2006 New York Code - Reports.

 
    § 405. Reports.  (a) Any person licensed pursuant to the provisions of
  this  chapter,  and  any  person engaged in the business of insurance in
  this  state  who  is  exempted  from  compliance  with   the   licensing
  requirements of this chapter, including the state insurance fund of this
  state,  who  has  reason to believe that an insurance transaction may be
  fraudulent, or has knowledge that a fraudulent insurance transaction  is
  about  to take place, or has taken place shall, within thirty days after
  determination  by  such  person  that  the  transaction  appears  to  be
  fraudulent,  send to the insurance frauds bureau on a form prescribed by
  the superintendent, the information  requested  by  the  form  and  such
  additional  information  relative  to  the  factual circumstances of the
  transaction and the parties involved as the superintendent may  require.
  The insurance frauds bureau shall accept reports of suspected fraudulent
  insurance  transactions from any self insurer, including but not limited
  to self insurers providing health insurance coverage or those defined in
  section fifty of the workers' compensation law,  and  shall  treat  such
  reports as any other received pursuant to this section.
    (b) The insurance frauds bureau shall review each report and undertake
  such further investigation as it deems necessary and proper to determine
  the validity of the allegations.
    (c)  Whenever  the  superintendent is satisfied that a material fraud,
  deceit, or  intentional  misrepresentation  has  been  committed  in  an
  insurance  transaction  or  purported  insurance  transaction,  he shall
  report any such violation of law to the  appropriate  licensing  agency,
  the  district  attorney of the county in which such acts were committed,
  when authorized by law, to the attorney general, and where  appropriate,
  to  the  person  who  submitted  the  report  of fraudulent activity, as
  provided by the provisions of this article. Within  one  hundred  twenty
  days  of receipt of the superintendent's report, the attorney general or
  the district attorney concerned shall inform the  superintendent  as  to
  the status of the reported violations.
    (d)  No  later  than  January  fifteenth  of  each  year, beginning in
  nineteen hundred ninety-four, the superintendent shall  furnish  to  the
  governor,  the  speaker of the assembly and the president pro tem of the
  senate a report containing:
    (1) a comprehensive summary and  assessment  of  the  frauds  bureau's
  efforts  in discovering, investigating and halting fraudulent activities
  and assisting in the prosecution of persons who are parties to insurance
  fraud;
    (2) the number of reports received from any person or persons  engaged
  in the business of insurance, the number of investigations undertaken by
  the   bureau   pursuant   to   any   reports  received,  the  number  of
  investigations undertaken not as  a  result  of  reports  received,  the
  number  of  investigations  that  resulted  in a referral to a licensing
  agency, a local prosecutor or the attorney general, the number  of  such
  referrals  pursued  by  a  licensing  agency,  a local prosecutor or the
  attorney general, and the disposition of such cases;
    (3) a delineation of the number of reported and investigated cases  by
  line of insurance;
    (4)  a  comparison  of  the frauds bureau's experience, with regard to
  paragraphs two and three of this subdivision, to the bureau's experience
  of years past;
    (5) the total number  of  employees  assigned  to  the  frauds  bureau
  delineated by title and location of bureau assigned;
    (6)  an  assessment  of  insurance  company  activities  in  regard to
  detecting, investigating and reporting fraudulent activities,  including
  a  list  of companies which maintain special investigative units for the
  sole  purpose  of  detecting,  investigating  and  reporting  fraudulent
  activities  and  the  number of investigators assigned to such units per
  every thirty thousand policies in force with such company;
    (7)  the  amount  of  technical  and monetary assistance requested and
  received by the frauds bureau from any insurance company or companies or
  any organization funded by insurance companies;
    (8) the amount of money returned by the  frauds  bureau  to  insurance
  companies  pursuant  to  any fraudulent claims that were recouped by the
  bureau;
    (9) the number and amount of civil  penalties  levied  by  the  frauds
  bureau  pursuant  to chapter four hundred eighty of the laws of nineteen
  hundred ninety-two;
    (10) recommendations for further statutory or  administrative  changes
  designed to meet the objectives of this article; and
    (11) an assessment of law enforcement and insurance company activities
  to detect and curtail the incidence of operating a motor vehicle without
  proper insurance coverage as required by this chapter.