Washington Code 48.30A.050 – Insurance antifraud plan — Specific procedures
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An insurer’s antifraud plan must establish specific procedures to:
Terms Used In Washington Code 48.30A.050
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Fraud: Intentional deception resulting in injury to another.
(1) Prevent insurance fraud, including internal fraud involving employees or company representatives, fraud resulting from misrepresentation on applications for insurance coverage, and claims fraud;
(2) Review claims in order to detect evidence of possible insurance fraud and to investigate claims where fraud is suspected;
(3) Report fraud to appropriate law enforcement agencies and cooperate with those agencies in their prosecution of fraud cases;
(4) Undertake civil actions against persons who have engaged in fraudulent activities;
(5) Train company employees and agents in the detection and prevention of fraud.
[ 1995 c 285 § 10.]