California § 1872.41. 1872.41. (Amended by Stats. 2023, Ch. 204, Sec. 12.)

California Statutes

§ 1872.41. — 1872.41. (Amended by Stats. 2023, Ch. 204, Sec. 12.)

California·Code INS Insurance Code - INS·Div. 1. DIVISION 1. GENERAL RULES GOVERNING INSURANCE·Part 2. PART 2. THE BUSINESS OF INSURANCE·Ch. 12. CHAPTER 12. The Insurance Frauds Prevention Act·Art. 2. ARTICLE 2. Bureau of Fraudulent Claims

(a)An agent or broker who, before placing an insurance application with an insurer, reasonably suspects or knows that a fraudulent application is being made shall, within 60 days after the determination by the agent or broker that the application appears to be fraudulent, submit to the Fraud Division, using the electronic form within Fraud Division’s Consumer Fraud Reporting Portal, the information requested by the form and any additional information relative to the factual circumstances of the application and the alleged material misrepresentations contained in the application. All data fields within the Fraud Division’s Consumer Fraud Reporting Portal electronic form shall be completed accurately, to the best of the agent or broker’s ability. An agent or broker shall not submit a

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(a)
An agent or broker who, before placing an insurance application with an insurer, reasonably suspects or knows that a fraudulent application is being made shall, within 60 days after the determination by the agent or broker that the application appears to be fraudulent, submit to the Fraud Division, using the electronic form within Fraud Division’s Consumer Fraud Reporting Portal, the information requested by the form and any additional information relative to the factual circumstances of the application and the alleged material misrepresentations contained in the application. All data fields within the Fraud Division’s Consumer Fraud Reporting Portal electronic form shall be completed accurately, to the best of the agent or broker’s ability. An
agent or broker shall not submit a fraud referral anonymously. The Fraud Division shall review each report and undertake further investigation it deems necessary and proper to determine the validity of the allegations.
(b)
An agent or broker who, after an insurance application has been placed with an insurer, reasonably suspects or knows that fraud has been perpetrated shall report that information directly to the insurer’s special investigative unit. An agent or broker shall furnish all papers, documents, reports, or other facts or evidence to the insurer’s special investigative unit upon request, and shall otherwise assist and cooperate with the insurer’s special investigative unit.
(c)
An agent or broker shall furnish all papers, documents, reports, or other facts or
evidence to the department upon request, and shall otherwise assist and cooperate with the department.
(d)
(1)
For purposes of this section, an “agent or broker” is a natural person licensed to transact insurance in a capacity described in Section 1625, 1625.5, 1625.55, 1626, or 1758.1 and is not the employee of an insurer.
(2)
An agent or broker is not considered a “contracted entity” or “integral antifraud personnel” pursuant to Section 2698.30 of Title 10 of the California Code of Regulations.

California § 1872.41. (1872.41. (Amended by Stats. 2023, Ch. 204, Sec. 12.)) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.