Ariz. Admin. Code § R2-10-102 - Reporting Procedures
A. Any agency,
provider, or other person or entity insured pursuant to A.R.S. §
41-621
shall report a property loss, liability claim, or incident that may give rise
to a claim under A.R.S. §
41-621 to RM as follows:
4.5. All other claims or
incidents within 10 days of the incident in writing or by electronic
means.
1. A physical injury within 1 day of the
incident orally, in writing, or by electronic means.
2. Property damage expected to exceed $10,000
within 1 day of the incident orally, in writing, or by electronic
means.
3. Property loss expected to
exceed $10,000 within 1 day of the incident orally, in writing, or by
electronic means.
4. Except for the
Board of Regents and State Universities, a data breach, security system breach
or security incident orally or in writing to the ADOA Chief Information Officer
within 72 hours of the incident or when the agency should have reasonably known
of the incident. For the Board of Regents and State Universities, a data
breach, security system breach or security incident orally or in writing to the
ADOA Risk Manager within 72 hours of the incident or when the agency should
have reasonably known of the incident.
B. Any agency,
officer, employee, or other person or entity insured pursuant to A.R.S. §
41-621, who receives a claim, notice, summons, complaint or other process by
any claimant or representative shall immediately forward the claim to RM. This
applies to all claims for injuries or damages whether the reporting party
believes there to be a factual basis for the claim, but excludes contract
lawsuits or other matters not covered under A.R.S. §
41-621.
C. Anyone who is insured pursuant to A.R.S.
§
41-621 shall cooperate in accordance with A.R.S. §
41-621(N) with
RM and the Attorney General's office or other counsel appointed by the Attorney
General to represent the insured, including providing all information and
materials requested to investigate and resolve a claim.
D. An agency shall submit a report of a loss
on the following RM forms:
1. A loss involving
a state-owned vehicle or a state driver on the "Automobile Loss Report".
Information required includes: the agency involved, facts of the incident, the
vehicles involved, description of injuries to individuals, names of witnesses,
and the police agency that investigated the incident.
2. A loss involving private property damage,
or injury to a member of the public as a result of alleged acts or omissions of
a state officer, employee, or other person insured pursuant to A.R.S. §
41-621, other than a loss arising out of use of a motor vehicle, on a "General
Liability Report". Information including the agency and employees involved,
facts of the incident, name of the claimant, and description of the claimant's
injuries, witnesses to the incident, and the name of the police agency that
investigated the incident.
3. A
loss to state property, whether personal property (other than motor vehicles)
or real property, on the "Property Loss Report". Information includes the
agency and employees involved, facts of the incident, description of the
damaged property, the party responsible for the loss, names of witnesses, and
the police agency investigating the loss.
4. A loss to employee-owned property covered
under A.R.S. §
41-621(A)(4) on the "Property Loss Report''. Information
necessary to document the loss and calculate the actual dollar value of the
claim is required. In addition, the employee shall submit a copy of any written
agreement between the employee and the employing state agency authorizing the
use of the employee-owned property on the job, and a copy of the Personal
Property Inventory form (PROPINV) maintained by the employing state
agency.
Notes
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