State RegulationsCO specificDifficulty 2/5
Under C.R.S. § 10-1-128, which of the following must a Colorado insurer's anti-fraud plan provide for?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
C.R.S. § 10-1-128 requires each insurer's anti-fraud plan to include procedures to prevent, detect, and investigate fraud, to educate employees and investigators about fraud, and to report suspected fraud to law enforcement. Education and law-enforcement reporting are affirmative components of the plan itself.
Why the other options are wrong
- B) Anti-fraud plans are proprietary under the statute; annual public posting of referral statistics is not a required component.
- C) The plan requires investigation and reporting procedures, not an automatic denial outcome for every referral.
- D) The statute requires the insurer to educate its own employees and investigators, not to replace its claims operation.
Memory hook
A fraud plan teaches its people and tells law enforcement.