Current through Register 2021 Notice Reg. No. 52, December 24, 2021
In order to be considered for funding, the local district
attorney must submit a plan outlining the projected and prior use of funds for
the purposes of the program. Funds assessed after January 1, 1993 shall be
distributed among these district attorneys who have submitted a plan. Seventy
percent (70%) of available funds will be distributed based on the applicant's
proportionate share of the state's population, twenty percent (20%) will be
distributed based on the applicant's proportionate share of the automobile
insurance suspected fraudulent claims submitted to the Fraud Division during
the prior three years and ten percent (10%) will be based on the Commissioner's
analysis of the County Plan. The plan must be submitted within the statutory
time-frame and must include the following elements:
(a) Problem Statement. A description of the
problem in the county, including how it arose, why it is important, its unique
aspects, if any, and what is needed to resolve the problem, including
supporting data, evidence, or indicators of fraudulent activity related to
automobile insurance.
(b)
Qualifications. A description of the applicant's experience in operating the
auto insurance fraud program using funds authorized under Section
1872.8
of the Insurance Code since 1989 including:
(1) The total amount of funds received by the
local district attorney since 1989.
(2) The total amount expended to support the
district attorney's investigation and prosecution of auto insurance fraud,
including details of the following items:
(A)
Personnel costs including salaries and benefits.
(B) Operations expenses, including space,
equipment, travel and other expenses in support of the program.
(3) The results obtained through
implementation of the program, including:
(A)
The number of investigations initiated or coordinated with other law
enforcement agencies.
(B) The
number of arrests and convictions.
(C) The number of indictments or
complaints.
(D) A comparison of the
amounts originally claimed in cases determined to be fraudulent compared to
payments actually made.
(c) Program Strategy:
(1) Outreach. A description of the manner in
which the district attorney will develop the district attorney's caseload, the
source(s) for referrals for cases for investigation or prosecution, whether
directly from the Fraud Division or from other law enforcement agencies and/or
insurers.
(2) Personnel.
Justification for the number of personnel, position titles and position
justification of personnel which will be funded fully or in part through grant
funds, including descriptions of the qualifications of personnel to be assigned
to the program and an organization chart identifying positions to be
funded.
(3) Program Coordination. A
description of the manner in which the district attorney plans to coordinate
involved sectors, including insurers, medical and legal provider communities,
auto repair facility operators, the Division, the California Highway Patrol,
local law enforcement and community safety agencies.
(4) Management Plan. A detailed plan and
schedule of the steps the district attorney will complete in achieving the
objectives of the program and a discussion of how the program staff will be
organized and what internal quality control and budget monitoring procedures
will be employed. This part shall also include how this program will be
integrated with any other anti-fraud program(s) maintained within the district
attorney's office;
(5) Staff
development. The plan for ongoing training of personnel on the investigation
and prosecution of automobile insurance fraud. Staff development may be
addressed through coordination with the Division, insurers, or other
entities.
(d)
Objectives. This section shall outline the district attorney's anticipated
achievements in the following areas:
(1)
Estimated number of investigations to be initiated during the grant period,
including separate estimate of the number resulting from carryover
investigations; and
(2) Estimated
number of prosecutions to be initiated during the grant period.
Notes
Cal. Code Regs. Tit.
10, §
2698.65
Note: Authority cited: Section
1872.8,
Insurance Code; CalFarm Insurance Company et al. v. Deukmejian, et al. (1989)
48 Cal.3d 805, 824. Reference: Section
1872.8,
Insurance Code.
1. New section filed
10-8-93; operative 11-7-93 (Register 93, No. 41).
2. Amendment of
section heading, amendment of subsections (b) and (b)(3)(A)-(B) and amendment
of Note filed 10-12-2001; operative 11-11-2001 (Register 2001, No.
41).
3. Change without regulatory effect amending subsection (c)(1)
filed 7-14-2021 pursuant to section 100, title 1, California Code of
Regulations (Register
2021, No. 29). Filing deadline specified in Government Code
section
11349.3(a)
extended 60 calendar days pursuant to Executive Order
N-40-20.
