| investigate and examine possible violations of law and to | take appropriate action against wrongdoers. |
|
| | 8.__Viatical or life settlement antifraud initiatives. In | accordance with this subsection, a settlement provider licensee | must have in place antifraud initiatives reasonably calculated to | detect, prosecute and prevent fraudulent viatical or life | settlement acts. |
|
| A.__At the discretion of the superintendent, the | superintendent may order, or a licensee may request and the | superintendent may grant, such modifications of the required | initiatives under paragraph B as necessary to ensure an | effective antifraud program. The modifications may be more | or less restrictive than the required initiatives as long as | the modifications may reasonably be expected to accomplish | the purpose of this subsection. |
|
| B.__Antifraud initiatives must include: |
|
| (1)__Fraud investigators, who may be employees of a | settlement provider or independent contractors; and |
|
| (2)__An antifraud plan, which must be submitted to the | superintendent. The antifraud plan must include, but is | not limited to: |
|
| (a) A description of the procedures for detecting | and investigating possible fraudulent viatical or | life settlement acts and procedures for resolving | material inconsistencies between medical records | and insurance applications; |
|
| (b) A description of the procedures for reporting | possible fraudulent viatical or life settlement | acts to the superintendent; |
|
| (c) A description of the plan for antifraud | education and training of underwriters and other | personnel; and |
|
| (d) A description or chart outlining the | organizational arrangement of the antifraud | personnel who are responsible for the | investigation and reporting of possible fraudulent | viatical or life settlement acts and investigating | unresolved material inconsistencies between | medical records and insurance applications. |
|
|