<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 31.04.15.06" title_num="31" subtitle_num="04" chapter_num="15" heading="Reporting of Fraud-Related Data.">
  <paragraph num="A.">
    <text>An insurer shall maintain appropriate records for the Commissioner to determine the effectiveness of its antifraud plan.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A report shall be developed and provided to the Administration on an annual basis regarding the plan's effectiveness and the effectiveness of the investigative and prosecutorial efforts.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The report shall be filed with the Administration by March 31 of each year, reporting the previous year's statistics. The report shall be limited to Maryland data. The following information shall be reported:</text>
    <paragraph num="(1)">
      <text>Number of policies in force;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Number of claims;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Number of suspected fraud cases;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Number of suspected fraud cases in which a claim was denied;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Number of suspected fraud cases reported to the authorities;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Number of suspected fraud cases by product line;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Number of suspected fraud cases in which a claim was denied, by product line;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Number of cases prosecuted by criminal authorities; and</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Breakdown by perpetrator, as follows:</text>
      <paragraph num="(a)">
        <text>Insured,</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Claimant,</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Insurance producer/employee,</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Noninsurance professional, by category, and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Other.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>