Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City 
NINETEENTH CONGRESS 
First Regular Session 
HOUSE BILL NO. ____ 
Introduced by HON. LUIS RAYMUND “LRAY” F. VILLAFUERTE, JR.,  
HON. MIGUEL LUIS R. VILLAFUERTE, HON. TSUYOSHI ANTHONY “HORI” G. 
HORIBATA AND HON. NICOLAS “NICK” C. ENCISO VIII 
EXPLANATORY NOTE 
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 shall be tasked to investigate and 
prosecute government insurance fraud involving government-owned and controlled 
corporations, 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 earnestly sought. 
LUIS RAYMUND “LRAY” F. VILLAFUERTE, JR. 
MIGUEL LUIS R. VILLAFUERTE 
TSUYOSHI ANTHONY “HORI” G. HORIBATA 
NICOLAS “NICK” C. ENCISO VIII 
September 13, 2022
8:00 am
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Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City 
NINETEENTH CONGRESS 
First Regular Session 
HOUSE BILL NO. ____ 
Introduced by HON. LUIS RAYMUND “LRAY” F. VILLAFUERTE, JR.,  
HON. MIGUEL LUIS R. VILLAFUERTE, HON. TSUYOSHI ANTHONY “HORI” G. 
HORIBATA AND HON. NICOLAS “NICK” C. ENCISO VIII 
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."  
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. - It is 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 
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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 management/management 
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.  
 
SEC. 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 benefit 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  
(i)  
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 NBI.  
 
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,