Powers and DutiesGenerally
Section § 12919
This law states that any information shared with the insurance commissioner about someone applying for or holding a license or certificate is considered confidential. You can't be sued for providing this information, but this doesn't mean you can skip other legal steps, like giving notice or providing evidence if required.
Section § 12920
This law requires the insurance commissioner to evaluate the adequacy and legal soundness of the financial guarantees, known as securities, provided by anyone participating in the insurance business. If these securities are found lacking or invalid, the commissioner must have them supplemented or renewed to ensure compliance.
Section § 12920.5
This law states that the insurance commissioner must refuse to approve or file a bond if they believe the companies involved are connected in such a way that if one goes bankrupt, it could make the other bankrupt too.
Section § 12921
The commissioner of insurance in California is responsible for enforcing all insurance laws in the state. They have the power to negotiate and approve settlements in administrative actions, with some limitations.
The commissioner can delegate negotiation but cannot approve settlements involving insurers, certain agents, or those accused of certain financial crimes. Settlements can't involve inappropriate donations or misuse of fines.
The commissioner can only direct payments to those owed due to the insurance law violations. Settlements are limited to specified sanctions and can include attorney's fees and enforcement costs. The commissioner can manage documents electronically or on paper and may set rules for such processes.
Section § 12921.1
This section requires the Insurance Commissioner to set up a program by July 1, 1991, to handle consumer complaints and inquiries about insurers. The program must include a toll-free number, public announcements, a complaint form, and a system for keeping records for at least three years. It must also provide guidelines for sharing information about complaints and enforcement with the public. Procedures for complaint handling, mediation, and enforcement must be clear and consistent with existing laws.
Additionally, the Commissioner must create regulations to determine the validity of complaints before making them public. Insurers will be informed of justified complaints at least 30 days before releasing a public report. Insurers need to appoint a contact for complaint-related communication, and they're required to use any online system set up for managing complaints.
Section § 12921.2
This law states that the public can access and copy public records from the department and commissioner, as long as these records are open for disclosure. You can view these records at department offices in Oakland, Los Angeles, and Sacramento. The offices will have facilities to make copies, and any fees charged will only cover the actual cost of copying.
Section § 12921.3
This law section outlines the roles and responsibilities of the insurance commissioner in handling complaints and inquiries about insurers and production agencies. The commissioner must investigate these complaints, even if the insured is represented by an attorney or involved in mediation, arbitration, or civil lawsuits. However, the commissioner can wait to investigate until these disputes are resolved. Additionally, the commissioner is tasked with educating the public and providing information about insurance issues.
Section § 12921.4
When someone files a written complaint about how an insurance company or its agent handled a claim or acted improperly, the Insurance Commissioner must acknowledge the complaint within 10 working days and provide a final action notice within 30 days.
The department must include or occasionally include a feedback form with the final action notice to evaluate how well it handled the complaint. Feedback can cover fairness, thoroughness, timing, staff knowledge, satisfaction, and whether the complainant would recommend the service.
If necessary, the Commissioner can inform the insurance company about the complaint, request relief for the complainant, and attempt to mediate between the parties. However, the Commissioner cannot make binding decisions on claims.
The Commissioner also studies patterns in complaints by company, area, type of insurance, and more to decide if further investigation or action is needed and reports these findings annually to the Governor and public.
Section § 12921.5
This law allows the insurance commissioner or their employees to meet with individuals and groups interested in insurance to ensure cooperation in following the state's insurance laws. It also authorizes them to share information about these laws to help inform and assist the public.
Section § 12921.6
This California insurance law allows the insurance commissioner to set a fee for reviewing documents that insurance companies must file. If no fee is specified by law, the commissioner can establish one, but can't increase it by more than $25 without legal approval. If a fee is specified but deemed inadequate, the commissioner can add up to 25% more. Anyone charged a fee can ask for an explanation of how it was calculated. 'Filings' refer to documents insurers have to submit to the commissioner. The cost-based fee does not need to be uniform as per Section 12978's requirements and applies directly to the department's review costs. 'Person' here includes any entity involved in insurance business within the state or needing a certification from the commissioner.
Section § 12921.7
This law explains the process that the California insurance commissioner must follow to create emergency regulations. Before submitting the regulation, the commissioner has to notify any person or group who previously asked to be informed about regulatory changes. This notice must be sent at least five working days in advance and should include a description of the problem the regulation addresses, why it's necessary as an emergency, and the full text of the proposed regulation.
Section § 12921.8
This law allows the insurance commissioner to take action against individuals who operate without the necessary license, registration, or certificate. First, the commissioner can issue a cease and desist order to the person who illegally acts in such a capacity. Second, they can also issue the same order to anyone who assists that person.
The commissioner can impose a fine, which is either five times the money the individual unlawfully earned or $5,000 per day of operation, whichever is higher. A presumption exists that the unlicensed activity was continuous until evidence shows otherwise. Those receiving a cease and desist order or penalty have seven days to request a hearing unless one is already scheduled.
This hearing will follow the procedures of the Administrative Procedure Act, and the affected person has the right to further review as outlined in the same act.
Section § 12921.9
If the California Department of Insurance issues a letter or legal opinion that answers a question about insurance laws or regulations, it must be made public. However, personal details like names or policy numbers can be hidden.
Even though these documents are shared publicly, they are not considered official rules or guidelines that apply to everyone.
Section § 12921.15
This law requires the insurance commissioner to create a report by July 1, 1999, containing complaints and enforcement details about individual insurers. This report should be available to the public upon request through various methods, including mail, a toll-free number, a website, and email, provided the requester can receive it electronically. The report will only include complaints that have been previously shared with the insurers.
The commissioner also has the option to publish validated complaints against insurance production agencies to help the public choose an agency. However, only complaints that have been shared with the agencies in advance will be included.
Section § 12922
Every year before August 1st, the insurance commissioner must provide a report to state leadership, including the Governor and certain legislative committees. This report includes a summary of insurance-related reports, the overall status of the insurance industry in California, and details about the money and fees collected by the commissioner's office.
Section § 12922.5
This law requires the insurance commissioner to form a working group to explore and suggest ways to use the risk transfer market, like insurance, to boost investment in natural infrastructure. The goal is to lower climate change risks from natural events and offer incentives for protecting the environment. The group should focus on solutions that attract private investment while remaining financially beneficial for insurance firms, and should consider approaches that benefit communities or regions as a whole. They must also explore how such strategies might encourage wetland restoration and forest management to mitigate disasters, and develop insurance policies that promote safer, climate-resilient community behaviors. The suggestions should also look at ways to reduce insurers' exposure to climate-related losses through innovative state policies or pricing models that reward protective actions.
Section § 12923
This law defines who qualifies as an actuary for insurance purposes in California. An actuary can either be a member of the American Academy of Actuaries or someone deemed competent by the Insurance Commissioner due to their training and experience.
The law requires the Insurance Commissioner to make rules about what documents must be signed by an actuary when submitted to them. It also requires rules to help identify who can be considered an actuary under these standards, following a formal notice and hearing process.
Section § 12923.5
This law establishes a team from the Department of Managed Health Care and the Department of Insurance to make sure that health care consumers in California understand their rights and know who enforces them. It requires this team to review laws and processes that affect both departments to ensure that consumer protections are consistent.
The team will look into how complaints are handled, how legal enforcement is managed, and how quickly claims are paid. They must report their findings annually to the heads of both departments, who will pass the final report along to the state legislature for five years.
Section § 12924
This law gives the insurance commissioner the power to issue subpoenas to have people testify and produce documents related to insurance matters. If someone doesn't comply, the commissioner can ask a court to order them to show up and possibly face contempt charges for disobedience. The rules for handling evidence apply to these proceedings, except when specified otherwise by certain government procedures.
Even if someone believes testifying could incriminate them, they must still provide the required information or documents. However, they can't be punished for those potentially incriminating admissions, except in cases of perjury or contempt related to their testimony.
Section § 12925
This law requires the commissioner to maintain a permanent record of their activities, including a summary report on the status of insurance companies, surplus line brokers, and motor clubs after they are examined.
Section § 12926
This law requires the insurance commissioner to ensure that all insurance companies fully comply with every aspect of the insurance code.
Section § 12926.1
This section details how funds from fines, penalties, or settlements related to compliance and enforcement actions under the jurisdiction of the California Insurance Commissioner should be handled. It specifies that such funds must be deposited into designated funds and outlines strict rules for their use, especially for public outreach efforts. Public outreach cannot include the commissioner's personal promotion and must focus on relevant enforcement information. Funds also cannot be used for general public education about insurance unless it specifically relates to the enforcement action. Court approval is required for any use of these funds.
Additionally, individuals with a vested interest can take legal action if these rules are violated, and successful plaintiffs can recover legal costs from the commissioner's nonpublic resources. The commissioner cannot hike fees on insurers to meet these obligations.
Section § 12926.2
This section outlines what counts as 'extraordinary circumstances' for insurance licensees, meaning situations they can't control that significantly impact their business operations. The insurance commissioner can take these circumstances into account when determining if someone hasn't complied with insurance regulations and whether they deserve penalties. Any settlement with the commissioner can't mention such circumstances unless it clearly states when these circumstances started and ended, which usually can't be more than six months. However, if certain conditions are met, such as documenting the circumstances and a public purpose for extending the time, a settlement can acknowledge these circumstances for longer than six months.
Section § 12927
This law states that whenever the insurance commissioner or insurance companies in California are required to make financial statements, estimates, percentages, or payments, they must use U.S. dollars.
Section § 12928
If the insurance commissioner finds that an insurer, its representatives, or anyone else has broken a criminal law, the commissioner must report the details to the district attorney of the area where the crime took place.
Section § 12928.5
The law allows the insurance commissioner to cancel an insurance contract if it's involved in legal issues, like fraud, unless the contract can't be canceled due to its terms and the insured didn't knowingly do anything wrong. The commissioner can also tell the insured why their policy was canceled.
If an insurance contract is involved with legal problems, the commissioner can stop the insurer or agents from selling insurance related to that policy for up to five years. Additionally, any licenses can be taken away if those involved don't follow the commissioner's orders.
Section § 12928.6
This section allows the insurance commissioner to take action if they believe a person is breaking or about to break certain rules or orders. The commissioner can go to court to stop that person from continuing the violation.
Additionally, the commissioner can ask the court to enforce an order requiring a person to pay restitution or penalties. The process includes presenting certified documents and a legal declaration confirming no other legal challenge is pending. A court judgment issued this way holds the same power as other civil judgments and can be enforced like any other court decision.
Section § 12928.7
This law allows the insurance commissioner to order restitution when someone suffers a loss due to another's conduct, generally in the context of regulatory violations. Restitution must be tied to other legal proceedings where violations are confirmed. The restitution order must outline who was affected, the amount owed, and be enforceable through the courts. It does not apply to licensed insurers or insurance transactions compliant with certain sections. The commissioner can also recover costs from the party ordered to pay restitution. Furthermore, restitution doesn’t prevent other legal actions or remedies, and funds collected are deposited into the Insurance Fund for distribution. "Restitution" here refers to compensating affected persons fully for losses.
Section § 12929
The commissioner has the power to correct any decision or rule they made, like a record, finding, or regulation, if they believe a mistake or error was made. This correction can be done by changing, deleting, or adding to the original decision, but it must be done within six months of the original action.
If the commissioner already knows the facts personally, they can make the correction themselves without anyone else being involved. Otherwise, someone has to formally request the correction in writing, explaining what went wrong, with supporting evidence. If anyone objects to the correction within 60 days, a hearing will be held.
Section § 12930
This law section explains that crimes related to insurers are treated the same way as other public offenses are, according to the Penal Code. Additionally, if evidence is needed, the insurance commissioner can provide certified copies of documents to a district attorney free of charge.
Section § 12931
This law outlines how legal documents can be served to insurance entities through the commissioner, especially when usual methods aren't possible. If serving a foreign or non-U.S. insurer's legal papers is tricky, the commissioner can step in to receive these papers instead, provided certain fees and processes are met. Once received, the commissioner has to mail copies to the last known business address of the insurer. This service approach is legally effective if confirmations are filed in court within specific timeframes. Claimants can't get a default judgment until 30 days after filing their compliance paperwork. Although this method is detailed, it doesn't restrict other legal serving methods.
Section § 12935
The law requires the insurance commissioner to create informational sheets in Spanish and Vietnamese by January 1, 1997, explaining common terms used in auto insurance policies. These sheets are for information purposes only and do not change the terms of the original English insurance policy, which prevails in case of disputes.
The sheets must include a disclaimer stating that the policy written in English is the only binding document. The commissioner may also create similar sheets for other forms of insurance and in additional languages if needed.
Public service announcements can be made to inform relevant communities about these informational sheets. Insurers can advertise policies or translated materials in other languages if it is clear that the final binding document remains the English version of the policy.
Section § 12936
This law mainly focuses on the handling of escheated funds related to the insurance sector. Escheated funds that were deposited in the Insurance Fund are to be transferred to the General Fund to repay a loan from 1996. If the funds from 1997-98 aren't enough, funds from 1998-99 can be used for repayment, with a possible extension for repayment to June 30, 1999.
Policyholders who were supposed to get rebates but didn't receive them can file a claim with the Controller. If the claim is verified, these rebates will be paid from unclaimed property funds connected to Proposition 103.
Section § 12937
This law explains what happens to unclaimed funds from insurance policyholders that end up in the state's possession, also known as "escheated funds." The state can use these funds to pay for legal proceedings and expenses related to certain insurance estates that owe money. If you're a policyholder who didn't receive your entitled funds, you can file a claim with the state to get your money, as long as the claim is verified as valid. The government isn't required to actively search for policyholders who haven't claimed their money.
Section § 12938
This law requires the insurance department to publicly share certain information about their investigations into unfair or deceptive practices by insurance companies. Specifically, they must post agreements, settlements, and reports about these investigations on their website, removing any personal details of policyholders. After finalizing a report on a company, the department sends a copy to a representative chosen by the company, who can respond within 20 business days. The report and the company’s comments are then published online. However, internal company documents and draft reports from the investigation aren’t required to be shared unless the law allows it.