Circular Letter No. 32 (2000)

December 11, 2000


All Insurers


Change in Qualifications for Employment in Insurer Special Investigations Units

Chapter 509 of the Laws of 2000, signed by Governor Pataki on October 4, 2000, modifies the requirements for employment as an investigator in an insurance company Special Investigations Unit. In order to qualify for investigator status under the new law, individuals must meet one of the following criteria:

1) possess an associate's or bachelor's degree in criminal justice or a related field;
2) possess five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies; or
3) possess seven years of professional investigation experience involving economic or insurance-related matters.

Special Investigations Units may also employ authorized medical professionals to evaluate medical-related claims. Current employees of Special Investigations Units who began such employment on or before September 10, 1996 are grandfathered under the bill.

The Insurance Department has initiated the promulgation of the Third Amendment to Regulation 95 in order to bring the Regulation into conformity with the provisions of Chapter 509 of the Laws of 2000. However, the law became effective on October 4, 2000. Therefore, all individuals acting as investigators in insurer Special Investigations Units on or after that date will be evaluated based on the new criteria.

Very truly yours,

Charles DeRienzo
Insurance Frauds Bureau