§ 409. Fraud prevention plans and special investigations units. (a)\nEvery insurer writing private or commercial automobile insurance,\nworkers' compensation insurance, or individual, group or blanket\naccident and health insurance policies issued or issued for delivery in\nthis state, except for insurers that write less than three thousand of\nsuch policies, issued or issued for delivery in this state annually, and\nevery entity licensed pursuant to article forty-four of the public\nhealth law except those entities with an enrolled population of less\nthan sixty thousand persons in the aggregate and, except those entities\nlicensed pursuant to sections forty-four hundred three-a, forty-four\nhundred three-c, forty-four hundred-d, forty-four hundred three-f and\nforty-four hundred eight-a of the public health law shall, within one\nhundred twenty days of the effective date of this amended section to be\npromulgated by the superintendent to implement this section, file with\nthe superintendent a plan for the detection, investigation and\nprevention of fraudulent insurance activities in this state and those\nfraudulent insurance activities affecting policies issued or issued for\ndelivery in this state. The superintendent may accept programs and\nprocesses implemented pursuant to section forty-four hundred fourteen of\nthe public health law as satisfying the obligations of this section and\nregulations promulgated thereunder.\n (b) (1) The plan shall provide the time and manner in which such plan\nshall be implemented, including provisions for a full-time special\ninvestigations unit and staffing levels within such unit. Such unit\nshall be separate from the underwriting or claims functions of an\ninsurer, and shall be responsible for investigating information on or\ncases of suspected fraudulent activity and for effectively implementing\nfraud prevention and reduction activities pursuant to the plan filed\nwith the superintendent. An insurer shall include in such plan staffing\nlevels and allocations of resources in such full-time special\ninvestigations unit as may be necessary and appropriate for the proper\nimplementation of the plan and approval of such plan pursuant to\nsubsection (d) of this section.\n (2) In lieu of a special investigations unit, an insurer may contract\nwith a provider of services related to the investigation of information\non or cases of suspected fraudulent activities; provided, however, that\nan insurer which opts for contracting with a separate provider of\nservices, shall provide to the superintendent a detailed plan therefor,\npursuant to requirements set forth in regulation by the superintendent.\n (3) Persons employed by special investigations units as investigators\nor by an independent provider of investigative services under contract\nwith an insurer shall be qualified by education or experience which\nshall include an associate's or bachelor's degree in criminal justice or\nrelated field, or five years of insurance claims investigation\nexperience or professional investigation experience with law enforcement\nagencies, or seven years of professional investigation experience\ninvolving economic or insurance related matters. For the purposes of\nevaluation of medical related claims insurers may employ or retain duly\nlicensed or authorized medical professionals. Notwithstanding these\nminimum requirements anyone employed as an investigator in a special\ninvestigation unit or by a provider of investigative services under\ncontract to an insurer as of the effective date of this paragraph and\nwho was also so employed on or before September tenth, nineteen hundred\nninety-six may continue in such employment provided the insurer\nidentifies such person in writing to the superintendent giving the date\nsuch employment began and a description of the person's qualifications,\nemployment history and current job duties.\n (c) The plan shall provide for the following:\n (1) interface of special in
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