A. Before an enrollee files an action pursuant to section 20-3153, the enrollee shall either:

Terms Used In Arizona Laws 20-3155

  • Action: includes any matter or proceeding in a court, civil or criminal. See Arizona Laws 1-215
  • Contract: A legal written agreement that becomes binding when signed.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Process: means a citation, writ or summons issued in the course of judicial proceedings. See Arizona Laws 1-215
  • Writing: includes printing. See Arizona Laws 1-215

1. Complete the health care appeals process prescribed in chapter 15, article 2 of this title.

2. Provide written notice to the health care insurer at least thirty days before filing suit stating the enrollee’s intention to file suit and setting forth the basis for the suit.

B. If the enrollee provides notice pursuant to subsection A, paragraph 2 of this section, the enrollee shall deliver the notice to the health care insurer in compliance with the terms specified for delivery of written notices prescribed in the policy, contract or evidence of coverage. If the policy, contract or evidence of coverage does not specify the terms for delivery of written notices, the enrollee may provide notice to the last representative of the health care insurer who corresponded in writing with the enrollee.

C. Participation in the health care appeals process prescribed in chapter 15, article 2 of this title does not prohibit or limit the enrollee from filing suit at the conclusion of the appeals process.