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CA Code and Ethics
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Introduction
1. Basic insurance concepts and principles
2. The insurance marketplace
3. Required fraud training — CDI
3.1 Introduction and learning objectives
3.2 Fraud Division
3.3 Fraud Division programs
3.4 Fraud detection
Wrapping up
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3.1 Introduction and learning objectives
CA Code and Ethics
3. Required fraud training — CDI
Our California Insurance Code and Ethics course is currently in development and is a work-in-progress.

Introduction and learning objectives

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Introduction

Insurance fraud weakens the entire insurance system. It can raise premiums, reduce consumer trust, and involve both claimants and insurance professionals. California requires anti-fraud training so licensees understand their responsibilities for preventing, detecting, and reporting fraud.

Learning objectives

By the end of this chapter, you should be able to:

  • Identify the role of California’s Fraud Division and its enforcement authority
  • Recognize types of insurance fraud and common indicators
  • Understand insurer and agent responsibilities regarding anti-fraud efforts
  • Identify fraud detection and reporting tools
  • Apply proper procedures when fraud is suspected

Insurance fraud overview

  • Increases premiums, reduces trust in insurance
  • Involves both claimants and professionals
  • California mandates anti-fraud training for licensees

California Fraud Division

  • Investigates and enforces insurance fraud laws
  • Holds enforcement authority in fraud cases

Types and indicators of insurance fraud

  • Multiple forms: claimant and professional fraud
  • Common indicators help identify suspicious activity

Insurer and agent responsibilities

  • Required to prevent, detect, and report fraud
  • Must follow state-mandated anti-fraud procedures

Fraud detection and reporting tools

  • Utilize specialized tools and resources
  • Proper reporting channels for suspected fraud

Procedures for suspected fraud

  • Follow established protocols when fraud is suspected
  • Ensure compliance with legal and ethical standards
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Introduction and learning objectives

Introduction

Insurance fraud weakens the entire insurance system. It can raise premiums, reduce consumer trust, and involve both claimants and insurance professionals. California requires anti-fraud training so licensees understand their responsibilities for preventing, detecting, and reporting fraud.

Learning objectives

By the end of this chapter, you should be able to:

  • Identify the role of California’s Fraud Division and its enforcement authority
  • Recognize types of insurance fraud and common indicators
  • Understand insurer and agent responsibilities regarding anti-fraud efforts
  • Identify fraud detection and reporting tools
  • Apply proper procedures when fraud is suspected
Key points

Insurance fraud overview

  • Increases premiums, reduces trust in insurance
  • Involves both claimants and professionals
  • California mandates anti-fraud training for licensees

California Fraud Division

  • Investigates and enforces insurance fraud laws
  • Holds enforcement authority in fraud cases

Types and indicators of insurance fraud

  • Multiple forms: claimant and professional fraud
  • Common indicators help identify suspicious activity

Insurer and agent responsibilities

  • Required to prevent, detect, and report fraud
  • Must follow state-mandated anti-fraud procedures

Fraud detection and reporting tools

  • Utilize specialized tools and resources
  • Proper reporting channels for suspected fraud

Procedures for suspected fraud

  • Follow established protocols when fraud is suspected
  • Ensure compliance with legal and ethical standards