Fraud Unit News: Undercover Sting Leads to Arrest for Insurance Fraud

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Department of Insurance and Financial Institutions (DIFI).

Phoenix, AZ – The Arizona Department of Insurance Fraud Unit arrested Donald Parra, 41, of Mesa.  Mr. Parra is the owner of “Precision 1 Auto Glass” (recently re-named to “Family Glass Shop”) located at 1947 North Lindsey Road, #107 in Mesa, AZ.  Mr. Parra was booked at the MCSO jail charged with several felony charges including Identity Theft and Insurance Fraud after making fictitious automobile glass claims to insurance companies.

As part of an undercover investigation of Mr. Parra and his business, Arizona Department of Insurance Fraud Unit investigators were solicited by one of Parra’s employees to make a fictitious claim to an insurance company.  The investigation also revealed Mr. Parra and his employees were filing fictitious automobile glass claims representing themselves as the insureds who had business with their company in the past.  In Arizona, it is a class 6 felony for an auto glass repairer or salesperson to knowingly submit a false claim to an insurance company if the services were not provided.

In addition to Mr. Parra, two other suspects were located, taken into custody and subsequently released after being interviewed.  To date, no charges have been filed against these suspects.  However, several computers and numerous other items were seized as evidence during a search warrant served on the business.

“All Arizonans should be proud of the great work done by the Fraud Unit,” said Arizona Acting Director of Insurance, Darren Ellingson. “The Fraud Unit’s efforts help reduce the overall cost of insurance for every Arizonan, while sending notice to other bad actors that Arizona will not tolerate insurance crimes.”

 

About the Fraud Unit

The Fraud Unit was established in the Arizona Department of Insurance in 1994 to deter, investigate and facilitate convictions of insurance fraud. By deterring fraud, the Fraud Unit reduces the inflationary impact of fraud that is passed on to consumers through higher costs of insurance products. If you believe you are a victim of insurance fraud or know of someone committing insurance fraud, please contact the Arizona Department of Insurance Fraud Unit at 602-364-2140.

About the Arizona Department of Insurance

The Arizona Department of Insurance, an agency of the State of Arizona, is responsible for the education and protection of insurance consumers and for oversight of the insurance industry in the state.  If you need assistance with your insurance, please contact the Arizona Department of Insurance Consumer Affairs Division at 602-364-2499 (metro Phoenix) or 800-325-2548 (outside Phoenix).

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)

Arizona's Surprise Bill Resolution Report for 2019

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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