State RegulationsOH specificDifficulty 2/5
A Columbus claims adjuster reports a suspected fraudulent insurance act to the Ohio Department of Insurance in good faith. The insured sues the adjuster for defamation over the report. Under ORC 3999.31, the outcome is:
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
ORC 3999.31 defines a fraudulent insurance act as knowingly, with intent to defraud, presenting or preparing a written statement in support of an application or claim containing materially false information or concealing material information. The same statute grants immunity from civil liability to persons who file reports about suspected fraudulent insurance acts, so long as the report is made without malice — which protects the good-faith adjuster here.
Why the other options are wrong
- A) Immunity does not wait for the Department to substantiate the suspicion; a good-faith, malice-free report is protected when filed, whatever the investigation later finds.
- C) The immunity in ORC 3999.31 expressly covers persons filing reports about suspected fraudulent insurance acts, including industry personnel, not just law enforcement.
- D) A written request from the insurer is not a condition of immunity; the statutory test is whether the report was made without malice.
Memory hook
Good-faith fraud reports get immunity — malice is the kill switch.