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Division of Insurance
Fraud
Information and Intelligence Sharing
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
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Contact SIU
Administrator:
Denise Prather
Senior Management Analyst I
200 East Gaines Street
Tallahassee, Florida 32399-0324
DIFSIUAdmin@MyFloridaCFO.com |
Contact DIF
Intelligence Unit:
Cherri Krall
Senior Management Analyst Supervisor
9800 4th Street North, Suite 100
St. Petersburg, Florida 33702
DIFIntel@MyFloridaCFO.com |
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