- A. A person alleging fraudulent activities, statements, or representations made in connection with Arizona workers’ compensation claims may file a written complaint with the Fraud Unit.
- B. The written complaint shall describe the specific actions of the claimant, employer, self-insured employer, insurance carrier, or claims processing representative alleged to constitute fraud. The Fraud Unit may require a complainant to provide additional information to determine whether it has jurisdiction over a complaint.
- C. Upon receipt of a complete complaint, the Fraud Unit shall have up to 30 days to determine if the Fraud Unit has jurisdiction to investigate the complaint.
- D. If the Fraud Unit determines it has jurisdiction over a complaint, it will open a formal investigation. If the Fraud Unit does not have jurisdiction over a complaint, it will notify the complainant.
- E. The Fraud Unit may open an investigation on its own motion under A.R.S. § 23-934(A).
Historical Note
Adopted effective September 9, 1998 (Supp. 98-3). Section repealed by final rulemaking at 28 A.A.R. 3435 (October 28, 2022), with an immediate effective date of October 5, 2022 (Supp. 22-4). New Section R20-5-702 made by final rulemaking at 31 A.A.R. 4199 (October 31, 2025), effective December 6, 2025 (Supp. 25-4).