New Jersey compliance
New Jersey insurance fraud training
New Jersey has the most detailed training rule in the country. Auto and health insurers must give entry-level fraud training within 180 days of hire and annual continuing education, with minimum hours set by role.
The requirement
What New Jersey requires
N.J.A.C. 11:16-6.5 requires the fraud prevention and detection plan of auto and health insurers to include an anti-fraud training program, approved by the Department of Banking and Insurance, for SIU investigators, SIU specialists, adjusters, claims processors and underwriters.
Basic entry-level training must be given within 180 days of starting in a covered position: at least 9 hours for SIU personnel and 4.5 hours for non-SIU personnel. After that, continuing education is required every year: at least 9 hours for SIU personnel and 2 hours for claims and underwriting personnel. Continuing education may be computer based. When the rule was adopted in 2014, the Department said online and virtual classroom delivery is acceptable if the content is sufficient.
The rule lists required topics separately for auto insurers (auto theft, PIP, bodily injury, fraudulent applications, fraud referrals and more) and health insurers (overbilling, coding, unnecessary services, referral abuse and more). It does not apply to auto insurers with fewer than 2,500 New Jersey auto policies or health insurers covering fewer than 10,000 lives.
- Entry level within 180 days: 9 hours SIU, 4.5 hours non-SIU
- Every year: 9 hours SIU, 2 hours claims and underwriting
- Topics set by the rule for auto and for health insurers
- Training program approved by DOBI as part of the fraud plan
- A fraud prevention and detection manual for relevant staff
Sources, checked October 2026
How NATG helps
Meet the New Jersey mandate with one program
- Annual and new-hire anti-fraud courses in versions for each line of business and department
- Online, or instructor-led at your location
- Completion records, certificates and reports for your fraud plan and examiners
- One program for every state you write in, tracked in one place
NATG specializes in insurance fraud and investigations. Our compliance courses are built around the detection, referral and reporting duties in state fraud plans.
Questions
New Jersey anti-fraud training questions
How many hours of fraud training does New Jersey require?
Under N.J.A.C. 11:16-6.5: entry-level training of 9 hours for SIU staff and 4.5 hours for non-SIU staff within 180 days, then 9 hours a year for SIU staff and 2 hours a year for claims and underwriting staff.
Who must be trained in New Jersey?
SIU investigators, SIU specialists, claims adjusters, claims processors and underwriters at auto insurers with 2,500 or more New Jersey policies and health insurers covering 10,000 or more lives.
Can the New Jersey training be online?
Annual continuing education may be computer based. The rule calls entry-level training classroom instruction; when the rule was adopted, DOBI said online and virtual classroom delivery is acceptable if the content is sufficient. Confirm your approach as part of your plan approval.
Can NATG build the New Jersey program?
Yes. NATG courses cover the auto and health topics in the rule, in the required hours, with completion records for DOBI. Your program still needs Department approval as part of your fraud plan.
Other states
Anti-fraud training requirements in other states
- Arkansas
- California
- Colorado
- Connecticut
- District of Columbia
- Florida
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Minnesota
- New Hampshire
- New Mexico
- New York
- Ohio
- Pennsylvania
- Tennessee
- Utah
- Vermont
- Washington
This page is a guide to help you comply with state law. It is not legal advice; confirm the current requirement with your counsel or the state insurance department.
Train your New Jersey staff
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