California Insurance Code & EthicsQuestion 60 of 215
An insurer in good faith reports a suspected fraudulent claim to law enforcement. Under California law, the insurer is:
a.Strictly liable to the claimant for any harm caused by the report
b.Liable unless the claimant is convicted
c.Generally immune from civil liability for the disclosure if made in good faith
d.Required to also pay the claim in full while the investigation proceeds
Explanation
Section 1879.5 grants insurers civil immunity for good-faith reports of suspected fraud to authorized agencies. Strict liability and conviction-based liability are not part of the statute, and the insurer is not required to pay a suspected fraudulent claim while the matter is investigated.
Law Reference: Cal. Ins. Code §1879.5Practice all 215 questions free — no signup required.
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