Title INS — California Ins. Code
0 chapters · 3,633 sections in this title.
Ins. Code § 1875.12 Section 1875.12
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(a) The commissioner may license an organization as an insurance claims analysis bureau if it meets the following qualifications: (1) Is a nonprofit corporation organized for the purpose of fraud prevention or is a corporation that has made the filings required by Section 1855.2.…
Ins. Code § 1875.13 Section 1875.13
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The commissioner shall license an insurance claims analysis bureau by class of claims, if an insurance claims analysis bureau makes application and is appropriately qualified, for the following classes of claims: (a) Automobile bodily injury, which shall include liability, uninsu…
Ins. Code § 1875.14 Section 1875.14
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An insurance claims analysis bureau shall perform the following functions: (a) Collect and compile information and data from members or subscribers concerning insurance claims. (b) Disseminate information to members or subscribers relating to insurance claims for the purpose of p…
Ins. Code § 1875.15 Section 1875.15
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(a) A licensed insurance claims analysis bureau shall develop rules governing the kind, quality, and frequency of data reporting, which shall be binding on all subscribers or members. The commissioner may require development of new claims categories for the suppression and preven…
Ins. Code § 1875.16 Section 1875.16
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Unless otherwise provided by law, any authorized entity which receives any information furnished pursuant to this article shall not release that information to public inspection (1) until such time as its release is required in connection with a criminal or civil proceeding, or (…
Ins. Code § 1875.17 Section 1875.17
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On or before May 1, 1992, and on or before May 1 of each year thereafter, any licensed insurance claims analysis bureau shall file with the department a report on the scope and extent of its activities in this state for the preceding year.
Ins. Code § 1875.18 Section 1875.18
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(a) Every bodily injury, medical payment, or uninsured motorist claim made under a policy of automobile insurance shall be available, upon request, to law enforcement agencies in this state, whenever that claim relates to an event that occurred within the state. (b) Every claim s…
Ins. Code § 1875.2 Section 1875.2
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If any insurer has reason to suspect that a fire loss was caused by incendiary means, the insurer shall furnish an authorized agency with all relevant information acquired during its investigation of the fire loss and cooperate in an investigation by an authorized agency. The aut…
Ins. Code § 1875.20 Section 1875.20
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Every insurer admitted to do business in this state, except those otherwise exempted in this code, shall provide for the continuous operation of a unit or division to investigate possible fraudulent claims by insureds or by persons making claims for services or repairs against po…
Ins. Code § 1875.21 Section 1875.21
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Insurers may maintain the unit or division required by this article using its employees or by contracting with others for that purpose.
Ins. Code § 1875.22 Section 1875.22
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Insurers shall establish the unit or division required by this article no later than July 1, 1992.
Ins. Code § 1875.23 Section 1875.23
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For purposes of this article, “unit or division” may include the assignment of fraud investigation to employees whose principal responsibilities are the investigation and disposition of claims. If an insurer creates a distinct unit or division, hires additional employees, or cont…
Ins. Code § 1875.24 Section 1875.24
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(a) If after examination, or upon the basis of other information, the commissioner has good cause to believe that an insurer to whom the provisions of this article apply does not comply with the requirements of this article, or with the regulations set forth in Article 2 (commenc…
Ins. Code § 1875.3 Section 1875.3
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An authorized agency shall notify the insurer, if known, and at the expense of the insurer, whenever it has reason to believe that a fire loss was not accidentally caused. The agency shall also release to the claimant’s insurer specific information regarding the fire loss at the …
Ins. Code § 1875.4 Section 1875.4
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In the absence of fraud or malice, no insurer or person acting in its behalf who (a) furnishes information whether oral or written, pursuant to this article, or (b) assists in any investigation conducted by an authorized agency, shall be liable for damages in a civil action, nor …
Ins. Code § 1875.5 Section 1875.5
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In any case in which an insurer willfully fails to comply with this article, the authorized agency may petition the superior court in an appropriate county for an order requiring compliance.
Ins. Code § 1875.6 Section 1875.6
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Any authorized agency that receives any information furnished as required by this article shall not make the information public until the time that its release is required in connection with a criminal or civil proceeding.
Ins. Code § 1875.8 Section 1875.8
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(a) There is hereby created the Arson Information Reporting System to permit insurers, law enforcement agencies, fire investigative agencies, and district attorneys to deposit arson case information in a common data base within the Department of Justice. The State Fire Marshal sh…
Ins. Code § 1876 Section 1876
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Every insurer who receives a bodily injury, medical payment, or uninsured motorist claim made under a policy of automobile liability insurance defined in Section 660 or Section 11622 shall within 20 days of the receipt of that claim deposit that claim information with a licensed …
Ins. Code § 1876.3 Section 1876.3
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Any information acquired pursuant to this article shall not be part of any public record except as follows: Except as otherwise provided by law, any authorized governmental agency, and insurer, or an agent authorized by an insurer to act on its behalf, which receives any informat…
Ins. Code § 1876.4 Section 1876.4
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No insurer, or the employees or agents of any insurer, shall be subject to civil liability for libel, slander, or any other tort cause of action arising from the deposit or furnishing of any information or data pursuant to this article.
Ins. Code § 1876.5 Section 1876.5
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As used in this article, “authorized governmental agency” and “insurer” have the same meaning as is given by Section 1874.1.
Ins. Code § 1877 Section 1877
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This article shall be known and may be cited as the Workers’ Compensation Insurance Fraud Reporting Act.
Ins. Code § 1877.1 Section 1877.1
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The following definitions govern the construction of this article, unless the context requires otherwise: (a) “Authorized governmental agency” means the district attorney of any county, any city attorney whose duties include criminal prosecutions, any law enforcement agency inves…
Ins. Code § 1877.2 Section 1877.2
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For the purposes of this article, “authorized governmental agency” includes, in addition to the entities listed in subdivision (a) of Section 1877.1, any licensing agency governed by the Chiropractic Initiative Act.
Ins. Code § 1877.3 Section 1877.3
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(a) Upon written request to an insurer or a licensed rating organization by an authorized governmental agency, an insurer, an agent authorized by that insurer, or a licensed rating organization to act on behalf of the insurer, shall release to the requesting authorized government…
Ins. Code § 1877.35 Section 1877.35
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(a) The Public Employees’ Retirement System may request information from an insurer for any specific investigation of eligibility for, and unlawful application or receipt of, benefits provided under Part 3 (commencing with Section 20000) of Division 5 of Title 2 of the Government…
Ins. Code § 1877.4 Section 1877.4
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(a) Any information acquired pursuant to this article shall not be a part of the public record. Except as otherwise provided by law, any authorized governmental agency, an insurer, or an agent authorized to act on its behalf, which receives any information furnished pursuant to t…
Ins. Code § 1877.5 Section 1877.5
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No insurer, agent authorized by an insurer to act on its behalf, or licensed rating organization who furnishes information, written or oral, pursuant to this article, and no authorized governmental agency or its employees who (a) furnishes or receives information, written or oral…
Ins. Code § 1879 Section 1879
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The purpose of this article is to confront aggressively the problem of insurance fraud in this state by facilitating the detection of insurance fraud, eliminating the occurrence of fraud through the development of fraud prevention programs, requiring the restitution of fraudulent…
Ins. Code § 1879.1 Section 1879.1
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(a) The commissioner or their designated deputy commissioner may convene meetings with representatives of insurance companies or representatives of self-insured employers to discuss specific information concerning suspected, anticipated, or completed acts of insurance fraud. (b) …
Ins. Code § 1879.3 Section 1879.3
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The commissioner shall appoint supervisory and investigatory personnel within the bureau. In addition, the commissioner shall assign staff counsel who are employed by the department and are under the supervision of the department’s general counsel to advise the department’s fraud…
Ins. Code § 1879.4 Section 1879.4
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(a) The Chief of the Fraud Division and those investigators designated by him or her may expend funds to conduct undercover activities, employ civilian operatives, or in any other manner not prohibited by law to investigate insurance fraud or workers’ compensation fraud. (b) The …
Ins. Code § 1879.5 Section 1879.5
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(a) Any person who believes that a violation of this article has been or is being made may notify the department immediately after discovery of the alleged violation and may send to the department, on a form and in a manner prescribed by the commissioner, the information requeste…
Ins. Code § 1879.6 Section 1879.6
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The commissioner may adopt administrative regulations as he or she deems necessary for the effective implementation of this article.
Ins. Code § 1879.7 Section 1879.7
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The commissioner shall report annually to the Legislature as to the activities of the department and the cost-effectiveness of the programs established pursuant to this article.
Ins. Code § 1879.8 Section 1879.8
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Nothing in this article shall be construed to preclude the applicability of any other provision of civil or criminal law that applies to any act committed or alleged to have been committed by any person.