CHAPTER 19. FRAUD INVESTIGATION INFORMATION EXCHANGE
IC 27-2-19
Chapter 19. Fraud Investigation Information Exchange
IC 27-2-19-1
"Governmental agency" defined
Sec. 1. As used in this chapter, "governmental agency" means
any:
(1) department;
(2) division;
(3) public agency;
(4) political subdivision; or
(5) other public instrumentality;
of a political subdivision, the state of Indiana, or the federal
government.
As added by P.L.187-1996, SEC.1.
IC 27-2-19-2
"Insurer" defined
Sec. 2. As used in this chapter, "insurer" means a person who
transacts a property and casualty insurance business.
As added by P.L.187-1996, SEC.1.
IC 27-2-19-3
"Law enforcement agency" defined
Sec. 3. As used in this chapter, "law enforcement agency" means
an agency or a department of any level of government whose
principal function is the apprehension of criminal offenders. The
term includes the office of the inspector general.
As added by P.L.187-1996, SEC.1. Amended by P.L.222-2005,
SEC.36.
IC 27-2-19-4
"Person" defined
Sec. 4. As used in this chapter, "person" includes individuals,
corporations, associations, limited liability companies, and
partnerships.
As added by P.L.187-1996, SEC.1.
IC 27-2-19-5
"Political subdivision" defined
Sec. 5. As used in this chapter, "political subdivision" has the
meaning set forth in IC 36-1-2-13.
As added by P.L.187-1996, SEC.1.
IC 27-2-19-6
Authorization or release from claimant; when required; exceptions
Sec. 6. (a) Except as provided in subsections (b) and (c), a law
enforcement agency, an insurer, or a governmental agency that has
reason to believe that an application for insurance or a claim for
insurance proceeds is being, or is likely to be, presented:
(1) based upon misrepresentation; and
(2) with intent to defraud;
is not required to obtain any authorization or release in order to
receive or provide any information other than medical records and
medical reports and medical related information contained in medical
records and medical reports regarding or in any way potentially
relating to that claim or application from or to any other law
enforcement agency, insurer, or governmental agency.
(b) In claims for bodily injury, only information:
(1) regarding the type of injury claimed;
(2) regarding the date of the alleged injury;
(3) regarding the name and address of each medical provider
submitted to support the claimed injuries; and
(4) referred to in subsection (a);
may be released without first obtaining authorization or a release
from the injured claimant.
(c) Medical records and medical reports and medical related
information contained in medical records and medical reports may
not be released under this chapter without first obtaining
authorization or a release from the injured claimant unless:
(1) the claim is a bodily injury claim; and
(2) the parties requesting the release have complied with section
8 of this chapter.
As added by P.L.187-1996, SEC.1.
IC 27-2-19-7
Immunity from liability
Sec. 7. (a) As used in this section, "representative" includes:
(1) a representative investigative agency; and
(2) an attorney;
of a law enforcement agency, insurer, or governmental agency.
(b) Any:
(1) law enforcement agency, insurer, or governmental agency;
or
(2) agent, employee, or representative of a law enforcement
agency, insurer, or governmental agency;
that receives or provides information referred to in this chapter in
good faith is immune from liability arising from the act of receiving
or the act of providing the information.
As added by P.L.187-1996, SEC.1.
IC 27-2-19-8
Obtaining medical records and reports in claims for bodily injury
Sec. 8. (a) A law enforcement agency, insurer, or governmental
agency who has obtained the names and addresses of a claimant's
medical providers under section 6(b) of this chapter may obtain the
claimant's medical records and medical reports from any other law
enforcement agency, insurer, or governmental agency:
(1) with the prior authorization or release of the injured
claimant; or
(2) without the prior authorization or release of the injured
claimant if:
(A) there is a reasonable belief that the mere request for
authorization or a release will hinder a fraud investigation;
and
(B) a verified application is presented to the circuit court in
the county where the application or claim is presented that
sets forth:
(i) probable cause for the need to obtain the medical
records and medical reports and medical related
information contained in the medical records and medical
reports without obtaining the proper release or
authorization; and
(ii) the specific medical records and medical reports and
medical related information contained in the medical
records and medical reports requested.
(b) The court, upon review of the information presented in
subsection (a), may issue an order authorizing the law enforcement
agency, insurer, or governmental agency to release the medical
records and medical reports and the medical related information
contained in the medical records and reports requested.
As added by P.L.187-1996, SEC.1.
IC 27-2-19-9
Conflict of laws
Sec. 9. For the purpose of insurance fraud investigation, if another
provision in Indiana law regarding the release or receipt of
information conflicts with this chapter, this chapter governs and
controls.
As added by P.L.187-1996, SEC.1.