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California Claims and SIU Regulations, Ethics and Rescission



Barry Zalma, Esq., CFE has created a library of insurance claims books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals. Over the past 51 years, he has dedicated his life to insurance claims and the need for defective insurance fraud.

Read about California Claims and SIU Regulations, Ethics and Insurance books by Barry Zalma, at http: // zalma.com/blog/insurance-claims-library/

California Fair Claims Settlement Practices Regulations

A Guide to Insureds, Public Insurance Adjusters, and Lawyers to Properly Investigate and Adjust Insurance Claims

This book was designed to assisting staff in the state of California. It will assist all insurance claims personnel, claims professionals, independent insurance adjusters, special fraud investigators, private investigators who work for the insurance industry, the management in the industry, the attorneys who serve the industry, public insurance adjusters, policyholders and counsel for policyholders working with insurers doing business in California. All insurers doing business in California must comply with the requirements of the regulations or face of, and attempts at financial punishment from, the CDOI. That punishment is now questionable and limited because some courageous insurers have considered the CDOI and succeeded before an administrative law judge who limited the right to punish. Regardless of difficulties in assessing the state of California requires all who are involved in the claims process – even if only tangentially – to be trained with regard to claims in compliance with the regulations and attestation to completion of such training under oath. To avoid the annual training the claims person can submit a sworn document that has been read and understood the Regulations. Reviewing this book and the Regulations set forth below should be sufficient to comply with the training requirements of the Regulations. It is necessary for insurance personnel who are engaged in any way in the presentation, processing, or negotiation of insurance claims in California to be familiar with the Regulations. Counsel for insurers and policyholders should also be familiar with the regulations since they set a minimum standard for claims handling in the state.

Available as a Kindle book

Available as a paperback.

 California SIU Regulations: The The California SIU Regulations is designed to assist California insurance claims personnel, claims professionals, independent insurance adjusters, special fraud investigators, private investigators who work for the insurance industry, the management in the industry, the attorneys who serve the industry, and all integral anti-fraud personnel working with California admitted insurers to comply with the requirements of California SIU Claims Regulations. </p>
<p> The state of California, by statute, requires all admitted insurers to maintain a Special Investigative Unit (in “SIU”) that complies with the requirements set forth in the Special Inves Tigative Unit Regulations (the "SIU Regulations") and train all integral anti-fraud personnel to detect indicators of insurance fraud. </p>
<p> Available as a Kindle Book </p>
<p> Available as a paperback </p><div><script async src=

Methods for Insurers and their Personnel to Act with the Utmost Good Faith  Product Details

Ethics is a process of systematically applying, using, defending and recommending concepts of right and wrong behavior. Ethical behavior is required by both parties to a contract or insurance for the system to work. Ethics is the essence of insurance. Ethical behavior is required by both parties to a contract or insurance for the system to work. If any party to the insurance contract acts unethically the ability to work effectively and profitably will fail. Ethics is the essence of insurance. Since insurance was first created it has been a business of utmost good faith.

Available as a paperback

Rescission of Insurance

 Product Details Rescission is an equitable remedy as ancient as the common law of Britain. When the United States was conceived in 1776 the founders were concerned with protecting their rights under British common law. They are adopted as the law of the new United States of America only by the limitations placed on the central government by the U.S. Constitution approved in 1789. The viability and ability to enforce contracts was recognized as essential to commerce. Courts of law were charged with enforcing legitimate contracts. Courts of equity were charged with protecting contracting parties from mistake, fraud, misrepresentation and concealment since enforcing a contract based on mistake, fraud, misrepresentation or concealment would not be fair. The common law developed rules that courts could follow to enforce the terms of a contract that was entered into because of mutual mistake of material fact, a unilateral mistake of material fact, the breach of warranty (a presumptively material promise to do or not) do something), a material concealment, or a material misrepresentation. The remedy – called rescission – created a method to apply fairness to the insurance contract and allow and insure to contract and allow courts to enforce such as a contract entered in the case of misrepresentation or concealment of material facts.

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About Barry Zalma

An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.


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