Insurance anti-fraud training requirements by state for SIU and claims
California wants orientation in 90 days, New Jersey counts hours in a 180-day window, Florida trains SIU staff yearly. One program can meet all three if the records hold up.
Short answer: Insurance anti-fraud training requirements are set state by state. California requires anti-fraud orientation within 90 days of hire, annual in-service training for integral anti-fraud staff and 5 hours a year for SIU staff. New Jersey requires 4.5 hours (9 for SIU) within 180 days, then 2 hours (9 for SIU) a year. Florida required 2 hours of initial training for anti-fraud investigative unit staff by the end of 2018 and requires a 1-hour course annually after that.
LMS Advisor is our top pick for running that program across states. You assign each role track as a course with a due date and a mandatory flag, the overdue report shows who is late by branch or department, and annual in-service runs on course certificates with a 12-month validity. Records export to CSV, Excel or PDF when the department asks. LMS Advisor ships no anti-fraud course content, and your SIU still files its own reports with each state.
The hard part is not any single rule. It is that a carrier writing auto in New Jersey, workers' comp in California and homeowners in Florida faces three clocks, three hour minimums and different ideas of who counts as covered staff. This guide lays the rules side by side and shows how to build one program that meets the strictest of them.
Which states require insurance anti-fraud training?
These are the rules we checked in September 2026. Confirm current text before relying on any row, since fraud regulations get amended and some apply only to certain lines of business.
| State | Who | Initial training | Ongoing training | Source |
|---|---|---|---|---|
| California | All new hires, integral anti-fraud personnel, SIU | Orientation within 90 days of starting assigned duties | Annual in-service, SIU at least 5 hours per calendar year | 10 CCR 2698.39 |
| New Jersey | Underwriters, adjusters, claims processors, SIU | 4.5 hours (9 for SIU) within 180 days | 2 hours a year (9 for SIU) | N.J.A.C. 11:16-6.5 |
| Florida | Anti-fraud investigative unit staff | At least 2 hours (statutory deadline was December 31, 2018) | 1 hour annually | Fla. Stat. 626.9891 |
| New York | Underwriting and claims personnel | Set in the fraud prevention plan | Hours and frequency described in the plan | Ins. Law 409, 11 NYCRR 86.6 |
| Kentucky, Colorado, DC, Delaware | Claims handlers, appropriate employees or investigators | Varies | DC 2-hour sessions, Delaware investigators 3 hours a year | CAIF compilation |
Rules with hours and deadlines
California, New Jersey and Florida give you numbers: a window after hire, a minimum number of hours, or both. These drive your due dates.
Rules that require a plan but leave hours to you
New York and several other states require training as part of a fraud prevention or anti-fraud plan without fixing the hours. There, the plan is the commitment. If your plan says four hours a year and you deliver two, the gap is between you and your own filing.
Where to confirm current text
The Coalition Against Insurance Fraud's SIU education list is the best starting index. It lists New York, New Jersey, Kentucky ("educate and train all claims handlers to identify possible insurance fraud"), California, Colorado ("educate appropriate employees about fraud detection"), DC and Delaware. The NICB State Mandated Training Guide is useful background but is dated July 2018, so read it as history, not current law.
What does California require for anti-fraud training?
California's rule, 10 CCR 2698.39, operative October 1, 2020, is the most detailed and the one most multi-state programs are built around. It has three tiers.
Orientation for every new hire within 90 days
"All newly-hired employees shall receive an anti-fraud orientation within ninety (90) days of commencing assigned duties." Note the scope: all new employees, not only claims staff. The orientation covers the function and purpose of the SIU, an overview of fraud detection, Fraud Division reporting requirements, an organization chart and SIU contact information. A short online module can cover it, as long as it names your SIU contacts and referral route.
Annual in-service for integral anti-fraud personnel
"Integral anti-fraud personnel shall receive annual anti-fraud in-service training." The regulation's topics include a review of the SIU's function, your written procedures, identifying red flags, emerging fraud trends and Fraud Division reporting requirements. In practice this group is claims, underwriting and anyone else whose work puts them in front of possible fraud. Write down who you put in it and why, because the rule leaves that call to you.
Five hours a year for SIU staff
"The SIU personnel shall receive at least five (5) hours of continuing anti-fraud training per calendar year." Acceptable formats include anti-fraud conferences, SIU roundtables hosted by the Fraud Division, anti-fraud association meetings and trainings, and insurer in-house trainings, so an SIU investigator's hours often come from several places. Your records have to pull them together.
The record fields California asks for
"Records of the anti-fraud training shall be prepared at the time training is provided and be maintained and available for inspection by the Department on request." Each record carries the title and date of the training, the instructor's name, title and contact information, the course materials or a description, the length of the training, and the names and job titles of participants. The CDI's SIU training compliance material says records must be "kept and provided to the CDI upon request" and describes desk audits built on the SIU annual reports filed by about 1,200 insurers. That is the moment the records matter: a request arrives and the records have to exist already.
New Jersey and Florida: the hour minimums
New Jersey: a 180-day window and annual hours
N.J.A.C. 11:16-6.5 requires SIU personnel to receive "no less than nine hours of classroom instruction" and other covered staff "no less than four and one-half hours" within 180 days of starting as underwriters, adjusters, claims processors or SIU staff. After that, SIU staff need "no less than nine hours of training per year" and claims and underwriting personnel "no less than two hours per year." The rule excepts smaller auto insurers (fewer than 2,500 New Jersey policies) and health insurers covering fewer than 10,000 lives, so check whether it reaches you.
Computer-based training is allowed
New Jersey accepts "classroom instruction, self-guided instruction, videotape, seminar, computer based, or by any other means." The phrase "classroom instruction" in the hour minimum trips people up, but the delivery clause is broad. Online modules count, provided the hours are real and documented.
Florida: 2 hours initially, then 1 hour a year for SIU staff
Florida Statutes 626.9891 required that "By December 31, 2018, each insurer shall provide staff of the anti-fraud investigative unit at least 2 hours of initial anti-fraud training," and then "annually thereafter ... a 1-hour course that addresses detection, referral, investigation, and reporting of possible fraudulent insurance acts." The anti-fraud plan you file must also include "a description of the required anti-fraud education and training." The statute sets no new-hire window, so we treat the 2-hour initial course as a new-hire requirement in the program below (a policy choice, not a statutory deadline).
How does New York handle anti-fraud training?
New York does not set hours. Insurers writing auto, workers' compensation or accident and health with 3,000 or more policies file fraud prevention plans under Insurance Law 409 and 11 NYCRR 86.6. According to DFS OGC Opinion 05-11-16, the plan must describe in-service training for underwriting and claims personnel, including "course descriptions, the approximate number of hours to be devoted to these sessions, and their frequency." The Department "has not established a set of specific substantive guidelines" and reviews each plan for reasonableness.
So in New York, the test is whether you did what your plan says. Keep a copy of the plan's training section next to the completion records, and update both together.
How to design one anti-fraud program for many states
Running a separate program per state is how records end up in five spreadsheets. We prefer one program set to the strictest clock, with small state add-ons.
Set the clock to the strictest state
Give every new hire the orientation within 90 days, because California applies it to all employees. Give new claims, underwriting and SIU staff their initial hours within that same window, which also sits inside New Jersey's 180 days.
Role tracks
| Track | Who | Initial | Every year |
|---|---|---|---|
| All staff | Every employee | Orientation within 90 days | Optional refresher |
| Claims and underwriting | Adjusters, claims processors, underwriters | 4.5 hours within 90 days | At least 2 hours of in-service |
| SIU | Investigators and SIU managers | 9 hours within 90 days | 9 hours, including conferences and roundtables |
Nine SIU hours a year covers New Jersey, California's five and Florida's one. Two hours of claims in-service covers New Jersey and gives you a defensible California in-service.
State add-on modules
Keep state-specific content short and separate: California Fraud Division reporting, New Jersey's referral rules, Florida's reporting route. Assign each add-on only to people who handle that state's business. When a rule changes, you update one module instead of the whole curriculum.
What records do examiners ask for?
NICB's guide "strongly suggests each company maintain training records on an individual basis to show compliance if audited." Examiners want per-person proof, not a list of sessions. For each training cycle, keep:
- A roster of who belongs to each track, by state, with job titles
- Per-person completion with course title, date and length
- Instructor name, title and contact details for each course or session
- The course materials, or a description, as delivered that year
- Outside SIU hours (conferences, roundtables) with proof of attendance
- Overdue lists and what was done about each late person
The rules we checked do not set a retention period (California says records must be maintained and available for inspection on request), so your own policy decides how long. Our post on training records retention requirements covers setting one schedule across rules. If an examiner asks whether the training worked, see how to measure compliance training effectiveness.
How to run anti-fraud training in LMS Advisor
LMS Advisor is our platform, so weigh that, but here is why we rank it first for insurers that own their anti-fraud curriculum. The role tracks, due dates, live SIU sessions and the evidence all sit in one system, and it can run on your own server if your security team wants claims training data in-house. The insurance LMS overview and our guide to claims adjuster training software show the wider setup, and the compliance training page covers assignments and overdue reports in general.
- Tracks and clocks. Each track is a course assigned to a group with a due date and a mandatory flag. SCIM 2.0 provisioning creates accounts as people are hired, so orientation can be assigned in week one. The overdue report shows who is late by branch or department.
- Annual in-service. Course certificates with a 12-month validity show an expiring-soon status 30 days out, and a certificate-expiring email rule chases people before they lapse.
- Real hours. A lesson minimum time and required blocks stop a two-hour module from being clicked through in ten minutes.
- Live SIU sessions. Zoom or Google Meet sessions inside a course, with attendance taken by hand or by QR check-in.
- Evidence. CSV, Excel or PDF report exports, audit logs, retention settings and course export to keep each year's version.
| Option (as of September 2026) | Best for |
|---|---|
| LMS Advisor (our platform, top pick) | Insurers running their own multi-state program with records they control |
| North American Training Group | Ready-made annual and new hire courses by line and role, online or on location, listed for 22 states |
| VRC University | California courses for new hires, integral personnel and SIU staff |
The limits: LMS Advisor ships no anti-fraud course content, so you build it or license it from a vendor like those above (ask whether they supply SCORM packages you can load). It does not file anything with a state. Put instructor names, titles and contact details in the course description, and confirm in a demo that your export carries job titles, or join it with an HR export, before you count on it for California's fields. To see one track built with your own policy, book a demo.
Frequently asked questions
Which states require anti-fraud training for insurance employees?
California, New Jersey and Florida set specific timing or hours, and New York requires training described in each insurer's fraud prevention plan. The Coalition Against Insurance Fraud also lists Kentucky, Colorado, DC and Delaware. Check each state for the lines of business it covers.
How many hours of anti-fraud training does SIU staff need in California?
At least five hours per calendar year, under 10 CCR 2698.39. Anti-fraud conferences, Fraud Division SIU roundtables, anti-fraud association meetings and insurer in-house trainings can count toward it.
Can anti-fraud training be done online?
Yes, in the states we checked. New Jersey expressly allows computer-based and self-guided instruction. Keep records of length and completion so online hours are as defensible as classroom ones.
Do claims adjusters need anti-fraud training every year?
In New Jersey, yes, at least two hours a year. California requires annual in-service for integral anti-fraud personnel, which usually includes claims staff. Other states depend on your plan.
Can LMS Advisor track anti-fraud training for SIU and claims staff?
Yes. LMS Advisor assigns role tracks with due dates, flags overdue people, renews annual in-service through 12-month course certificates and exports per-person records. It does not include anti-fraud course content or file reports with any state.
Does anti-fraud training count toward adjuster CE?
Only if the course is approved for CE in the adjuster's licensing state. Employer anti-fraud training and state-approved CE are separate requirements, so check with the CE provider before assuming one counts for both.
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I'm Swati Priyadarshani, Founder & CEO of LMS Advisor and Co-Founder of WorldWin Coder Pvt. Ltd. (est. 2019). Over the last 10+ years, I've helped enterprises build learning platforms that actually get used - not just deployed.
