The reservation of rights letter notifies the policyholder that the insurer reserves the right to deny coverage of a claim, in whole or part, pending outcome of a claims investigation.
The Red Flag checklist helps determine whether a rear-end collision may have been a staged accident; this maneuver is referred to as a swoop and squat crash by the Coalition Against Insurance Fraud. Claims with numerous red flags may need to be referred to the special investigations unit (SIU).
This legislation establishes insurance fraud as a specific crime and as a felony in felony cases. It attacks insurance fraud at the source and can be used as a framework for additional laws, such as creating an insurance fraud bureau. The model addresses all forms of insurance fraud, including claims fraud, underwriting fraud, deceptive sales practices and scams by insurance operators.