Arizona Department of Insurance—Department’s process to prioritize fraud referrals for investigation lacks important components and practices for managing conflicts of interest increase risk of nondisclosure

The Arizona Department of Insurance (Department) regulates and monitors insurance companies and professionals operating in Arizona to protect the public and help ensure that these entities comply with State and federal laws. Key Department functions include licensing qualified insurance professionals and companies, investigating consumer complaints and suspected fraud, overseeing insurance companies’ financial solvency, and reviewing insurance policies, rates, and products to protect the public from excessive, inadequate, or unfairly discriminatory rates. According to Department data, as of July 2019, there were 1,691 insurance companies licensed to operate in Arizona. We found that the Department’s fraud-referral prioritization process lacks components to ensure it investigates high-priority referrals. Additionally, we identified deficiencies with the Department’s conflict-of-interest process. Finally, the Department should improve its management and administration of long-term care insurance rate reviews and information technology (IT) security.