Antifraud (D) Task Force
Market Regulation and Consumer Affairs (D) Committee

Mission

The mission of the Antifraud (D) Task Force is to serve the public interest by assisting the state insurance supervisory officials, individually and collectively, to promote the public interest through the detection, monitoring and appropriate referral for investigation of insurance crime, both by and against consumers. The Task Force will assist the insurance regulatory community through the maintenance and improvement of electronic databases regarding fraudulent insurance activities. Disseminate the results of research and analysis of insurance fraud trends as well as case‑specific analysis to the insurance regulatory community. Provide a liaison function between insurance regulators, federal, state, local and international law enforcement and other specific antifraud organizations. Coordinate between state and federal regulators regarding the USA PATRIOT Act anti-money laundering amendments to the federal Bank Secrecy Act. The Task Force also will serve as a liaison with the NAIC Information Systems Division and other NAIC committees to develop technological solutions for data collection and information-sharing. The Task Force will monitor all aspects of antifraud activities by its working groups and subgroups on the following charges.

Ongoing Support of NAIC Programs, Products or Services:

1. Develop and recommend an uniform fraud reporting form and uniform fraud reporting standards for private health insurers for fraud referrals to state agencies in accordance with section 6603 of the Affordable Care Act to be provided to the U.S. Secretary of Health and Human Services—Essential

2. Work with the Title Insurance (C) Task Force to review issues and concerns related to fraud activities and schemes related to title insurance fraud and consider a joint regulator education program—Essential

3. Maintain six working groups: 1) Agent and Unlawful Activities Working Group; 2) Antifraud Liaison Working Group; 3) Antifraud Training and Seminar Working Group; 4) Federal and International Enforcement Coordination Working Group; 5) Information Sharing and Technology Working Group; and 6) Securities Enforcement Coordination Working Group.

4. Appoint the Agent and Unlawful Activities Working Group to coordinate efforts to address national concerns related to agent fraud and activities of unauthorized agents related to insurance sales—Essential

5. Appoint the Antifraud Liaison Working Group to coordinate activities and information from national antifraud organizations and provide information to state insurance fraud bureaus—Essential. The Working Group will evaluate and recommend method to track national fraud trends—Important

6. Appoint the Antifraud Training and Seminar Working Group to develop and present seminars, trainings and webinars regarding insurance fraud, as necessary, during the course of the year—Essential

7. Appoint the Federal and International Enforcement Coordination Working Group to coordinate with state, federal and international law enforcement agencies in addressing antifraud issues relating to the insurance industry—Essential. The Working Group will review and provide comments on behalf of the Antifraud Task Force on Insurance Core Principles related to insurance fraud for the International Association Insurance Supervisors—Essential

8. Appoint the Information Sharing and Technology Working Group to evaluate sources of antifraud data and propose methods for enhancing the utilization and exchange of information among insurance regulators, fraud investigative divisions, law enforcement officials, insurers and antifraud organizations—Essential

9. Appoint the Securities Enforcement Coordination Working Group to coordinate the enforcement and investigation efforts of state and federal securities regulators with state insurance fraud bureaus—Essential

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