Committees & Activities

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. 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 Antifraud (D) Task Force Working Groups:

  • Agent and Unlawful Activities (D) Working Group
  • Antifraud Liaison (D) Working Group
  • Antifraud Training and Seminar (D) Working Group
  • Federal and International Enforcement Coordination (D) Working Group
  • Information Sharing and Technology (D) Working Group
  • Securities Enforcement Coordination (D) Working Group

2014 Charges

  1. 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

  2. Discuss state perspectives regarding the regulation of the activities of assistors and navigators established by the federal Affordable Care Act and coordinate with the Health Insurance (B) Committee, as necessary. —Essential

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

  4. Appoint the Antifraud Liaison (D) Working Group to coordinate activities and information from national antifraud organizations and provide information to state insurance fraud bureaus.—Essential

  5. The Working Group will evaluate and recommend methods to track national fraud trends.—Important

  6. Appoint the Antifraud Training and Seminar (D) Working Group to develop and present seminars, trainings and webinars regarding insurance fraud.—Essential

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

  8. Appoint the Information Sharing and Technology (D) 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 (D) Working Group to coordinate the enforcement and investigation efforts of state and federal securities regulators with state insurance fraud bureaus.—Essential
Conference Call Calendar

NAIC conference calls & interim meetings are available on the NAIC Conference Call Calendar. See NAIC's revised policy statement on open meetings.

Advance Materials

Antifraud (D) Task Force
Sunday, August 17, 2014
1:30 p.m. – 3:00 p.m Eastern
Louisville Marriott Downtown—Marriott Ballroom V—Level 2

Basic Fraud Investigations
Available Year-Round

More Information
Register Online

Go to the exposure draft index.

Navigator White Paper Proposal

In 2013 the Antifraud (D) Task Force was provided a task to assist with the drafting part of a white paper proposal concerning the potential fraud issues related to the activities of navigators, producers and non-navigator assistance personnel. The Task Force created a Navigator Issues (D) Subgroup to complete this draft which was presented to the AFTF and opened for comment.

During the NAIC 2013 Fall National Meeting the AFTF discussed the comments received and the decision was made to the comments and present the Task Force with a revised draft which would be up for adoption at the NAIC 2014 Spring National Meeting.

documents and resources
Financial Crimes Network (FinCEN) presentation
Frequently Asked Questions - Anti-Money Laundering Program and Suspicious Activity Reporting Requirements for the Insurance Industry
For informational purposes only

Insurance Department Investigator Safey Guidelines
The Antifraud (D) Task Force developed an Insurance Department Investigator Safety Guidelines to be used by state department investigators and auditors. The safety guideline was adopted by the NAIC full membership during the 2013 Summer National Meeting.

Reporting Fraud

Related NAIC Publications
Minutes for the four most recent NAIC National Meetings are available free for meeting attendees and members. Members may access minutes via StateNet. If you do not know your User ID or password, please contact the NAIC Help Desk.

Annual Antifraud Statistical Report Form

Antifraud Resources Report

Application and Use of Insurance Fraud-Related Databases and Sources of Information: A Guide for State Insurance Departments

Guidelines for Industry for Reporting Suspicious Claims or Activity to State Fraud Bureaus

Model Laws, Regulations and Guidelines

Contacts
Media queries should be directed to the NAIC Communications Division at 816-783-8909 or news@naic.org.

Greg Welker
Antifraud Coordinator & Market Regulation Specialist II
816-783-8872

Lois Alexander
Market Regulation Manager
816-783-8517
Tim Mullen
Director Market Regulation
Phone: 816-783-8260
Fax: 816-460-7875
Please see the current Committee List for a complete list of committee members.