The Department's Anti-Fraud
Compliance Division works to ensure licensed entities are in compliance with
state & federal fraud regulations aimed at increasing the detection,
investigation, prosecution and prevention of insurance fraud in Pennsylvania.
The Department has compiled an overview of Anti-Fraud compliance requirements, available here. Please note this is general guidance and a brief summary of the Commonwealth's Anti-Fraud plan filing, reporting and compliance requirements. You should consult the actual statutes and regulations for a complete understanding of all requirements associated with Anti-Fraud plans, filings, reporting and compliance.
Insurers are responsible for meeting the reporting requirements in a
timely manner as set forth below. Insurance companies failing to file or timely file
statements or reports are subject to the penalty provisions of Section
320(e)(1) (40 P.S. §443) of The Insurance Company Law. Extensions to
the filing deadline may be considered at the discretion of the Division
Chief. Any request for an extension must be submitted via mail or email
no later than 10 business days prior to the filing deadline.
Extensions will be considered on a case-by-case basis.
Special Market Notice regarding Insurance Fraud Investigations, issued 7/14/2017...
Helpful Anti-Fraud Resources for Licensees:
A Matrix of Pennsylvania Anti-Fraud Compliance Requirements
Compliance Reporting & Filing Requirements
Model Plan Template
Anti-Fraud Statistical Reporting
Anti-Fraud Statistical Reporting FAQ's
To contact the Anti-Fraud compliance division, email email@example.com.