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 Bank Secrecy Act. The Task Force will also 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.

2008 Charges

Ongoing Maintenance of NAIC Programs, Products, or Services.

1. Appoint an Antifraud Training & Seminar Working Group to identify and develop training sessions regarding antifraud issues of importance to insurance regulators, industry and interested parties. (Essential)
   
2. Appoint an Information Sharing & 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, and law enforcement, insurers and antifraud organizations. Recommend secure systems for the dissemination of confidential information between insurance fraud agencies. (Essential)
   
3. Appoint an Antifraud Liaison Working Group to (1) develop initiatives and guidelines to enhance relationships with industry Special Investigation Units (SIUs), external private sector antifraud entities and antifraud organizations to include but not limited to training opportunities, model and guideline protocols and bench marking projects. Projects will include updating the State Insurance Department Antifraud Resources Report, and guidelines for working with insurance fraud prosecutors, and fraud bureaus. (2) Develop industry SIU regulations guidelines (3) Develop an industry antifraud plan guideline. (4) Explore the feasibility of establishing a “National Insurance Fraud Prevention Day/Week. (5) Provide an advisory role to the Coalition Against Insurance Fraud, International Association of Special Investigation Unit (IASIU) and the National Insurance Crime Bureau (NICB). (Essential)
   
4. Appoint a Federal and International Enforcement Coordination Working Group to (1) coordinate with state, federal and international law enforcement agencies in addressing antifraud issues relating to the insurance industry, (2) support insurance regulator efforts to gain access to the FBI Fingerprint Identification Record System/Criminal History Record Identification System, and (3) monitor and recommend appropriate guidance on state issues arising from the application of 18 U.S.C. 1033, 1034. (Essential)
   
5. Appoint a Producer, Company, Unauthorized Entities & Unlawful Activities Working Group to (1) develop a program to enhance recognition, investigation, and prosecution of unauthorized entities by updating and maintaining the Unauthorized Entities Manual and by (2) identifying and developing recommendations for coordination and cooperation between state insurance department and law enforcement authorities on unauthorized issues. (3) Research and define the process to measure the impact of regulatory and law enforcement efforts to combat insurance fraud and (4) develop methods to enhance the investigation and prosecution of financial services fraud. (5) Establish guidelines on the investigation and prosecutorial resources necessary to investigate insider insurance industry fraud. (Essential)
   
6. Appoint a NAIC/North American Securities Administrators Association (NASAA) Enforcement Coordination Working Group to (1) develop an education and training seminar in cooperation with NASAA. (2) Identify and develop recommendations of cooperation and communication between insurance and securities regulators. (Essential)