Division of Insurance Fraud
Welcome to the Division of Insurance
Fraud
Anti-Fraud Compliance Requirements
In July 1996, Florida law required that
all licensed insurers establish a
special investigative unit and/or file
an anti-fraud plan to the Division of
Insurance Fraud. Effective October,
1999, all Health Maintenance
Organizations were required to establish
a special investigative unit and/or file
an anti-fraud plan to the Division.
Effective October 5, 2006, Rule 69D-2
was promulgated to incorporate and
expand the compliance requirements of
sections 626.9891 and 641.3915, Florida
Statutes. Additionally, effective July
1, 2000, Florida law required all
licensed viatical provider companies to
file an anti-fraud plan to the Division
of Insurance Fraud. Effective August,
2004, section 626.9891 (6), Florida
Statute was modified to include a
Workers’ Compensation Anti-fraud Report
filing. The information below includes
the applicable statutes for compliance
and DFS Informational Bulletin &
Memorandums establishing compliance
guidelines for licensees.
Insurers
Section 626.9891, Florida
Statutes, Insurer Anti-fraud
Investigative units and Anti-fraud plans
MEMORANDUM Rule 69D-2, effective October
5, 2006, Insurer Anti-fraud
Investigative Units and Anti-fraud Plans
BULLETIN 96-001, Special
Investigative Units and Anti-fraud Plans
HMO's
Section 641.3915, Florida
Statutes, Health Maintenance
Organization Anti-fraud plans and
Investigative units
MEMORANDUM 99-109M All Health
Maintenance Organizations Authorized
Viatical Settlement Providers and
Life Expectancy Companies
Section 626.99278, Florida Statutes,
Viatical provider Anti-fraud plan
MEMORANDUM 00-001M, Viatical
Settlement Provider Companies
Workers’ Compensation Insurers
Section 626.9891(6), Florida Statutes,
Legislation Relating to Workers’
Compensation Anti-fraud Report Filing
MEMORANDUM DFS 04-002M, Legislation
Relating to Workers’ Compensation
Anti-Fraud Report Filing |
