An Act To Create. the Insurance Fraud Division within the Department of Professional and Financial Regulation, Bureau of Insurance
Maine Legislature, Session 124, LD 1285
Committee: Insurance and Financial Services
Sponsors: SULLIV AN
Amends: 16 MRSA §614, 24-A MRSA §2186, 24-A MRSA §2187

MAINE STATE LEGISLATURE 
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124thMAINE LEGISLATURE 
Legislative Document 
No. 1285 
S.P.466 
In Senate, March 31, 2009 
An Act To Create. the Insurance Fraud Division within the 
Department of Professional and Financial Regulation, Bureau of 
Insurance 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Senator SULLIV AN of York .. 
Printed on recycled pilper 
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JOY J. O'BRIEN 
Secretary ofthe Senate 
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Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 16 MRSA §614, sub-§l, as amended by PL 1999, c. 155, Pt. A, §5, is 
further amended to read: 
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---1.-" LimitatioD_ondissemination of intelligence and investigative information. 
Reports or records that contain intelligence and investigative irrformaHon and that are 
prepared by, prepared at the direction of or kept in the custody of a local, county or 
district criminal justice agency; the Bureau of State Police; the Department of the 
Attorney General; the Maine Drug" Enforcement Agency; the Office of State Fire 
Marshal; the Oepartment of Corrections; the Department of Professional and Financial 
Regulation, Bureau of Insurance, Insurance Fraud Division; the criminal law enforcement 
units of the Department of Marine Resources or the Department of Inland Fisheries and 
Wildlife; or the Department of Conservation, Division of Forest Protection when the 
reports or records pertain to arson are confidential and may not be disseminated if there is 
a reasonable possibility that public release or inspection of the reports or records would: 
A. 
Interfere with law enforcement proceedings; 
B. 
Result in public dissemination of prejudicial information concerning an accused 
person or concerning the prosecution's evidence that will interfere with the ability of 
a court to impanel an impartial jury; 
C. 
Constitute an unwarranted invasion of personal privacy; 
D. Disclosethe identity of a confidential source; 
E. 
Disclose confidential inf?rmation furnished only by the confidential source; 
F. 
Disclose trade secrets or other confidential commercial or [mancial information 
designated as such by the owner or source o(the information or by the Department of 
the Attorney General; 
G. 
Disclose investigative techniques "and procedures or security plans and 
procedures not generally known by the general public; 
H. 
Endanger the life or physical safety of any individual, including law 
enforcement personnel; 
I. 
Disclose conduct or statements made or documents submitted by any person in 
the course of any mediation" or arbitration conducted under the auspices of the 
Department of the Attorney General; 
J. 
Disclose information designated confidential by some other statute; or 
K. 
Identify the source of complaints made to the Department of the Attorney 
General involving violations of consumer or antitrust laws. 
Sec. 2. 24-AMRSA §2179, as amended by PL 1973, c. 585, § 12, is repe~led. 
Sec. 3. 24-A MRSA §2186, sub-§4, ~C is enacted to read: 
C. An insurer having knowledge or a reasonable belief that a fraudulent insurance act 
is being, will be or has been committed shall provide to the superintendent the 
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infonnation required by the superintendent in a manner prescribed by the 
superintendent. For purposes of this subsection, "insurer" does not' include an 
insurance producer or other person acting on behalf of the insurer. 
Sec. 4. 24-A MRSA §2186, sub-§4, 'lID is enacted to read: 
D. Any person having knowledge or a reasonable belief that a fraudulent insurance 
act is being, will be or has been committed may provide ·to the superintendent the 
infonnation required by the superintendent in a manner prescribed by the 
superintendent. 
Sec. 5. 24-A MRSA §2187, sub-§l, ~, as amended by PL 2005, c. 433, § 1 and 
affected by §28, is further amended to read: 
B. "Authorized agency" or "authorized agencies" means: 
(1) The Attorney General; 
(2) . A district attorney responsible for prosecution in the municipality where the 
fraud occurred; 
(3) The Federal Bureau of Investigation, or any other federal agency, only for the. 
purposes of subsection 2; . 
(4) The State Fire Marshal; 
(5)- The Superintendent of Insurance; 
(6) The Superintendent of Financial Institutions; 
(7) . The United States Attorney's office when authorized or charged with 
investigation or prosecution of the insurance fraud in question, only for the 
purposes of subsection 2; 
(8) The State Police, state law enforcement officials or local law enforcement 
officials; ef 
(9) The National Association of Insurance Commissioners7~ 
(10) An international association of insurance supervisors; 
(11) An international criminal police organization; 
(12) A national insurance crime bureau or similar organization that collects, 
receives, investigates or analyzes infonnation concerning insurance fraud; 
(13) Insurance superVisors ~r law enforcement authorities outside the United 
States; or 
(14) The Workers' Compensation Board. 
Sec. 6. 24-A MRSA §2187, sub-§4, as enacted by PL 1997, c. 675, §2, IS 
repealed. 
Sec. 7. 
24-A MRSA §2187, sub-§5, as enacted by PL 1997, c. 675, §2, IS 
amended to read: 
5. Immunity. In the absence of fraud, malice or bad faith, any person, including, but 
not limited to, an insurer or authorized agency, that furnished information relating to 
suspected, anticipated or completed fraudulent insurance acts is not liable for any 
. damages in any civil action for furnishing the information if i~at information is furnished 
to or received from an authorized agency. In the absence of fraud, malice or bad faith, an 
insurer that furnished information to or received information from another insurer for the 
purpose of detecting, prosecuting or preventing fraudulent insurance acts is not liable for 
any damages in any civil action for furnishing or receiving that information. Nothing in 
this subsection is intended t6 abrogate or modify iii any way any common law or 
statutory privilege or immunity previously enjoyed by any person. 
Sec. 8. 24-A MRS A §2188 is enacted to read: 
§2188. Insurance Fraud Division 
1. Division established. The Insurance Fraud Division, referred to in this section as 
"the division," is established within the bureau. The division shall work in coordination 
with other bureau divisions and· staff and other regulatory and law enforcement agencies 
to accomplish its duties. 
2. Duties. The duties of the division are to: 
34. 
A. Initiate independent inquiries and conduct independent investigations when the. 
division has cause to believe that a fraudulent insurance act as defined in section 
2186, deceptive insurance practice or insurance deception may be or has been 
committed; 
. B. Review reports or complaints of alleged fraudulent insurance acts as dermed in 
section 2186, deceptive insurance practices and insurance deception from federal, 
state and local law enforcement and regulatory agencies, persons engaged in the 
business of insurance and the public to determine whether the reports require further 
investigation and to conduct these investigations; 
C. Conduct independent examinations of alleged fraudulent insurance acts as defined 
in section 2186, deceptive insurance practices and insurance deception and undertake 
independent studies to determine the extent of fraudulent insurance acts, deceptive 
insurance practices and insurance deception; 
D. Assist the superintendent in developing and implementing programs to prevent 
fraudulent insurance acts as defined in section 2186, deceptive insurance practices 
and insurance deception; 
E. 
Assist the Attorney General in the prosecution and prevention of fraudulent 
insurance acts, deceptive insurance practices and insurance deception; and 
F. 
Prepare any reports regarding fraudulent insurance acts, deceptive insurance 
practices and insurance deception required by law. .. 
3. Other law enforcement; regulatory authority. This section does not: 
A. Preempt the authority or relieve the duty of other law enforcement or regulatory 
agencies to investigate, examine and prosecute suspected violations oflaw; 
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B. Prevent or prohibit a person from disclosing voluntarily information concerning 
fraudulent insurance· acts, deceptive insurance practices or insurance deception to a. 
law enforcement or regulatory agency other than the division; or 
C. Limit the powers granted elsewhere by the laws of this State to the superintendent 
or the division to investigate and examine possible violations of law and to take 
appropriate action against wrongdoers. 
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4. Confidentiality. Records that are prepared by, prepared at the direction of or kept 
in the custody of the division that contain investigative information are subject to the 
requirements of Title 16, section 614, except that the superintendent may share 
information with an authorized agency, as defined in section 2187, subsection 1, 
paragraph B. Except as provided in Title 16, section 614 or required for a criminal or civil 
proceeding, an authorized agency shall hold the information in confidence and may not 
release the information to any person other than an authorized agency. 
SUMMARY 
This bill establishes' the Insurance Fraud Division within the Department of 
Professional and Financial Regulation, Bureau of Insurance. The bill requires insurers 
with knowledge or suspicion of fraudulent insurance acts to report those activities to the 
Superintendent of Insurance. The bill provides for the confidentiality of records relating 
. to Insurance fraud investigations in a manner similar to the provision of confidentiality 
under current state law for investigative and intelligence information in the possession of 
other law enforcement entities. The bill does permit the Insurance Fraud Division to share 
investigatory information with certain national and international agencies. The bill also 
extends the immunity provision in current law to certain communications between 
insurers with. respect to fraudulent insurance acts.