If you believe your insurance company has acted in “bad faith” it may be helpful to know a few basic things. Here is some information to help you out:
When you hire an insurance company, you sign a contract with them that states that they will act in “good faith” toward you. In some instances, insurance companies do not fulfill their promises to the insured, unjustly withholding benefits and laying the foundation for bad faith lawsuits. This is what is called acting in “bad faith”:
- Failing to thoroughly investigate a claim
- Delaying payment
- Denying benefits to a claim unjustly
- Refusing to settle a case
- Failure to reimburse you in entirety
- Consumer Communications Bureau (Hotline)
The California Department of Insurance operates a statewide toll-free consumer hotline at 800-927-HELP (4357), which provides callers with immediate access to current information on insurance issues. The hotline is staffed by knowledgeable insurance professionals who can answer questions, give direction and provide assistance to consumers who are experiencing insurance-related problems or concerns. By calling the hotline, a consumer or their insurance lawyer can ask questions on insurance claims and underwriting practices as well as check the license status of his/her insurance company, agent or broker.
After listening to and discussing a consumer’s concerns over the phone, a hotline officer may decide to send the consumer a Request for Assistance (RFA) form to be completed and returned to the department. The RFA provides the necessary information to open a complaint investigation, which will be handled by officers in the Claims Services Bureau or the Rating and Underwriting Services Bureau, depending on the subject matter involved. Within 10 working days, the consumer will receive an acknowledgment from the officer who will be handling the file.
Claims Services Bureau
The Claims Services Bureau is responsible for investigating, evaluating and resolving all consumer claims complaints regarding claims handling practices.
Rating and Underwriting Services Bureau
The Rating and Underwriting Services Bureau is responsible for investigating, evaluating and resolving all consumer rate and underwriting complaints.
Consumer Education
Along with assisting consumers with specific insurance concerns, the California Department of Insurance publishes free brochures to help consumers become aware of their rights and to aid them in making informed insurance decisions. These publications can be requested by calling toll-free 800-927-HELP (4357). Also, as part of the department’s mission to protect consumers, the Education and Outreach Program provides speakers who can travel off-site to participate in public events, such as town hall meetings, business and community fairs and professional association events.
For more key issues in insurance law, visit the San Diego County Bar Association website.
This information is for educational purposes only and is not intended to provide legal counsel or serve as legal advice. If you have an insurance law matter, it is best to consult the advice of an attorney. You can get referred to an attorney for a free 30-minute consultation through the San Diego County Bar’s Lawyer Referral & Information Service at www.sdcba.org/ineedalawyer or by calling 1 (800) 464-1529.