Fraud Investigation Management & Training Company [FIMAT] was founded to fill a need created by recent enactments of the California Legislature and Regulations issued by the Department of Insurance.

Those statutes and Regulations require that every insurer in the state of California is required to have in place a fraud investigation unit. The California Legislature enacted California Insurance Code §§ 1875.20 et.seq. last year as part of the California Insurance Fraud Prevention Act. It provides:

1875.20 Every insurer admitted to do business in this state shall maintain a unit or division to investigate possible fraudulent claims by Insureds or by persons making claims for services or repairs against policies held by Insureds.

1875.21 Insurers may maintain the unit or division required by this article using its employees or by contracting with others for that purpose.

1875.22 Insurers shall establish the unit or division required by this article no later than July 1, 1992.

1875.23 [I]f an insurer … contracts with another entity to fulfill the requirements of this article, the additional cost incurred shall be included as an administrative expense for rate-setting purposes.

Regulations now in force state the Department of Insurance will punish violators of these statutes with fines of $55,000 or removal of their certificate of authority.

The following is an outline of the services provided by Fraud Investigation and Management and Training  Company:

FIMAT will be your Fraud Investigation Unit.

• FIMAT will, immediately after you sign our service agreement advise the Department of Insurance that FIMAT is acting as your Fraud Investigation unit in compliance with California Insurance Code §§ 1875.20 et.seq. & Code of Regulations §§2698.40 et.seq.
• FIMAT will provide you with forms for your claims representatives to fill out when referring files to FIMAT.
• FIMAT will thoroughly review and analyze all potential fraud claims referred by you and will promptly report the results of its review and analysis, including:

1. Whether a report should be submitted to the Fraud Division in accordance with California Insurance Code § 1872, et.seq.
2. Whether further investigation is required.
3. If further investigation is required FIMAT will advise you of the availability of its staff of fraud investigators to perform the investigation required or whether independent investigators are required.
4. Whether the advice and counsel of independent, experienced fraud defense attorneys are required.
5. Provide you with an estimate of the cost of the services recommended.

• Our fee for these services will be agreed.
• With instruction and approval from you FIMAT will:

1. File reports on your behalf with the Fraud Division as required by California Insurance Code §§ 1872 et.seq.
2. Investigate potential fraud.
3. Supervise and control the work of the investigators.
4. Retain and control the services of independent fraud counsel.
5. Report regularly the results of the work of the investigators and attorneys.
6. Make recommendations for further work.

• FIMAT will provide, at your site, fraud recognition and investigation training including

1. The Orientation Program for Integral anti-fraud personnel required by California Regulations.
2. FRAUD INVESTIGATION handbooks written by Barry Zalma, Esq. a principal of FIMAT's partner, ClaimSchool, a Certified Fraud Examiner (CFE) and a nationally recognized expert in insurance fraud investigation and control.
3. Provide live one or more day fraud seminars for your staff.