P&COhiomedium
An Ohio insurer's claims adjuster develops a reasonable belief that a homeowners claim is fraudulent. Under R.C. 3999.42, what is the adjuster's primary obligation?
APay the claim in full immediately to avoid any bad-faith litigation exposure
BRefer the insured to the BWC for investigation
Report the suspected fraud to ODI or another authorized agency
DWait for the insured to file a written complaint first
Why this is the answer
Ohio's anti-fraud statute (R.C. 3999.42) requires insurers, producers, and adjusters who reasonably suspect insurance fraud to notify ODI or another authorized agency in writing and provide supporting documentation in furtherance of any investigation.
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