The Coalition has long called for insurers to be proactive in identifying and deterring insurance fraud.
To this end, our model state fraud law initially drafted in 1994 requires insurers to create anti-fraud plans that serve as blueprints for how they investigate suspicious activity.
The clear intent is to make combating fraud schemes cost-effective. That means a justifiable ROI, with insurers saving more money than they spend fighting this crime. Such a net-plus is good for business and consumers.
Uniformity is a central element: All states should have similar requirements for insurer fraud plans. That way insurers need not “reinvent the wheel” for each state where they do business.
This hardly means one template plan for every state. Rather, it means a basic framework driven by certain core principles. Insurers can shape plan specifics to the unique challenges they confront in a given state.
The NAIC’s antifraud task force is crafting a guideline for insurer fraud plans. The task force hopes to finalize the model at its November meeting.
We applaud this effort. The model will bring us a big step closer to much-needed uniformity. The Coalition already is discussing holding a meeting of regulators and fraud fighters in 2016. It will explore how, together, insurers and regulators will better know what is expected in crafting and maintaining their fraud plans.
Look for more developments as we finalize plans for 2016.
About the author: Howard Goldblatt is director of government affairs for the Coalition Against Insurance Fraud.