Complaint of Bad Faith and/or Unfair Claims Processing Practices

This form may be used to file allegations of unfair claims processing practices and/or bad faith per Rule 20-5-163. 

It must be completed in its entirety and signed. The request should include a detailed description of the allegations made. Supporting documents can be submitted by uploading as a 'bad faith reply' document type or faxing or mailing to ICA.

Copies of the Arizona Workers’ Compensation Laws and Arizona Workers’ Compensation Rules and information about the Industrial Commission of Arizona claims and hearing process are available at the Industrial Commission offices and through the ICA website located at https://www.azica.gov/