Special Investigative Units (SIU) Regulations Update

On July 1 CWCI distributed an Executive Memo to alert our members that on June 19 the Department of Insurance had submitted proposed amendments to the SIU regulations to the Office of Administrative Law (OAL) for approval.  At the time, the amended regs were under review, with no effective date set pending final approval. 

As a follow-up to our earlier memo, please be advised that on July 30, OAL approved the amended SIU regulations and filed them with the Secretary of State.  The effective date is October 1, 2020.  A copy of the final regulations has been posted on the Institute’s website under the Regulation tab at https://www.cwci.org/regulatory.html.

As previously noted, these are the first amendments to the SIU regulations since they initially took effect in October 2005. With the recent approval, the Department of Insurance has added more stringent requirements to existing regulations, including but not limited to, “investigation of suspected fraud “(Ins, Code §2698.36), “referral of suspected fraud” (Ins. Code §2698.37), and “anti-fraud training” (Ins. Code §2698.39). The anti-fraud training for internal claims staff requires particular attention in view of the October 1 effective date as five (5) hours of annual SIU training will be required, whereas the duration of such training has previously been left to the discretion of claims administrators. 

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