What are the requirements for insurance fraud investigation?

In South Carolina, insurance fraud investigations must adhere to certain requirements. Generally, the investigation must be conducted by an authorized representative of the insurance carrier, such as a special investigator or claims adjuster. The investigator must be trained and certified in the area of insurance fraud investigation. Additionally, the investigation must be conducted in a fair and reasonable manner, and any evidence that is obtained must also be documented. The investigator must conduct the investigation according to the laws outlined in the South Carolina Unfair Trade Practices and Consumer Protection Law, which governs insurance fraud in the state. This law states that an "investigation of suspected fraud shall be conducted with due diligence." In addition, the law states that the investigation must be conducted in an impartial manner and that any evidence obtained must be properly stored and documented. In order to investigate insurance fraud, the insurance carrier must also have sufficient resources to utilize. This includes access to auditing services, investigative techniques, support staff, and other resources. The investigative team must also be trained in the methods used to detect and investigate insurance fraud. Once an investigation is complete, the results must be reported to the proper authorities. If the investigation reveals evidence of fraud, a copy of the investigation report must be provided to the South Carolina Department of Insurance. The report must contain the results of the investigation, any evidence collected, and a description of the investigative methods used. The report is an important part of the process in ensuring that insurance fraud is properly investigated and that offenders are held accountable.

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What are the requirements for insurance fraud investigation?

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