California Insurance Code & EthicsQuestion 41 of 53185% of test-takers answer this correctly

Insurers writing certain lines of insurance in California must establish what unit to investigate possible fraudulent claims?

a.A FAIR Plan committee
b.A Department of Managed Health Care liaison
c.A Special Investigative Unit (SIU)
d.A Property Loss Research Bureau

Explanation

Article 4.5 of the Insurance Code (§1875.20 et seq.) requires insurers to maintain a Special Investigative Unit, or SIU, to detect and investigate suspected insurance fraud. The FAIR Plan handles residual property risks, not fraud investigation, and DMHC regulates HMOs.

Law Reference: Cal. Ins. Code §1875.20 et seq.

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