California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 9 - Insurance Fraud › Article 2 - Special Investigative Unit › Section 2698.37 - Referral of Suspected Insurance Fraud

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The SIU shall provide for the referral of
				  acts of suspected insurance fraud to the Fraud Division and, as required,
				  district attorneys.
(b) Referrals
				  shall be submitted in any insurance transaction where the facts and
				  circumstances create a reasonable belief that a person or entity may have
				  committed or is committing insurance fraud.
(c) Referrals shall be made within the period
				  specified by statute.
(d) The SIU
				  shall complete as much of its investigation as is reasonable prior to the time
				  the referral is made to the Fraud Division. Each referral of suspected
				  insurance fraud shall indicate whether the investigation is complete or further
				  investigation is needed.
(e) The
				  requirements of this section do not affect the immunity granted under
				  California Insurance Code section
				  1872.5 or
				  other such similar codes contained in the Insurance Frauds Prevention
				  Act.
(f) The requirements of this
				  section do not diminish statutory requirements contained in the Insurance
				  Frauds Prevention Act regarding the confidentiality of any information provided
				  in connection with an investigation.
1. New
					 section filed 9-4-2003 as an emergency; operative 9-4-2003 (Register 2003, No.
					 36). A Certificate of Compliance must be transmitted to OAL by 1-2-2004 or
					 emergency language will be repealed by operation of law on the following
					 day.
2. New section refiled 1-2-2004 as an emergency; operative
					 1-3-2004. (Register 2004, No. 1). A Certificate of Compliance must be
					 transmitted to OAL by 5-3-2004 or emergency language will be repealed by
					 operation of law on the following day.
3. New section refiled
					 5-4-2004 as an emergency; operative 5-4-2004 (Register 2004, No. 19). A
					 Certificate of Compliance must be transmitted to OAL by 9-1-2004 or emergency
					 language will be repealed by operation of law on the following
					 day.
4. Editorial correction of HISTORY 3 (Register 2004, No.
					 36).
5. New section refiled 9-1-2004 as an emergency; operative
					 9-1-2004 (Register 2004, No. 36). A Certificate of Compliance must be
					 transmitted to OAL by 12-30-2004 or emergency language will be repealed by
					 operation of law on the following day.
6. New section refiled
					 12-28-2004 as an emergency; operative 12-30-2004 (Register 2004, No. 53). A
					 Certificate of Compliance must be transmitted to OAL by 4-29-2005 or emergency
					 language will be repealed by operation of law on the following
					 day.
7. New section refiled 4-29-2005 as an emergency; operative
					 4-29-2005 (Register 2005, No. 17). A Certificate of Compliance must be
					 transmitted to OAL by 8-29-2005 or emergency language will be repealed by
					 operation of law on the following day.
8. Certificate of Compliance
					 as 4-29-2005 order, including repealer and new section, transmitted to OAL
					 8-26-2005 and filed 10-7-2005 (Register 2005, No. 40).
9. New
					 subsection (d) and subsection relettering filed 7-30-2020; operative 10-1-2020
					 (Register 2020, No. 31).
Note: Authority cited: Section
						1708, Civil
						Code; Sections
						1872.4,
						1874.6,
						1875.24,
						1875.4,
						1877.3,
						1877.5,
						1879.5 and
						1879.6,
						Insurance Code; Calfarm Ins. Co. v. Deukmejian (1989) 48 Cal.3d. 805, 824, 258
						Cal. Rptr. 161, 771 P.2d 1247; Credit Ins. Gen. Agents Assn. v. Payne (1976) 16
						Cal.3d 651, 656, 128 Cal. Rptr. 881, 547 P.2d 993; and Garris v. Carpenter
						(1939) 33 Cal. App. 2d. 649, 653, 92 P.2d 688. Reference: Sections
						1872.5,
						1873.2,
						1874.2,
						1874.4,
						1875.20,
						1875.21,
						1875.24,
						1877.3,
						1879.5,
						12921(a)
						and
						12926,
						Insurance Code.