Arson Suspect Indicted in $120,050 Insurance Fraud Scheme

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Phoenix, AZ The Arizona Department of Insurance (ADOI) Fraud Unit, in conjunction with the Phoenix Fire Department Investigations Unit, arrested Mohamed Abdulrahman on multiple felony charges, including arson of a structure, fraudulent insurance claim, and forgery. 

The fire occurred in a commercial storage building in the early hours of November 1st, 2017.  When Mr. Abdelrahman was interviewed by insurance adjusters, he misrepresented details and facts during the claim process, which is a violation of Arizona statutes.  During the claim process, Mr. Abdelrahman pushed for a fast settlement, and even filed complaints with the Arizona Department of Insurance Consumer Affairs Division, requesting assistance because the insurance companies were not paying him for his losses.

During the four-month investigation that would ensue, investigators learned that Mr. Abdelrahman had increased his insurance coverage on the unit a few days prior to the fire.  Mr. Abdelrahman was in the area of the storage facility when the fire was discovered and used his vehicle to block first responders from entering the location, alleging his vehicle broke down in-front of the facility entrance. The building security cameras were sabotaged hours before the fire was reported.

The claims Abdelrahman filed with insurance companies totaled $120,050.00.  The case is being prosecuted by the Arizona Attorney General’s Office for criminal charges.  If found guilty, Mr. Abdelrahman could receive up to 12 1/2 years in prison.

For a copy of the indictment, CLICK HERE.

Insurers Offering Individual Health Insurance in Arizona

Lists insurance companies that are offering health insurance to individuals and families in Arizona in 2020.  Open enrollment starts November 1st and now runs through December 17th, 2019.  Individuals can start shopping for coverage now at healthcare.gov or cuidadodesalud.gov (Spanish)

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As shown in the attached report prepared pursuant to A.R.S. § 20-3118(A), the Department of Insurance received 91 requests for dispute resolution in Calendar Year 2019.  Of those, 53 have been resolved or closed, and health plan enrollees saved $41,538 by submitting their surprise bills for resolution.  

Not all health care bills qualify for the surprise bill resolution process.  The Department's Suprise Out-of-network Billing Dispute Resolution website (https://insurance.az.gov/soonbdr, and especially the section entitled, "I got a surprise bill. Can I submit a request for arbitration?") lists conditions when a health care bill may not qualify under Arizona law for the dispute resolution process.  But for those that do, the enrollee will only be responsible for paying the enrollee's cost-sharing amounts (copay, coinsurance and deductible) if the enrollee provides information the Department needs, and participates in an informal settlement teleconference with the health care insurer and the health care provider.

Notice of Proposed Rulemaking - Corporate Governance Annual Disclosure Model Regulation In 2019, the Arizona Legislature adopted the NAIC Corporate Governance Annual Disclosure Model Act at Arizona Revised Statutes (“ARS”) by enacting the Corporate Governance Act at Title 20, Chapter 2, Article 16 (Laws 2019, 1st Reg. Sess., Ch. 180, § 1).   The Department of Insurance (“Department”) seeks to adopt the correlate Corporate Governance Annual Disclosure Model Regulation.  ARS § 20-492.02 allows the Department to adopt rules to carry out the Act upon notice and an opportunity to be heard.  The Legislature has exempted the Department from Title 41, Chapter 6 for one year after the effective date of the Act.  (Laws 2019, 1st Reg. Sess., Ch. 180, § 2.)
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