California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 9 - Insurance Fraud
Article 4 - Program for Investigation and Prosecution of Automobile Insurance Fraud
Section 2698.65 - County Plan and Criteria for Distribution of Funds to the District Attorney Grantee

Universal Citation: 10 CA Code of Regs 2698.65

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

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.

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.

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.

Disclaimer: These regulations may not be the most recent version. California may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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