Press Release 2013-03 Business Owner Arrested After Being Video Taped Committing Insurance Fraud.

NEW ADDRESS


Arizona Department of Insurance
100 North 15th Avenue, Suite 261

Phoenix, AZ  85007-2630

Starting July 1, 2020, we will be the
Department of Insurance and Financial Institutions (DIFI).

Media Contact: Darren Ellingson Deputy Director (602) 364-3471

For Immediate Release September 24, 2013

PHOENIX - On July 20, 2013, Richard Sparta, who is owner of APEX Carpet Cleaning, was hired to give an estimate on mold damage to a policy holder's Mesa, AZ, residence. The allegations are that Sparta brought a Persian rug into the residence explaining to the policy holder they would have it damaged and the insurance company would pay her thousands of dollars.

Sparta also wanted the policy holder to leave the residence so he could break a plumbing pipe in order to cause additional damage. He instructed the insured they would then make a fraudulent insurance claim. The policyholder’s son recorded the actions with his cell phone and the video was turned over to the Insurance Department’s Fraud Unit. On July 25, 2013, the suspect arrived at the residence to complete the scam where he was arrested by agents of the Fraud Unit.

Sparta has been charged with Conspiracy to commit Fraud Schemes and Insurance Fraud. The case is being prosecuted by the Arizona Attorney General’s Office.

Consumers who suspect insurance fraud are encouraged to call the Fraud Unit of the Arizona Department of Insurance 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. 

 

Period: 
2013
Priority: 
03
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.)
Regulatory Bulletin 2020-01

Uninsured and Underinsured Motorist Coverage Offer Form; SB1087