We will keep this page updated periodically as questions are received. If you have a question about fraud, please send
an e-mail to the Invesitgations Section
Is a licensed insurer required to submit a fraud report?
Yes. An insurer is required to report a fraudulent report within 60 days by
§41-290.
We inadvertently overlooked to report a fraud which happened about two years ago. Is it too late to do so now?
No. Please submit a report. We will still review the report.
The claim was denied so there was no loss to the insurer. Do we still need to report to the Department?
Yes. If it is a fraudulent claim, you are still required to report to us.
The insured or the claimant withdrew the claim. Do we still need to report a fraudulent claim?
Yes. If there is suspected fraud, you are still required to report to us.
If there is suspected fraud but the insurer and the insured or the claimant negotiated a monetary settlement, should a report to the Department still be necessary?
Yes. Please submit a report In order to be in compliance with
§41-290.
If the insurer is not able to gather enough evidence to prove fraud, should we still submit a fraud report?
Yes. If there is suspected fraud, you are still required to report to us.
Should we wait to submit a report until after we complete our investigation?
The Idaho Code,
§41-290, requires the insurer to report a fraudulent claim within 60 days. As you look into the case and suspect fraud, please submit a report. If we require more information, we will ask for it.
Do we need to use the reporting form on the Department of Insurance Web site?
No. We accept any written report form, such as NAIC form.
Is a provider required to submit a fraud report?
No. But please do so if an insurer has not reported. We will contact the insurer.