2006 Utah Code - 31A-36-117 — Antifraud initiatives.

     31A-36-117.   Antifraud initiatives.
     (1) The following shall establish and maintain antifraud initiatives which are reasonably calculated to prevent, detect, and assist in the prosecution of violations of Section 31A-36-113:
     (a) a provider of viatical settlements; and
     (b) an agency that is a producer of viatical settlements.
     (2) The commissioner may order, or a licensee may request and the commissioner may approve, modifications of the measures otherwise required under this section, more or less restrictive than those measures, as necessary to protect against fraud.
     (3) Antifraud initiatives shall include:
     (a) fraud investigators, that may be either:
     (i) employees of a provider or producer of viatical settlements; or
     (ii) independent contractors;
     (b) an antifraud plan submitted to the commissioner, which shall include:
     (i) a description of the procedures for:
     (A) detecting and investigating possible violations of Section 31A-36-113; and
     (B) resolving material inconsistencies between medical records and applications for insurance;
     (ii) a description of the procedures for reporting possible violations to the commissioner;
     (iii) a description of the plan for educating and training underwriters and other personnel against fraud; and
     (iv) a description or chart of the organizational arrangement of the personnel responsible for detecting and investigating possible violations of Section 31A-36-113 and for resolving material inconsistencies between medical records and applications for insurance.
     (4) A plan submitted to the commissioner shall be classified as a protected record under Title 63, Chapter 2, Government Records Access and Management Act.

Enacted by Chapter 81, 2003 General Session