Insurance agents and brokers would need training on insurance fraud to obtain a license in California and would need to report suspected fraud under a recently amended bill.
Changes made by the Senate Insurance Committee to SB 1242 would also change the requirements for insurance companies to report suspected fraud to the Ministry of Insurance.
Current law requires an insurer who “reasonably believes or knows that a fraudulent claim is being made” to report it within 60 days.
The amended bill would require an insurer that has determined, “after the insurer’s special investigation unit has been completed, that it reasonably suspects or knows that an insurance fraud has occurred or may occur,”; to file a fraud report within 60 days.
At the same time, the bill would create a new requirement for agents and brokers to report suspected fraud.
Agents and brokers who suspect or know that a fraudulent application is being made must report their suspicions to the Department of Insurance within 60 days. Agents or brokers who suspect that fraud is taking place after an insurance has been taken out would need to report it to the insurer’s special investigation unit and cooperate with any subsequent investigations.
Agents and brokers would also need to complete at least one hour of insurance fraud studies, starting March 1, 2023, as a condition of obtaining or renewing a license.
SB 1242 is the Senate’s Insurance Committee’s omnibus law and, unanimously adopted by the Senate in April, included several amendments that were “non-controversial, technical or otherwise classified as code cleaning,” according to a bill analysis.
SB 1242 is currently awaiting a hearing by the Assembly Insurance Committee.
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