance
with federal and state antitrust laws.
   (c) There is no fraud or malice on the part of the representatives
of the insurance companies or the commissioner or his or her
designated deputy commissioner.


1879.2.  (a) Any insurer that prints, reproduces, or furnishes a
form to any person upon which that person gives notice to the insurer
of a claim under any contract of insurance or makes a claim against
the insurer for any loss, damage, liability, or other covered event
shall cause to be printed or displayed, in comparative prominence
compared to other contents, the following statement: "Any person who
knowingly presents a false or fraudulent claim for the payment of a
loss is guilty of a crime and may be subject to fines and confinement
in state prison." The statement shall be preceded by the words: "For
your protection California law requires the following to appear on
this form" or other explanatory words of similar meaning.
   (b) Any insurer that has produced or caused to be printed forms
containing the statement required by subdivision (a), as originally
added by Chapter 1008 of the Statutes of 1994, may continue to use
those forms until December 31, 1996. This subdivision is intended to
prevent any unnecessary waste of resources that might result from
insurers' efforts to comply with conflicting provisions of law.




1879.3.  The commissioner shall appoint supervisory and
investigatory personnel within the bureau. In addition, the
commissioner shall assign staff counsel who are employed by the
department and are under the supervision of the department's general
counsel to advise the department's fraud division, and to further the
purposes of this article and Article 1 (commencing with Section
1871). The attorneys' duties may include representing the
commissioner and the department in civil lawsuits pursuant to Article
1 (commencing with Section 1871). Those persons shall be qualified
by training and experience to perform the duties of their position.
   When so requested by the commissioner, the Attorney General may
assign one or more deputy attorneys general to assist the
commissioner in the performance of these duties.



1879.4.  (a) The Chief of the Fraud Division and those investigators
designated by him or her may expend funds to conduct undercover
activities, employ civilian operatives, or in any other manner not
prohibited by law to investigate insurance fraud or workers'
compensation fraud.
   (b) The money expended pursuant to subdivision (a) shall be paid
out of the funds appropriated or made available by law for the
support or use of the department.



1879.5.  (a) Any person who believes that a violation of this
article has been or is being made may notify the department
immediately after discovery of the alleged violation and may send to
the department, on a form and in a manner prescribed by the
commissioner, the information requested and any additional
information relative to the alleged violation as the department may
request. The division shall review the reports and select those
alleged violations as may require further investigation. It shall
then cause an independent examination or evaluation of the facts
surrounding the alleged violation to be made to determine the extent,
if any, to which fraud, deceit, or intentional misrepresentation of
any kind exists.
   (b) No person shall be subject to civil liability for libel,
violation of privacy, or otherwise by virtue of the filing of reports
or furnishing of other information, in good faith and without
malice, provided pursuant to this section or requested by the
department as a result of the authority conferred upon it by law.
   (c) The commissioner may, by regulation, require admitted insurers
to keep any records and other information as he or she deems
necessary for the effective enforcement of this article.



1879.6.  The commissioner may adopt administrative regulations as he
or she deems necessary for the effective implementation of this
article.


1879.7.  The commissioner shall report annually to the Legislature
as to the activities of the department and the cost-effectiveness of
the programs established pursuant to this article.



1879.8.  Nothing in this article shall be construed to preclude the
applicability of any other provision of civil or criminal law that
applies to any act committed or alleged to have been committed by any
person.