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Republic of the Philippines
HOUSE OF REPRESENTATIVES

Queson City

EIGHTEENTH CONGRESS:
Second Regular Session

HoUsE BILL No.8282

Introduced by HON. LUIS RAYMUND “LRAY” F. VILLAFUERTE, JR.

AN ACT CREATING THE INSURANCE FRAUD DETECTION DIVISION UNDER
THE NATIONAL BUREAU OF INVESTIGATION, AND FOR OTHER PURPOSES

This bill proposes to create an Insurance Fraud Detection Division which shall be
organized under the National Bureau of Investigation (NBI). The Insurance Fraud
Detection Division shall be the primary division under the NBI which shall Investigate
and prosecute government insurance fraud to ensure that similar schemes and other
government insurance fraud would be detected, investigated, and prosecuted
speedily.

Insurance contributions come from hard-earned money. It is unfair to the Filipinos if
government insurance is always involved in anomalies and scandals such as the
creation of ghost members, irregular fast-tracking of claims, fake receipts and other
similar issues.

Hence, the Insurance Fraud Detection Division is tasked to investigate and prosecute
government insurance fraud involving government owned and controlled corporation,
such as but not limited to, the Philippine Health Insurance Corporation (PhilHealth),
Social Security System (SSS), Government Service Insurance System (GSIS), and
other government agencies engaged in insurance.

in view of the foregoing, the approval of this bill is most eamestly sought.

LU frm
LUIS RAYM'! “LRAY" |F/ VILLAFUERTE, JR.


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
Second Regular Session

HoUuSE BILL No. 8282

Introduced by HON. LUIS RAYMUND “LRAY” F. VILLAFUERTE, JR.

AN ACT CREATING THE INSURANCE FRAUD DETECTION DIVISION UNDER
THE NATIONAL BUREAU OF INVESTIGATION, AND FOR OTHER PURPOSES

Be it enacted by the Senate and the House of Representatives of the Philippines in
Congress assembled:

SECTION 1. Short Title. This Act shall be known as the "Insurance Fraud Detection
Act of 2020."

SEC. 2. Declaration of Policy. - The State recognizes that the country's insurance
systems, by its nature, are susceptible to fraud and the need to proactively fight the
same. Thus, it is the policy of the state to ensure that our Insurance government
agencies are viable and sustainable. Fraudulent schemes and transactions have no
place in our insurance systems as millions of Filipinos depend on this for their health,
retirement, and an overall better quality of living. Therefore, It is also the policy of the
state to detect, investigate, and prosecute government insurance fraud speedily and
actively.

SEC. 3. The Insurance Fraud Detection Division. - itis hereby created and established
an Insurance Fraud Detection Division which shall be organized under the NBI within
sixty (60) days after the effectivity of this Act.

SEC. 4, Composition. - The Insurance Fraud Detection Division shall be composed of
one (1) Head Agent and thirty (30) agents. Being a highly specialized office, agents In
this division shall consist only of individuals with high level of competence, as proven
by their educational background and/or work experience, in any of the following areas:
information technology, data science/data analytics, accountancy with required
specialization on forensic accounting, and engineering managementimanagement
engineering.

The NBI Director shall ensure that all areas of specialization as specified in this section
are adequately represented in the staffing requirements of the proposed Insurance
Fraud Detection Division.


SEG. 5. Mandate and Scope. - The Insurance Fraud Detection Division shall be the
primary division under the NBI which shall investigate and prosecute government
insurance fraud involving government owned and controlled corporation, such as but
not limited to, the Philippine Health Insurance Corporation (PhilHealth), Social Security
System (SSS), Government Service Insurance System (GSIS), and other government
agencies engaged in insurance.

SEC. 6. Powers and Duties of the Division. - The Insurance Fraud Detection Division
shall have the following powers, functions, and duties, among others;

(a) Shall conduct an inventory of all cases of government insurance fraud from all
government sources;

(b) Shall undertake investigation and detection of all crimes and offenses of
government insurance fraud;

(c) Issue subpoena for the appearance of any person for investigation or production
or production of documents, through the NBI officers from the ranks of Regional
Director to Director;

(d) Create a national clearing house of criminal records and other related information
regarding government insurance fraud, for the beneiit of the government;

(e) Render technical assistance to government agencies and instrumentalities, when
so requested;

(f) Set-up field offices in the various insurance government agencies;

(g) Shall have access to all data of the various insurance government agencies;

(h) Conduct intelligence operations in furtherance of the foregoing powers and
functions; and

() Perform such other functions as the NBI Director may assign.

SEC. 7. Inter-governmental Cooperation. - The Insurance Commission, Department
of Health, Securities and Exchange Commission, Governance Commission for GOCC,
Commission on Audit, shall provide its technical skills and knowledge, cooperation
and share information and intelligence for investigation with the Insurance Fraud
Detection Division of the NBL.

SEC. 8. Philippine National Police Assistance. - The Philippine National Police shall
provide investigative teams and field agents to directly coordinate and assist in the
various government insurance fraud.

SEC. 9. Appropriations. -The amount necessary to carry out the implementation of this
Act shall be sourced from the budget of the NBI.

SEC. 10. Separability Clause. - If any provision of this Act is declared unconstitutional,
such sections or parts not affected thereby shall remain in full force and effect.

SEC. 11. Effectivity Clause. - This Act shall take effect fifteen (15) days after its
publication in the Official Gazette or in a newspaper of general circulation.

Approved,