FL H1007

Every insurer admitted to do business in Florida must establish an anti-fraud investigative unit or contract with one, adopt an anti-fraud plan, designate at least one primary anti-fraud employee, and provide annual anti-fraud training (at least 2 hours initial, 1 hour annually thereafter) by December 31, 2017, with fraud-related data reported annually to the Department of Financial Services beginning March 1, 2019; noncompliance may result in administrative fines of up to $2,000 per day.

The Division of Investigative and Forensic Services must create a best practices report for insurance fraud detection, investigation, prevention, and reporting by December 31, 2018, updated at least every 2 years, and must collect and report data from state attorney offices receiving appropriations for dedicated insurance fraud prosecutors.

Defines "fraudulent viatical settlement act" and "stranger-originated life insurance practice" (STOLI) under the Viatical Settlement Act, making contracts furthering STOLI practices void and unenforceable, and authorizing life insurers to contest policies obtained through such practices regardless of the standard contestability period.

Effective January 1, 2019, insurers may opt out of mandatory preinsurance inspection requirements for private passenger motor vehicles by filing a manual rule with the Office of Insurance Regulation, though they may establish their own inspection requirements and may not charge applicants for inspection costs.

Health maintenance organizations authorized to exclusively sell Medicare Advantage plans in Florida must be actively engaged in managed care within 24 months of licensure, designate at least one anti-fraud employee, and adopt an anti-fraud plan to maintain certificate of authority eligibility.