Rooting Out Insurance Fraud: How to Spot It and What Brokers & Agents Must Report If It’s Suspected

This one-hour ethics course satisfies California's Anti-Fraud training requirement, and provides insurance professionals with a practical understanding of how insurance fraud is identified and investigated in California, highlighting current fraud trends, common red flags, and real case examples. Participants will learn the ethical and legal obligations of agents and brokers under California Insurance Code §1872.41, including how to recognize suspicious activity, document concerns, and properly report suspected fraud to an insurer’s SIU. The course also clarifies insurers’ SIU requirements and the role of the California Department of Insurance Fraud Division, giving producers the timely, real-world knowledge needed to strengthen ethical decision-making, meet compliance standards, and help protect the integrity of the insurance marketplace.

Basic Course Information

• Understand ethical and legal obligations under California law to recognize, document, and report suspected insurance fraud
• Learn proper reporting procedures for referring suspicious activity to an insurer’s Special Investigative Unit (SIU)
• Gain insight into insurers’ responsibilities to establish, operate, and maintain effective SIUs in compliance with state regulations
• Become familiar with statewide anti-fraud efforts, including how the California Department of Insurance and law enforcement investigate, prosecute, and deter insurance fraud

• Get clear on your legal duties under California Insurance Code §1872.41 and SIU regulations—learn exactly what brokers and agents must recognize, document, and report when fraud is suspected
• Understand how insurers’ Special Investigative Units (SIUs) work, including detection requirements, referral protocols, investigation standards, and how your role fits into the broader anti-fraud framework
• Learn real fraud indicators and emerging trends, including underwriting red flags, database resources, and recent case examples straight from the California Department of Insurance
• Strengthen your ethical decision-making with practical steps to take when fraud is suspected—plus insight into how the Fraud Division and law enforcement investigate, prosecute, and deter fraud statewide