New Jersey Administrative Code
Title 13 - LAW AND PUBLIC SAFETY
Chapter 88 - OFFICE OF INSURANCE FRAUD PROSECUTOR
Subchapter 3 - INSURANCE FRAUD DETECTION REWARD PROGRAM
Section 13:88-3.12 - Multiple applications

Universal Citation: NJ Admin Code 13:88-3.12

Current through Register Vol. 56, No. 18, September 16, 2024

(a) Except when a contrary result is required to prevent manifest injustice, in cases where two or more applicants submit substantially identical information which proximately results in the arrest, prosecution and conviction of persons or entities who have committed health care claims fraud, insurance fraud or any other criminal offense related to an insurance transaction, only the person who has filed his or her application first in time shall be considered for the receipt of a reward pursuant to this subchapter.

(b) In cases where two or more applicants submit different information which proximately results in the arrest, prosecution and conviction of persons or entities who have committed health care claims fraud, insurance fraud or any other criminal offense related to an insurance transaction, thereby rendering both applicants eligible for a reward pursuant to this subchapter, the Insurance Fraud Prosecutor may apportion the amount of the reward among the applicants based upon consideration of relevant factors including, but not limited to:

1. The timing (chronological order) of each application filed;

2. The relative overall accuracy of information in each application filed; and

3. The relative extent of cooperation with the prosecution by each applicant in the particular case for which the information has been provided.

(c) Upon such apportionment set forth in (b) above, the Insurance Fraud Prosecutor shall provide each eligible applicant with a written statement of the reasons for the determination.

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