New York State Seal
STATE OF NEW YORK
INSURANCE DEPARTMENT
25 BEAVER STREET
NEW YORK, NEW YORK 10004

NOTE: WITHDRAWN EFFECTIVE JANUARY 29, 2007

Circular Letter No. 26 (1999)
September 13, 1999
TO: All Insurers and Self-Insurers
RE: Revised Insurance Department Fraud Reporting Form (IFB-1 REV. 8/99)

Section 405 of the New York Insurance Law requires insurers and self-insurers to report to the Insurance Frauds Bureau all incidents of suspected insurance fraud on a form prescribed by the Superintendent. Effective immediately, the Superintendent has replaced the original Fraud Reporting Form (IFB-1) with Form IFB-1 REV. 8/99. The new Form is designed to elicit more specific information about suspected insurance fraud. The enhanced information will help to expedite the Frauds Bureau’s review process and ensure a prompt investigation of each report.

In addition to the information requested on Reporting Form IFB-1, the new Form seeks the following information:

Insurers are advised that Reporting Form IFB-1 REV. 8/99 is effective upon receipt of this Circular Letter. A copy of the new Form is attached.

Very truly yours,
__________________________
Charles DeRienzo
Director
Insurance Frauds Bureau