R20-5-702. Opening a Fraud Unit Investigation

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. Page 62 Supp. 26-2 June 30, 2026 Arizona Administrative Code 20 A.A.C. 5 TITLE 20. COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE CHAPTER 5. INDUSTRIAL COMMISSION OF ARIZONA 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).