Arizona Insurance Fraud Laws

Insurance fraud can be perceived as a victimless crime, but the estimated losses from this crime exceed $100 Billion every year. Ten percent of all types of insurance claims (property & casualty, health, life, workers’ compensation) are suspected to be fraudulent.

In the state of Arizona, insurance fraud can occur in several different ways including automobile fraud, worker's compensation fraud, property fraud, and casualty fraud. Generally insurance fraud offenses can occur when someone tries to deceive an insurance company, agent or other person to fraudulently get money they aren't entitled to.

It happens when someone puts false information on an insurance application and when false or misleading information is given or important information is omitted in an insurance transaction or claim.

Who Enforces and Prosecutes Insurance Fraud Laws?

The Arizona Department of Insurance (ADOI), Fraud Unit and local prosecutors handle insurance fraud cases under the state's penal laws. The Federal Government can also prosecute insurance fraud under a number of criminal statutes including as "mail fraud," "criminal racketeering" or other federal offenses.

How do I File a Complaint Against an Arizona Insurance Company?

You can file an online complaint (PDF) against insurance carriers and other providers, including reporting suspected insurance fraud.

The following table highlights the main provisions of Arizona's insurance fraud laws. See also Association of Certified Fraud Examiners, Fraud, Fraud and Financial Crimes, and Arson.

Code Section

A.R.S. §20-463

What is Prohibited

Any time a person files a claim against an insurance company or policy using false information or intentionally deceiving the claim representative, they are committing a fraud.

Penalties

Typically a class six felony that can mean 10 years in prison, a maximum fine of $150,000 and possibly a civil penalty of $5,000 for each violation.

Who Can Be Prosecuted Consumers, providers (such a doctor and auto repair shop), and insurance companies, adjusters and others
Types of Insurance Fraud
  • Automobile accidents and insurance
  • Health care claims such as medical and dental.
  • Insurance applications
  • Medicaid
  • Disability benefits
  • Unemployment insurance
  • Workers' compensation

Because insurance fraud laws can sometimes get complicated, it may also be a good idea to consult an experienced Arizona criminal defense attorney if you have questions about your specific situation. Always remember that it is a good idea to have an attorney if you are thinking of entering into a plea deal to fully understand the consequences of your plea.

Research the Law

Arizona Insurance Fraud Laws: Related Resources

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Insurance fraud is a crime of moral turpitude. Not sure what that means? It is important you know that a conviction or plea could impact your ability to get a job down the road. This is why it is important you have an experienced attorney on your side if you are facing these charges in Arizona. Start the process now with a free case review.

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