INTELLIGENCE SHARING: The Information and Intelligence Sharing Forum is a proactive resource in the detection of developing insurance fraud schemes, emerging insurance fraud crime trends and patterns, and identification of individuals and enterprises suspected of criminal insurance fraud. The information shared and intelligence produced through this network constitutes active criminal intelligence and/or criminal investigative information as defined in Section 119.011(3), F.S., and is thereby confidential and exempt from Florida’s public records law pursuant to Section 626.989(5), F.S., and Section 119.071(2)(c), F.S. DIFIntel@MyFloridaCFO.com
REPORTING: Section 626.989(6), F.S. requires insurers to report acts of suspected insurance fraud to the division. Rule 69D-2 mandates that insurers must report the suspected fraud acts electronically using either the E-file Referral or the NICB interface site. Insurance Company Tips or NICB Members Referral Interface
COMPLIANCE: Section 626.9891, F.S. requires insurers to submit SIU descriptions and anti-fraud plans to the division. Effective October 5, 2006, Rule 69D-2 implemented new requirements for insurers to file updated SIU descriptions or anti-fraud plans to the division. The division created a database known as the Insurance Fraud Plan Report (IFPR) system so that the required filings could be submitted electronically to the database. SIU Descriptions and Anti-Fraud Plan Filing Reports/ Insurance Fraud Plan Reporting (IFPR)
COMPLIANCE: In August 2004, Section 626.9891(6), F.S. was amended to require Workers’ Compensation insurers to file an annual Workers’ Compensation Anti-fraud Report. The Workers’ Compensation Anti-Fraud (WCAF) report database was created so that insurers could electronically file this statistical report to the division. The report is due annually on August 1. The WCAF report database is active from July 1 until September 30 of each year. File Workers’ Compensation Anti-fraud Report –DUE ANNUALLY from July1 through September 30
COMMUNICATION: Section 626.989(4)(d), F.S. provides that persons identified as designated employees whose responsibilities include the investigation and disposition of claims relating to suspected fraudulent insurance acts may share information relating to persons suspected of committing fraudulent insurance acts with other designated employees employed by the same or other insurers whose responsibilities include the investigation and disposition of claims relating to fraudulent insurance acts, provided the department has been given written notice of the names and job titles of such designated employees prior to such designated employees sharing information. Unless the designated employees of the insurer act in bad faith or in reckless disregard for the rights of any insured, neither the insurer nor its designated employees are civilly liable for libel, slander, or any other relevant tort, and a civil action does not arise against the insurer or its designated employees.
ADD or DELETE A DESIGNATED EMPLOYEE: Click on DIFSIUAdmin@MyFloridaCFO.com to provide the written notice of the NAME and JOB TITLE of the “designated employee” whose responsibilities include the investigation and disposition of claims relating to suspected fraudulent acts. The email request must also provide the insurer identifiers making the request.
CHECK FOR A DESIGNATED EMPLOYEE: Click on DIFSIUAdmin@MyFloridaCFO.com if you need to confirm if a person is listed as a “designated employee” in the DIF database. Please include the person’s name and the insurer’s name that has requested the file information. DIF will reply with a confirmation form acknowledging that the person is listed as designated employee in the DIF database.
QUERY THE STATUS OF YOUR REFERRAL: Insurers should use the Case or Tip Status query to check on the status of their referral. You will need either your tip number (T06-XXX) or case number (06-XXX) in order to receive information on the development of your referral. Look up Your Tip or Case Status