Every California tortfeasor must read, understand, or be educated about the California Fair Claims Settlement Practices Regulations by September 1 of each year.
This recently updated and rewritten book is designed to help insurance professionals doing business in the state of California with the obligation to apply the provisions that should be provided to each tortfeasor in your business.
It will advise:
- all staff in insurance claims,
- independent insurance adjuster,
- special fraud investigators,
- private investigators working for the insurance industry,
- industry management,
- the lawyers who serve the industry,
- public insurance adjusters,
- policyholders and
- advisers for policyholders working with insurance companies doing business in California
The information needed to correctly, efficiently and fairly resolve insurance claims in full compliance with the requirements of the regulations so that they can understand that the regulations are only minimum standards and each insurer requires that the service provided exceeds the requirements of the regulations.
All insurance companies doing business in California must comply with the requirements of the regulations or face the CDOI’s annoyance and attempted financial penalties. That sentence was found to be dubious and limited due to a brave insurer who fought against the CDOI and succeeded before an administrative law judge who restricted the right to punish. That success has, as far as I have been able to ascertain, not been imitated.
Regardless of the difficulty of assessing punishment, the State of California requires that all those involved in the litigation process – even if only tangential – be trained in law enforcement in accordance with the regulations and certify that such training has been completed under oath. In order to avoid the required annual training, the injured party may submit an affidavit to the insurer or insurers for whom the injured party certifies that he or she has read and understood the provisions.
By reviewing this book, the regulations and comments listed below should be sufficient to meet the training requirements of the regulations.
It is imperative that insurance personnel who are in some way involved in the presentation, processing, or negotiation of insurance claims in California be familiar with the regulations.
Because California’s regulations appear to be detailed, draconian, and equal to or more extensive than similar regulations in other states, understanding and working under the regulations should suffice in each state.
The insurer’s solicitor will need to know and establish that the insurer complied with the requirements of the regulations as it will show to a driver of facts that the insurer complied with the minimum requirements required and required its claims staff to comply with the regulations. Knowledge of the regulations can help the lawyer evaluate the exposure of an insurer and help the lawyer present an effective defense to an insurer that has been sued for violating the union of good faith and fair handling.
In the same way, the lawyer representing a policyholder’s client needs complete knowledge of the regulations in order to be able to use them to prove that the insurer did not meet the minimum requirements set out in the regulations. Even if there is no evidence that failure to comply with the requirements of the regulations can go a long way to convincing an expert (judge or jury) that the insurer did not act fairly and in good faith. Compliance with the regulations is important for the evaluation of a claim for breach of the union of good faith and fair handling and evaluation of a claim for damages arising from the damages in bad faith.
Knowledge of the requirements in the regulations is important for everyone involved in insurance business, regardless of whether it is as an insurance adjuster, insurance claims manager, public insurance adjuster, policyholder, defense attorney, insurance protection attorney and the policyholder’s attorney.
For details on this book and many more by Barry Zalma go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/
(c) 2022 Barry Zalma & ClaimSchool, Inc.
Barry Zalma, Esq., CFE, now limits his internship to the position of insurance consultant specializing in insurance coverage, insurance claims management, non-insurance and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as a lawyer for insurance coverage and claims management and more than 54 years in the insurance industry. He is available at http://www.zalma.com and email@example.com.
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