2023 Membership

2023 Adopted Charges

The mission of the Antifraud (D) Task Force is to serve the public interest by assisting the state insurance supervisory officials, individually and collectively, through the detection, monitoring, and appropriate referral for the investigation of insurance crime, both by and against consumers. The Task Force will assist the insurance regulatory community by conducting the following activities: 1) maintaining and improving electronic databases regarding fraudulent insurance activities; 2) disseminating the results of research and analysis of insurance fraud trends, as well as case-specific analysis, to the insurance regulatory community; and 3) providing a liaison function between state insurance regulators, law enforcement—i.e., federal, state, local, and international—and other specific antifraud organizations. The Task Force will also serve as a liaison with the NAIC Information Technology Group (ITG) and other NAIC committees, task forces, and/or working groups to develop technological solutions for data collection and information sharing. The Task Force will monitor all aspects of antifraud activities by its working groups on the following charges.

Ongoing Support of NAIC Programs, Products or Services

1. The Antifraud (D) Task Force will:

A. Work with NAIC committees, task forces, and working groups (e.g., Title Insurance (C) Task Force, etc.) to review issues       and concerns related to fraud activities and schemes related to insurance fraud.

B. Coordinate efforts to address national concerns related to agent fraud and activities of unauthorized agents related to          insurance sales.

C. Coordinate the enforcement and investigation efforts of state and federal securities regulators with state insurance fraud       bureaus.

D. Coordinate with state, federal, and international law enforcement agencies in addressing antifraud issues relating to the       insurance industry.

E. Review and provide comments to the International Association of Insurance Supervisors (IAIS) on its Insurance Core            Principles (ICPs) related to insurance fraud.

F. Coordinate activities and information from national antifraud organizations and provide information to state insurance            fraud bureaus.
G. Coordinate activities and information with state and federal fraud divisions to determine guidelines that will assist with           reciprocal involvement concerning antifraud issues resulting from natural disasters and catastrophes.
H. Coordinate efforts with the insurance industry to address antifraud issues and concerns.
I.  Evaluate and recommend methods to track national fraud trends.
J. Develop seminars, trainings, and webinars regarding insurance fraud. Provide three webinars by the 2023 Fall National        Meeting.

2. The Antifraud Technology (D) Working Group will:

A. Work with the NAIC to develop an Antifraud Plan Repository to be used by insurers to create and store an electronic             fraud plan for distribution among the states/jurisdictions. Complete by the 2023 Fall National Meeting.
B. Evaluate sources of antifraud data and propose methods for enhancing the utilization and exchange of information                 among state insurance regulators, fraud investigative divisions, law enforcement officials, insurers, and antifraud                   organizations. Complete by the 2023 Fall National Meeting.

3. The Improper Marketing of Health Insurance (D) Working Group will:

A. Coordinate with state insurance regulators, both on a state and federal level, to provide assistance and guidance                   monitoring the improper marketing of health plans and coordinate appropriate enforcement actions, as needed, with             other NAIC committees, task forces, and working groups.
B. Review existing NAIC models and guidelines that address the use of lead generators for sales of health insurance                products and identify models and guidelines that need to be updated or developed to address current marketplace                activities.

NAIC Support Staff: Greg Welker/Lois E. Alexander