File a Complaint | AZDIFI
We are here to help! We can resolve issues within our jurisdiction. For matters outside our purview, this guide will direct you to the proper authorities. The Arizona DIFI provides equal access to communication for people with disabilities. Call our ADA Coordinator at (602) 364-3100 for accommodations.
Is it an Appeal or a Complaint?
Having difficulty with the mental health or medical benefits under your health insurance policy? Some problems require you to APPEAL, while others call for a COMPLAINT.
Generally speaking, if an insurance company denies a request for service or claim for service as not covered or as not medically necessary, that should be submitted as an APPEAL. Other health insurance problems should be filed as a COMPLAINT.
| What kind of problem are you having? | File an Appeal (With Insurer) | File a Complaint (With DIFI) | Other Resources |
|---|---|---|---|
| I can’t find an in-network doctor to help me | ✓ | ||
| The insurer is denying prior-authorization of my visit to a doctor | ✓ | ||
| The insurer is denying my referral to a specialist | ✓ | ||
| The insurer is denying coverage for a particular medication | ✓ | ||
| Why doesn’t my insurance policy include mental health benefits? | ✓ | ||
| My insurance company won’t respond to my coverage questions | ✓ | ||
| My insurer is not responding to my urgent request for MH/SUD services | ✓ | ||
| My insurer only paid a small portion of my claim | ✓ | ||
| I’m having problems with my AHCCCS (Medicaid) plan | AHCCCS (opens in a new tab) | ||
| I’m having problems with my Medicare plan | Medicare.gov (opens in a new tab) or SHIP (opens in a new tab) | ||
| I received a Surprise Bill for services | Surprise Bill Dispute (opens in a new tab) |
Self-Funded Health Plans
Many large employers provide health benefits using a "self-funded" or "self-insured" program, which are generally regulated by the U.S. Department of Labor (opens in a new tab).
- Self-funded plan ID cards often contain phrases near the insurer's name like: "Administered by," "As administrator for," "Administrative services only," or "ASO." Check with your employer benefits office to confirm.
- State-regulated health insurance ID cards may contain the phrase "Underwritten by" or "Insured by". Starting in 2022, ID cards must display "AZDOI" if the coverage is NOT self-funded, Medicare, or Medicaid.
Insurance Entities & Producers
IMPORTANT: Each submitted insurance consumer complaint, the response to the complaint, and many of the related documents become a public record pursuant to Arizona law.
How We Can Help
We Can Help With:
- Certain surprise health care bills through our surprise billing program
- Health provider grievances
- Denied health insurance claims and denied requests for services through the health care appeals process
We Can Investigate:
- Claim-handling delays, denials, or unsatisfactory settlements
- Non-renewals and cancellations
- Delays in premium refunds
- Underwriting errors
- Conflicting information from your insurer
- Allegations of misconduct against insurance producers
We Cannot:
- Give legal advice, act as your lawyer, recommend insurers, or make liability/fault decisions.
- Resolve complaints requiring a judge or jury to determine truthfulness.
- Intervene in disputes between insurance companies and their employees or contractors.
- Help resolve complaints regulated by other agencies, including:
- Medicaid/AHCCCS benefits
- Medicare and Medicare Advantage Plans
- TriCare or Federal/State Employee Benefit Plans
- COBRA or Employer self-funded health benefit plans
- Arizona unemployment insurance
Step-by-Step Instructions
- Gather Documents: Scan and save necessary records (e.g., insurance cards, full policies, correspondence). Do not use thumb drives.
- File Online: Complete the online form using the links above. Note: The system only allows one opportunity to attach documents. Ensure your documents are ready before starting.
- Additional Documents: If you need to provide more documents later, email [email protected] with your original confirmation number. Do not submit an additional online complaint.
- DIFI Review: We will ask the entity to respond, evaluate all information, and determine if a violation of law occurred. You will be notified upon closure.
Tips for Filling Out the Form
System rejections frequently happen due to DATE fields. Follow these tips:
- Use the calendar drop-down menu when clicking a date field.
- If typing manually, use the exact format mm/dd/yyyy with slashes.
- Do not enter text (like "NA" or "Unknown") into date fields.
- If a date is unknown or not applicable, leave it completely blank.
Download Third Party Consent Form (opens in a new tab) if someone is filing on your behalf.
Read the Consumer Guide to DIFI (opens in a new tab).
Financial Institutions & Enterprises
File a complaint if you suspect you are a victim of an unlicensed entity or if a regulated entity has violated Arizona statutes.
Entities We Regulate
Financial Institutions and Enterprises include:
- Advance Fee Loan Brokers
- Banks
- Collection Agencies
- Commercial Mortgage Bankers
- Commercial Mortgage Brokers
- Consumer Lenders
- Credit Unions
- Debt Management Companies
- Escrow Agents
- Loan Originators
- Money Transmitters
- Mortgage Bankers
- Mortgage Brokers
- Premium Finance Companies
- Sales Finance Companies
- Trust Companies
How We Can Help
We Can:
- Provide your complaint to your financial institution/enterprise and require a response.
- Review the response for compliance with Arizona Revised Statutes and Administrative Code.
- Require corrective action if the regulated entity did not meet statutory regulations.
We Cannot:
- Award damages, provide legal advice, or intervene in pending litigation.
- Disclose complaint information to the public.
- Process complaints outside our jurisdiction, such as:
- Federally chartered banks (visit the FDIC Information Center (opens in a new tab))
- Federally chartered credit unions (visit the NCUA Consumers page (opens in a new tab))
- Motor vehicle dealers (see the ADOT Auto Dealer Complaint page (opens in a new tab))
- Pawnbrokers (contact your local County Sheriff's office)
Step-by-Step Instructions
- Verify License: Use the az.gov License Search (opens in a new tab) to look up the license number and exact name of the entity. Include this in your complaint.
- File Complaint: Submit your complaint online using the button above.
- Supporting Documents: If your complaint requires supporting documents, email them along with a copy of your submitted form to [email protected], or mail them to:
Financial Services Consumer Service Section
Arizona DIFI
100 N 15th Ave, STE 261
Phoenix AZ 85007-2630 - Resolution: We will conduct a review, require a response from the entity, and notify you when the case is closed.
Appraisers & Tax Agents
File a complaint against an Appraiser, Appraisal Management Company, or Property Tax Agent. Note: Investigations frequently take a year to close.
How We Can Help
We Can:
- Require the appraiser or property tax agent to respond to your complaint.
- Review for compliance with Arizona laws, rules, and the Uniform Standards of Professional Appraisal Practice (USPAP).
- Impose disciplinary or corrective action if violations occurred.
We Cannot:
- Award damages or order appraisers to amend appraisals or reimburse fees.
- Give you a new value for your property or confirm if the appraiser's opinion is correct.
- Act as your attorney, arbitrator, or provide findings for legal matters.
- Disclose investigation findings or documents to the complainant.
- Handle Reconsideration of Value (contact your lender) or Realtor complaints (contact the Dept. of Real Estate).
Complaint Review Stages
1. Initial Review & Investigation
The Department screens complaints for jurisdictional requirements. If met, we may require the Respondent to submit a written response and workfile within 10 days. The Department analyzes complaints for USPAP violations and may use a qualified investigator. If no violations occurred, the complaint is closed.
2. Continued Investigation & Settlement
If a violation occurred, the Respondent may respond to investigative findings. The Department may formally proceed or settle the matter by consent (e.g., education, probation, civil penalty, suspension) in lieu of a hearing.
3. Formal Administrative Actions
If not settled informally, the Department issues an Order or files a Notice of Hearing at the Office of Administrative Hearings. An administrative law judge hears the case and issues a recommended decision, which the Director accepts, rejects, or modifies.
4. Compliance File Review
If education, mentorship, or suspension is imposed, the Department conducts compliance reviews and may initiate further action for noncompliance.
Step-by-Step Instructions
- Look up the license: Use the License Search (opens in a new tab) for the appraiser or tax agent and include their license number and full name.
- Submit Form: File the complaint online using the button above.
- Process: DIFI will evaluate the response, conduct research, and determine if violations occurred. Unless filed anonymously, we will notify you when the case is closed.
Before You File
- The Department of Insurance and Financial Institutions’ (DIFI) ability to take action is limited to situations where there is an apparent violation of statutes and rules subject to its jurisdiction.
- In cases where DIFI has jurisdiction, the Department can pursue administrative remedies, injunctive relief through the office of the Attorney General, or refer the matter for criminal prosecution.
- The Department represents the public by enforcing laws designed to protect against misleading or unlawful practices by state-regulated entities.
- If you have questions concerning your personal legal rights or responsibilities, you should contact a private attorney.
- If you are already represented by an attorney, or have a legal action pending regarding the complaint, the Department may not be able to further pursue your complaint.
- Filing a consumer complaint with the Department will not extend any time limitations specified in policy provisions, statutes, or regulations.
- File a complaint if you believe we have jurisdiction. We conduct a preliminary review to verify jurisdiction and will notify you if we do not have authority to assist.
Referrals to Other Agencies
To report identity theft, unwanted telemarketing, texts, spam, or business practices that are unfair to consumers, contact:
Arizona Attorney General (opens in a new tab)
- Phoenix Metro Area: (602) 542-5763
- In-state Toll-free: (800) 352-8431