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Division of Insurance Fraud
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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