REPORTING: Section 626.989(6), F.S. requires insurers to report acts of suspected insurance fraud to the division. Rule 69D-2 mandates that insurers must report the suspected fraud acts electronically using either the E-file Referral or the NICB interface site.

Insurance Company Tips 

or

NICB Members Referral Interface

COMPLIANCE: Section 626.9891, F. S. requires insurer to submit an SIU Description/Anti-Fraud Plan to the Division. Effective September 1, 2017 the statute has been amended, adding new required elements and annual filing. Additional statistical data is required by March 1, 2019. Rule 69D-2 has also been amended to establish guidelines and detailing the reporting requirements.

The division created a database known as the Florida Reporting and Employee Designation Database (FREDD) so that the required filings could be submitted electronically (form L1-1689).

COMPLIANCE - WORKERS' COMPENSATION: Section 626.9891(6) requires Workers’ Compensation insurers to file an annual Worker’ Compensation Anti-Fraud report. Effective September 1, 2017 the statutory deadline for the annual report is amended to March 1, 2019.

The Florida Reporting and Employee Designation Database (FREDD) was created so that insurers could electronically file this report to the division (form L1-9891).

COMMUNICATION: Section 626.989(4)(d), F.S. provides that persons identified as designated employees whose responsibilities include the investigation and disposition of claims relating to suspected fraudulent insurance acts may share information relating to persons suspected of committing fraudulent insurance acts with other designated employees employed by the same or other insurers whose responsibilities include the investigation and disposition of claims relating to fraudulent insurance acts, provided the department has been given written notice of the names and job titles of such designated employees prior to such designated employees sharing information.

Unless the designated employees of the insurer act in bad faith or in reckless disregard for the rights of any insured, neither the insurer nor its designated employees are civilly liable for libel, slander, or any other relevant tort, and a civil action does not arise against the insurer or its designated employees.

ADD or DELETE A DESIGNATED EMPLOYEE: Click on DIFSIUAdmin@MyFloridaCFO.com to provide the written notice of the NAME and JOB TITLE of the “designated employee” whose responsibilities include the investigation and disposition of claims relating to suspected fraudulent acts.

The email request must also provide the insurer identifiers making the request.

CHECK FOR A DESIGNATED EMPLOYEE: Click on DIFSIUAdmin@MyFloridaCFO.com if you need to confirm if a person is listed as a “designated employee” in the DIFS database. Please include the person’s name and the insurer’s name that has requested the file information. DIFS will reply with a confirmation form acknowledging that the person is listed as designated employee in the DIFS database.

QUERY THE STATUS OF YOUR REFERRAL: Insurers should use the Case or Tip Status query to check on the status of their referral. You will need either your tip number (T06-XXX) or case number (06-XXX) in order to receive information on the development of your referral. Look up Your Tip or Case Status