Engrossed Substitute Senate Bill 6031 amends multiple sections of chapter 48.135 RCW, reenacts and amends RCW 9A.04.080, and adds a new section to chapter 48.135 RCW to create and staff an insurance fraud program within the Office of the Insurance Commissioner. The commissioner may employ investigators, legal and clerical staff, obtain office space and equipment, fund one or more Washington State Patrol officers and assistant attorneys general from the program budget, make grants or reimbursements to local prosecuting attorneys from the program budget, and enter agreements to share records and coordinate investigations with other agencies. The bill defines and lists specific acts that constitute the offense of insurance fraud (including false statements in applications or claims, embezzlement or conversion of insurer funds, submitting false bills or codes, misrepresenting damages or medical information, impersonation, premium-finance fraud, biased appraisal conduct, and attempts or conspiracies to commit these acts), defines "insurer" in statute, provides that CPT and HCPCS code disputes should be considered with reference to the AMA and CMS code sets, and classifies insurance fraud as a class B felony with each instance a separate offense. It also expands the commissioner's investigative powers (including subpoenas, administering oaths, collecting evidence, conducting independent and out-of-state inquiries as described, and reporting or assembling evidence for prosecution), authorizes fraud program investigators who are certified as peace officers to exercise limited authority Washington peace officer powers, and requires insurers, licensees, certain businesses financing premiums, and law enforcement with reasonable belief of fraud to disclose information to the commissioner. The bill creates procedural changes and confidentiality rules: it sets venue rules for prosecution, requires the commissioner and county prosecuting attorney to agree on payment of prosecution costs before commissioner-initiated prosecutions, exempts investigative materials from public disclosure while allowing sharing with specified entities (NAIC, NICB, other regulators and insurers), and provides that insureds or insurers who are victims may be considered victims for restitution purposes. It also addresses statutes of limitation for various crimes generally and includes a 10-year limit referenced for RCW 48.135.010 (language on the exact tolling or discovery rule is truncated in the available text). Important parts of the bill text are missing from the provided extracts (including the full out-of-state investigation clause, the specific amendments to RCW 48.135.050, .060, .070, and the reenacted language of RCW 9A.04.080), so some details and exact wording could not be confirmed.

If enacted, the Office of the Insurance Commissioner would run a dedicated insurance fraud program with its own investigators (some with limited peace officer powers), legal staff, and the ability to obtain evidence, subpoena witnesses, and work with local, state, federal, and out‑of‑state officials. The office can use the program’s budget to pay for state patrol officers, assistant attorneys general, and grants or reimbursements to county prosecutors; insurers, licensees, and premium‑finance firms must report suspected fraud and send certain finance agreements to the commissioner, increasing reporting and cooperation duties for those businesses. Insurers, consumers, and other crime victims would also be recognized for restitution in criminal cases, and the commissioner could share otherwise exempt investigative records with national and state partners to support prosecutions. The practical effects are more active, centralized fraud enforcement and higher operational costs that must come from the program’s budget, meaning the commissioner will need to reallocate or use existing program funds to pay for new staff, law enforcement support, and prosecutor grants. Insurers and premium‑finance companies will face added compliance work and potential exposure to criminal investigations for a broad list of actions now defined as insurance fraud, and local prosecutors will need to negotiate cost agreements with the commissioner before jointly pursuing cases. Some implementation details remain unclear in the available text — notably the full scope of out‑of‑state investigative authority and exact statute‑of‑limitations language in the omitted portions.