Getting Help From the CA. Dept. of Insurance – United Policyholders

Q: What does the California Department of Insurance do for the public?

A: The California Commissioner of Insurance and his staff at the Department of Insurance (“CDI”) are charged with regulating insurance companies, agents, brokers, and public adjusters doing business in this state.

Reading: What does the california insurance commissioner do

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There are laws and regulations in California that protect consumers from unfair insurance practices. You can learn what they are by reading a guide to your insurance legal rights.

The insurance commissioner’s job is to make sure insurance companies keep their promises and have enough money to pay claims. the position of commissioner is an elected position in the state of california with a four-year term. the california department is divided into “bureaus”: the bureau of consumer services handles consumer complaints.

q: what does the cdi do to help disaster survivors?

a: Provides forums for owners to ask questions and get answers.

the cdi holds public meetings in disaster areas. homeowners and businesses can come and ask and get their questions answered. they are an important opportunity for the community to educate the cdi on how insurance companies are behaving. insurance companies often send high-level personnel to these public meetings. owners can personally speak with these staff after meetings.

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receives and processes consumer complaints.

cdi has attorneys and complaint handling staff whose job it is to help resolve insurance claim problems. Filing a complaint is the first step you should take to let them know you have a problem. In order for your complaint to be recorded and “official”, you or someone acting on your behalf must complete a request for assistance (“rfa”) form.

cdi’s toll-free hotline number is: 1-800-927-help (4357). Keep in mind that when you file a formal complaint, the CDI contacts your insurance company, tells them about your complaint, and gets their side of the story. the cdi will not “adjudicate” (act as a judge and make a decision regarding: disputes of fact or law. you may be disappointed in the results of your complaint handling, or be helped. the department looks for patterns of similar problems. when they find them, they take action. if they don’t get complaints documenting the problems, they can’t take action.

Important Reminder: If you attend a public meeting organized by the CDI or if you file a formal complaint through an RFA, take the opportunity to get answers and inform the CDI about the problems of sure you have. to have. keep your comments general. avoid sharing details about your dealings with your agent, broker, or insurer, especially if you’re underinsured. The cdi needs to know if you are underinsured so they can include that fact in their statistics, but if you are underinsured, you can hurt your chances of recovering in a lawsuit if you go into too much detail on a cdi complaint form. This is because the cdi cannot adjudicate disputes of fact or law.

United Policyholders strongly encourage underinsured complaints to be filed and marked “for informational purposes only” indicate the name of your insurance company and the fact that you are underinsured, but keep it simple to protect your continued ability to work toward a fair deal.

website resources and publications

the department may create a special section of its website for local disasters, such as wildfires

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They also publish disaster bulletins of new laws. two important ones have to do with beer payments (additional living expenses). Your insurer must give you at least 24 months of benefits and a list of beer items you can claim.

the cdi publishes publications that balance the perspectives of insurance companies and consumers. United Policyholders’ website and publications are intended solely to assist consumers. It is not our job to offer the perspective of the insurance companies.

market conduct tests and data calls

the cdi can audit insurance company claims files to see if they comply with the law. these audits are called “market conduct reviews”. After the 1994 northridge earthquake, cdi staff identified thousands of claims-handling violations that resulted in large fines, legislative hearings, much bad publicity for insurance companies, and better settlements for many homeowners. The CDI can issue “data calls” that require insurers to provide them with specific information about their policies, rates, and/or claims.

p: what doesn’t the cdi do?

a: The department does not normally resolve disputes between individuals and insurers involving large-dollar disputes or coverage disputes. the cdi can help you obtain a copy of your policy, resolve small to medium problems, and can identify and penalize patterns of misconduct. If you are underinsured or are being treated poorly by your insurer, you are more likely to resolve the situation through a private attorney experienced in representing policyholders and handling “bad faith” claims. visit the “search help” directory for more information.

United Policyholders have had a good working relationship with most of California’s elected commissioners since 1991. Together with communities, the CDI, and private attorneys, we have resolved many insurance issues after natural disasters. But just as we challenge the insurance companies when they don’t do their job, we challenge the department and the commissioner when they don’t do theirs.

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