Section § 12919

Explanation

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.

Communications to the commissioner or any person in the commissioner’s office in respect to any fact concerning the holder of, or applicant for, any certificate or license issued under this code are made to the commissioner in official confidence within the meaning of Sections 1040 and 1041 of the Evidence Code. Liability shall not exist and no action or proceeding shall lie for or on account of any communication or the making thereof, but the existence of the communication shall not be deemed to dispense with or nullify any requirement of notice, hearing, or production of evidence before the commissioner as otherwise required by law.

Section § 12920

Explanation

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.

The commissioner shall determine the sufficiency and validity of all securities required to be given by persons engaged, or to be engaged, in insurance business, and shall cause such security to be supplemented or renewed in case of the insufficiency or invalidity thereof.

Section § 12920.5

Explanation

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.

In addition to and independent of any and all other proper causes for refusal by the commissioner to approve or accept any bond filed or presented for filing with the commissioner under any provision of this code or other laws, the commissioner shall decline to approve, accept, or file any bond, if, in the commissioner’s opinion, the principal and the surety are affiliated in any manner whereby insolvency of the one party would affect the solvency of the other or whereby it is made uncertain whether or not that result might occur.

Section § 12921

Explanation

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.

(a)CA Insurance Code § 12921(a) The commissioner shall perform all duties imposed upon the commissioner by the provisions of this code and other laws regulating the business of insurance in this state, and shall enforce the execution of those provisions and laws.
(b)CA Insurance Code § 12921(b) In an administrative action to enforce the provisions of this code and other laws regulating the business of insurance in this state, any settlement is subject to all of the following:
(1)CA Insurance Code § 12921(b)(1) The commissioner may delegate the power to negotiate the terms and conditions of a settlement to designated deputy commissioners. The commissioner may delegate the power to approve a settlement, unless the settlement involves any of the following:
(A)CA Insurance Code § 12921(b)(1)(A) An insurer.
(B)CA Insurance Code § 12921(b)(1)(B) A managing general agent or production agent that manages the business of an insurer.
(C)CA Insurance Code § 12921(b)(1)(C) A title company.
(D)CA Insurance Code § 12921(b)(1)(D) A home protection company.
(E)CA Insurance Code § 12921(b)(1)(E) An insurance adjuster whose claims practices are at issue.
(F)CA Insurance Code § 12921(b)(1)(F) An insurance agent or broker, or an applicant for an insurance agent or broker license, who has allegedly engaged in theft, fraud, or the misappropriation of premium or other funds in an amount that exceeds fifty thousand dollars ($50,000).
(2)CA Insurance Code § 12921(b)(2) Unless specifically provided for in a provision of this code, the commissioner may not agree to any of the following:
(A)CA Insurance Code § 12921(b)(2)(A) That the respondent contribute, deposit, or transfer any moneys or other resources to a nonprofit entity.
(B)CA Insurance Code § 12921(b)(2)(B) That a respondent contribute, deposit, or transfer any fine, penalty, assessment, cost, or fee except to the commissioner for deposit in the appropriate state fund pursuant to Section 12975.7.
(C)CA Insurance Code § 12921(b)(2)(C) That the commissioner may or shall direct the transfer, distribution, or payment to another person or entity of any fine, penalty, assessment, cost, or fee.
(D)CA Insurance Code § 12921(b)(2)(D) The use of the commissioner’s name, likeness, or voice in any printed material or audio or visual medium, either for general distribution or for distribution to specific recipients.
(3)CA Insurance Code § 12921(b)(3) The commissioner may only agree to payment to those persons or entities to whom payment may be due because of the respondent’s violation of a provision of this code or other law regulating the business of insurance in this state.
(4)CA Insurance Code § 12921(b)(4) A settlement may only include the sanctions provided by this code or other laws regulating the business of insurance in this state, except that the settlement may include attorney’s fees, costs of the department in bringing the enforcement action, and future costs of the department to ensure compliance with the settlement agreement.
(c)CA Insurance Code § 12921(c) Notwithstanding any other law, the commissioner may accept documents submitted for filing or approval, process transactions, and maintain records in electronic form or as paper documents, and may adopt regulations to further this subdivision.

Section § 12921.1

Explanation

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.

(a)CA Insurance Code § 12921.1(a) The commissioner shall establish a program on or before July 1, 1991, to investigate complaints and respond to inquiries received pursuant to Section 12921.3, to comply with Section 12921.4, and, when warranted, to bring enforcement actions against insurers or production agencies, as those terms are defined in subdivision (a) of Section 1748.5. The program shall include, but not be limited to, the following:
(1)CA Insurance Code § 12921.1(a)(1) A toll-free telephone number published in telephone books throughout the state, dedicated to the handling of complaints and inquiries.
(2)CA Insurance Code § 12921.1(a)(2) Public service announcements to inform consumers of the toll-free telephone number and how to register a complaint or make an inquiry to the department.
(3)CA Insurance Code § 12921.1(a)(3) A simple, standardized complaint form designed to assure that complaints will be properly registered and tracked.
(4)CA Insurance Code § 12921.1(a)(4) Retention of records on complaints for at least three years after the complaint has been closed.
(5)CA Insurance Code § 12921.1(a)(5) Guidelines to disseminate complaint and enforcement information on individual insurers to the public, that shall include, but not be limited to, the following:
(A)CA Insurance Code § 12921.1(a)(5)(A) License status.
(B)CA Insurance Code § 12921.1(a)(5)(B) Number and type of complaints closed within the last full calendar year, with analogous statistics from the prior two years for comparison. The proportion of those complaints determined by the department to require that corrective action be taken against the insurer, or leading to insurer compromise, or other remedy for the complainant, as compared to those that are found to be without merit. This information shall be disseminated in a fashion that will facilitate identification of meritless complaints and discourage their consideration by consumers and others interested in the records of insurers.
(C)CA Insurance Code § 12921.1(a)(5)(C) Number and type of violations found, by reference to the line of insurance and the law violated. For the purposes of this subparagraph, the department shall separately report this information for health insurers.
(D)CA Insurance Code § 12921.1(a)(5)(D) Number and type of enforcement actions taken.
(E)CA Insurance Code § 12921.1(a)(5)(E) Ratio of complaints received to total policies in force, or premium dollars paid in a given line, or both. Private passenger automobile insurance ratios shall be calculated as the number of complaints received to total car years earned in the period studied.
(F)CA Insurance Code § 12921.1(a)(5)(F) Any other information the department deems is appropriate public information regarding the complaint record of the insurer that will assist the public in selecting an insurer. However, nothing in this section shall be construed to permit disclosure of information or documents in the possession of the department to the extent that the information and those documents are protected from disclosure under any other provision of law.
(6)CA Insurance Code § 12921.1(a)(6) Procedures and average processing times for each step of complaint mediation, investigation, and enforcement. These procedures shall be consistent with those in Article 6.5 (commencing with Section 790) of Chapter 1 of Part 2 of Division 1 for complaints within the purview of that article, consistent with those in Article 7 (commencing with Section 1858) of Chapter 9 of Part 2 of Division 1 for complaints within the purview of that article, and consistent with any other provisions of law requiring certain procedures to be followed by the department in investigating or prosecuting complaints against insurers or production agencies.
(7)CA Insurance Code § 12921.1(a)(7) A list of criteria to determine which violations should be pursued through enforcement action, and enforcement guidelines that set forth appropriate penalties for violations based on the nature, severity, and frequency of the violations.
(8)CA Insurance Code § 12921.1(a)(8) Referral of complaints not within the department’s jurisdiction to appropriate public and private agencies.
(9)CA Insurance Code § 12921.1(a)(9) Complaint handling goals that can be tested against surveys carried out pursuant to subdivision (a) of Section 12921.4.
(10)CA Insurance Code § 12921.1(a)(10) Inclusion in its annual report to the Governor, required by Section 12922, detailed information regarding the program required by this section, that shall include, but not be limited to: a description of the operation of the complaint handling process, listing civil, criminal, and administrative actions taken pursuant to complaints received; the percentage of the department’s personnel years devoted to the handling and resolution of complaints; and suggestions for legislation to improve the complaint handling apparatus and to increase the amount of enforcement action undertaken by the department pursuant to complaints if further enforcement is deemed necessary to ensure proper compliance by insurers or production agencies with the law.
(b)CA Insurance Code § 12921.1(b) The commissioner shall promulgate a regulation that sets forth the criteria that the department shall apply to determine if a complaint is deemed to be justified prior to the public release of a complaint against a specifically named insurer or production agency.
(c)CA Insurance Code § 12921.1(c) The commissioner shall provide to the insurer or production agency a description of any complaint against the insurer or production agency that the commissioner has received and has deemed to be justified at least 30 days prior to public release of a report summarizing the information required by this section. This description shall include all of the following:
(1)CA Insurance Code § 12921.1(c)(1) The name of the complainant.
(2)CA Insurance Code § 12921.1(c)(2) The date the complaint was filed.
(3)CA Insurance Code § 12921.1(c)(3) A succinct description of the facts of the complaint.
(4)CA Insurance Code § 12921.1(c)(4) A statement of the department’s rationale for determining that the complaint was justified that applies the department’s criteria to the facts of the complaint.
(d)CA Insurance Code § 12921.1(d) An insurer shall provide to the department the name, mailing address, telephone number, and facsimile number of a person whom the insurer designates as the recipient of all notices, correspondence, and other contacts from the department concerning complaints described in this section. The insurer may change the designation at any time by providing written notice to the Consumer Services Division of the department.
(e)CA Insurance Code § 12921.1(e) The commissioner may establish an Internet-accessible complaints response system to distribute and receive complaint information as described in subdivisions (a) and (c). Insurers shall be required to submit and receive complaint information, including, but not limited to, requested claim files, underwriting files, correspondence, and other supporting documents, using any system established by the commissioner pursuant to this subdivision.
(f)CA Insurance Code § 12921.1(f) For the purposes of this section, notices, correspondence, and other contacts with the designated person shall be deemed contact with the insurer.

Section § 12921.2

Explanation

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.

All public records of the department and the commissioner subject to disclosure under Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code shall be available for inspection and copying pursuant to those provisions at the offices of the department in the City of Oakland, the City of Los Angeles, and the City of Sacramento. Adequate copy facilities for this purpose shall be made available. Notwithstanding any other law, a person requesting copies of these records shall receive the copies from employees of the department and the fee charged for the copies shall not exceed the actual cost of producing the copies.

Section § 12921.3

Explanation

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.

(a)CA Insurance Code § 12921.3(a) The commissioner, in person or through employees of the department, shall receive complaints and inquiries, investigate complaints, prosecute insurers or production agencies when appropriate and according to guidelines determined pursuant to Section 12921.1, and respond to complaints and inquiries by members of the public concerning the handling of insurance claims, including, but not limited to, violations of Article 10 (commencing with Section 1861) of Chapter 9 of Part 2 of Division 1, by insurers or production agencies, or alleged misconduct by insurers or production agencies.
(b)CA Insurance Code § 12921.3(b) The commissioner shall not decline to investigate complaints for any of the following reasons:
(1)CA Insurance Code § 12921.3(b)(1) The insured is represented by an attorney in a dispute with an insurer, or is in mediation or arbitration.
(2)CA Insurance Code § 12921.3(b)(2) The insured has a civil action against an insurer.
(3)CA Insurance Code § 12921.3(b)(3) The complaint is from an attorney, if the complaint is based upon evidence or reasonable beliefs about violations of law known to an attorney because of a civil action.
(c)CA Insurance Code § 12921.3(c) The commissioner may defer the investigation until the finality of a dispute, mediation, arbitration, or civil action involving the claim is known.
(d)CA Insurance Code § 12921.3(d) The commissioner, as he or she deems appropriate, and pursuant to Section 12921.1, shall provide for the education of, and dissemination of information to, members of the general public or licensees of the department concerning insurance matters.

Section § 12921.4

Explanation

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.

(a)CA Insurance Code § 12921.4(a) The commissioner shall, upon receipt of a written complaint with respect to the handling of an insurance claim or other obligation under a policy by an insurer or production agency, or alleged misconduct by an insurer or production agency, notify the complainant of the receipt of the complaint within 10 working days of receipt. Thereafter, the commissioner shall notify the complainant of the final action taken on that complaint within 30 days of the final action.
The department shall include, with each notification of final action, or, at a minimum, with a number of randomly selected notifications of final action sufficient to assure the validity of results, a complaint handling evaluation form. This form shall clearly and concisely seek an evaluation of the department’s performance in handling the complainant’s grievance. The areas of evaluation shall include, but not be limited to: whether the complaint was handled in a fair and reasonable manner, evaluated thoroughly and without bias; the time required for resolution of the complaint; whether the complaint was referred and, if so, whether it was referred within a satisfactory time; whether the staff involved in handling the complaint demonstrated an adequate knowledge of the issues involved in the complaint; whether the complainant was satisfied with the result of the department’s intervention; and whether the complainant would recommend the department’s complaint handling services to others.
The commissioner shall, if deemed appropriate, notify insurers or production agencies against whom the complaint is made of the nature of the complaint, may request appropriate relief for the complainant, and may meet and confer with the complainant and the insurer in order to mediate the complaint. This section shall not be construed to give the commissioner power to adjudicate claims.
(b)CA Insurance Code § 12921.4(b) The commissioner shall ascertain patterns of complaints by insurer, geographic area, insurance line, type of violation, and any other valid basis the commissioner may deem appropriate for further investigation, and periodically evaluate the complaint patterns to determine additional audit, investigative, or enforcement actions which may be taken by the commissioner, and report on all actions taken with respect to those patterns of complaints in the commissioner’s annual report to the Governor pursuant to Section 12922, and to the public. For the purposes of this subdivision, complaints mean those written complaints received by the commissioner under subdivision (a), and written complaints received by the commissioner from any other sources, alleging misconduct or unlawful acts by insurers or production agencies.

Section § 12921.5

Explanation

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.

The commissioner may in person or through employees of the division meet with persons, organizations and associations interested in insurance for the purpose of securing cooperation in the enforcement of the insurance laws of this State and may disseminate information concerning the insurance laws of this State for the assistance and information of the public.

Section § 12921.6

Explanation

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.

(a)Copy CA Insurance Code § 12921.6(a)
(1)Copy CA Insurance Code § 12921.6(a)(1) If no fee is designated in this code for the review of filings required to be made pursuant to this code, the commissioner may establish a fee to permit the department to recover the actual cost of review of those filings. The fee so established shall not be increased by more than twenty-five dollars ($25), unless the increase is made by law.
(2)CA Insurance Code § 12921.6(a)(2) If this code designates a fee for any required filing, which fee the commissioner determines to be inadequate to cover the actual cost of review, the commissioner may assess an additional fee pursuant to this section not to exceed 25 percent of the fee designated by the code for the filing.
(3)CA Insurance Code § 12921.6(a)(3) Any person assessed a fee under this section shall be entitled, upon request, to receive reasonable substantiation from the department for the fee assessed, based upon the cost records of the department.
(4)CA Insurance Code § 12921.6(a)(4) As used in this section, “filings” means those items which the insurers are required to file with the department or commissioner pursuant to this code.
(b)CA Insurance Code § 12921.6(b) The fee provided for by this section shall be assessed without regard to the requirements of Section 12978 as to uniformity of increase, but shall be based upon the actual cost to the department for the review of the filing.
(c)CA Insurance Code § 12921.6(c) As used in this section, “person” means any person or entity subject to examination by the commissioner, or purporting to do insurance business in this state, or in the process of organization with intent to do insurance business in this state, or from whom the commissioner’s certificate of authority is required for the transaction of business, or whose certificate of authority is revoked or suspended.

Section § 12921.7

Explanation

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.

Notwithstanding any other provision of law, the following shall apply to the adoption by the commissioner of any regulation as an emergency regulation pursuant to subdivision (b) of Section 11346.1 of the Government Code.
(a)CA Insurance Code § 12921.7(a) At least 5 working days prior to submission of the emergency regulation to the Office of Administrative Law, the commissioner shall mail a notice of proposed emergency action to every person, group, or association who had previously filed a request for notice of regulatory actions with the commissioner.
(b)CA Insurance Code § 12921.7(b) The notice of proposed emergency action shall include the following:
(1)CA Insurance Code § 12921.7(b)(1) A description of the problem and the necessity for the regulation.
(2)CA Insurance Code § 12921.7(b)(2) A description of the justification for adoption of the regulation as an emergency regulation.
(3)CA Insurance Code § 12921.7(b)(3) A copy of the text of the proposed emergency regulation.

Section § 12921.8

Explanation

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.

(a)CA Insurance Code § 12921.8(a) The commissioner may do the following:
(1)CA Insurance Code § 12921.8(a)(1) Issue a cease and desist order to a person who has acted in a capacity for which a license, registration, or certificate of authority from the commissioner was required but not possessed.
(2)CA Insurance Code § 12921.8(a)(2) Issue a cease and desist order to a person who has aided or abetted a person described in paragraph (1).
(3)CA Insurance Code § 12921.8(a)(3) Impose a monetary penalty, pursuant to an order to show cause, on a person described in paragraph (1) or (2). The monetary penalty shall be the greater of the following:
(A)CA Insurance Code § 12921.8(a)(3)(A) Five times the amount of money received by the person for acting in the capacity for which the license, registration, or certificate of authority was required but not possessed.
(B)CA Insurance Code § 12921.8(a)(3)(B) Five thousand dollars ($5,000) for each day the person acted in the capacity for which the license, registration, or certificate of authority was required but not possessed. In the absence of contrary evidence, it shall be presumed that a person continuously acted in a capacity for which a license, registration, or certificate of authority was required on each day from the date of the earliest such act until the date those acts were discontinued, as proven by the person at a hearing.
(b)CA Insurance Code § 12921.8(b) A person to whom a cease and desist order or order to show cause has been issued, may, within seven days after service of the order, if a hearing has not already been scheduled by the commissioner, request a hearing by filing a request for the hearing with the commissioner. The hearing shall be conducted in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340), Chapter 4 (commencing with Section 11370), Chapter 4.5 (commencing with Section 11400), and Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code), and the commissioner shall have all the powers granted therein.
(c)CA Insurance Code § 12921.8(c) A person who has a hearing pursuant to subdivision (b) shall be entitled to have the proceedings and the order of the commissioner reviewed by means of any remedy provided by the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340), Chapter 4 (commencing with Section 11370), Chapter 4.5 (commencing with Section 11400), and Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code).

Section § 12921.9

Explanation

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.

(a)CA Insurance Code § 12921.9(a) A letter or legal opinion signed by the Commissioner or the Chief Counsel of the Department of Insurance that was prepared in response to an inquiry from an insured or other person or entity and that discusses either generally or in connection with a specific fact situation the application of the Insurance Code or regulations promulgated by the commissioner shall be made public. The department may redact the name, address, policy number, and other identifying information regarding a particular insured or other person or entity from the letter or legal opinion when it is made public.
(b)CA Insurance Code § 12921.9(b) A letter or legal opinion made public pursuant to this section shall not be construed as establishing an agency guideline, criterion, bulletin, manual, instruction, order, standard of general application, rule, or regulation, as those terms are described in Sections 11340.5 and 11342.600 of the Government Code.

Section § 12921.15

Explanation

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.

(a)CA Insurance Code § 12921.15(a) On or before July 1, 1999, the commissioner shall prepare a written report, to be made available by the department to interested individuals upon written request, that details complaint and enforcement information on individual insurers in accordance with guidelines established under paragraph (5) of subdivision (a) of Section 12921.1. The report shall be made available by mail through the department’s consumer toll-free telephone number and through the department’s Internet website and transmitted via electronic mail if the individual has the ability to obtain the report in this manner. No complaint information shall be included in the report required by this section that has not been provided to the insurer in accordance with subdivision (c) of Section 12921.1
(b)CA Insurance Code § 12921.15(b) The commissioner may also, if deemed appropriate, publish the record of complaints against the production agency that have been determined by the department to be justified and that will assist the public in selecting a production agency. No complaint data shall be published that has not been provided to the production agency in accordance with subdivision (c) of Section 12921.1.

Section § 12922

Explanation

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.

The commissioner shall, on or before the first day of August in each year, make a report to the Governor, the Legislature, and to the committees of the Senate and Assembly having jurisdiction over insurance containing a tabular statement and synopsis of the reports which have been filed in the commissioner’s office and showing, generally, the condition of the insurance business and interests in this state, and other matters concerning insurance. The report shall also contain a detailed verified statement, of the moneys and fees of office received by the commissioner, and for what purpose.

Section § 12922.5

Explanation

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.

(a)CA Insurance Code § 12922.5(a) The commissioner shall convene a working group to identify, assess, and recommend risk transfer market mechanisms that:
(1)CA Insurance Code § 12922.5(a)(1) Promote investment in natural infrastructure to reduce the risks of climate change related to catastrophic events.
(2)CA Insurance Code § 12922.5(a)(2) Create incentives for investment in natural infrastructure to reduce risks to communities.
(3)CA Insurance Code § 12922.5(a)(3) Provide mitigation incentives for private investment in natural lands to lessen exposure and reduce climate risks to public safety, property, utilities, and infrastructure.
(b)CA Insurance Code § 12922.5(b) To the extent that the working group recommends risk transfer market mechanisms that would be provided by insurance and reinsurance companies, the working group shall recommend mechanisms that:
(1)CA Insurance Code § 12922.5(b)(1) Are profitable to insurance and reinsurance companies.
(2)CA Insurance Code § 12922.5(b)(2) If appropriate, apply to communities or regions, rather than individual land parcels.
(c)CA Insurance Code § 12922.5(c) The policies recommended pursuant to subdivisions (a) and (b) shall include all of the following questions:
(1)CA Insurance Code § 12922.5(c)(1) What are the California analogies to examples in other countries for creating incentives for investment in natural infrastructure as part of insurance policies that mitigate elemental risks?
(2)CA Insurance Code § 12922.5(c)(2) Can we use insurance to create incentives for wetland restoration to help defend the coast against storm surge?
(3)CA Insurance Code § 12922.5(c)(3) Can we create incentives for forests to be managed to reduce the risk of major fires?
(4)CA Insurance Code § 12922.5(c)(4) Can we reduce the exposure of insurance companies to climate change-related losses through innovative state policies or insurance pricing mechanisms that reward good behavior and charge premiums for actions that increase public safety risks or losses of property or environmental attributes?
(5)CA Insurance Code § 12922.5(c)(5) Can we develop rating systems based on community risk factors to climate events, and use insurance incentives to make a community more resilient?

Section § 12923

Explanation

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.

(a)CA Insurance Code § 12923(a) With respect to all classes of insurance (1) to (20), inclusive, as defined in Sections 101 to 120, inclusive, “actuary,” for the purposes of this section, means either of the following:
(1)CA Insurance Code § 12923(a)(1) A member of the American Academy of Actuaries.
(2)CA Insurance Code § 12923(a)(2) An individual who has demonstrated by training and experience actuarial competence to the satisfaction of the Insurance Commissioner.
(b)CA Insurance Code § 12923(b) The commissioner shall, after notice and hearing, pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, promulgate reasonable rules and regulations which do all of the following:
(1)CA Insurance Code § 12923(b)(1) Describe the documents which must be signed by an actuary when the documents are filed with the commissioner.
(2)CA Insurance Code § 12923(b)(2) Implement paragraph (2) of subdivision (a).

Section § 12923.5

Explanation

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.

(a)CA Insurance Code § 12923.5(a) The Department of Managed Health Care and the Department of Insurance shall maintain a joint senior level working group to ensure clarity for health care consumers about who enforces their patient rights and consistency in the regulations of these departments.
(b)CA Insurance Code § 12923.5(b) The joint working group shall undertake a review and examination of the Health and Safety Code, the Insurance Code, and the Welfare and Institutions Code as they apply to the Department of Managed Health Care and the Department of Insurance to ensure consistency in consumer protection.
(c)CA Insurance Code § 12923.5(c) The joint working group shall review and examine all of the following processes in each department:
(1)CA Insurance Code § 12923.5(c)(1) Grievance and consumer complaint processes, including, but not limited to, outreach, standard complaints, including coverage and medical necessity complaints, independent medical review, and information developed for consumer use.
(2)CA Insurance Code § 12923.5(c)(2) The processes used to ensure enforcement of the law, including, but not limited to, the medical survey and audit process in the Health and Safety Code and market conduct exams in the Insurance Code.
(3)CA Insurance Code § 12923.5(c)(3) The processes for regulating the timely payment of claims.
(d)CA Insurance Code § 12923.5(d) The joint working group shall report its findings to the Insurance Commissioner and the Director of the Department of Managed Health Care for review and approval. The commissioner and the director shall submit the approved final report under signature to the Legislature by January 1 of every year for five years.

Section § 12924

Explanation

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.

(a)CA Insurance Code § 12924(a) The commissioner may issue subpoenas and subpoenas duces tecum for witnesses to attend, testify, and produce documents before the commissioner, on any subject touching insurance business, or in aid of the commissioner’s duties. This process may be served, obeyed, and enforced as provided in the Code of Civil Procedure for civil cases. A defaulting witness may, upon application by the commissioner to the superior court, be required by order of the court to appear before the commissioner to testify as the court may order. The court may punish disobedience of its order as a contempt of court.
All the provisions of the Code of Civil Procedure relating to means of production of evidence shall be applicable to any hearing or investigation under this section. The provisions of this subdivision shall not apply to proceedings required by other provisions of this code to be conducted in accordance with Chapter 5 (commencing with Section 11500), Part 1, Division 3, Title 2 of the Government Code.
(b)CA Insurance Code § 12924(b) A person shall not be excused from testifying or from producing any book, document, or other thing under the person’s control upon any hearing or investigation on the ground that the person’s testimony, or the book, document, or other thing required, may tend to incriminate the person, or may have a tendency to subject the person to punishment for a felony or misdemeanor; but no individual shall be prosecuted or be subjected to punishment for a felony or misdemeanor for or on account of any act, transaction, matter, or thing concerning which that individual is so compelled, after validly claiming the privilege against self-incrimination, to testify or produce, except for perjury or contempt committed in that testimony.

Section § 12925

Explanation

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.

The commissioner shall keep and preserve in a permanent form a full record of the commissioner’s proceedings, including a concise statement of the condition of each insurer, surplus line broker, or motor club examined as to their condition and affairs.

Section § 12926

Explanation

This law requires the insurance commissioner to ensure that all insurance companies fully comply with every aspect of the insurance code.

The commissioner shall require from every insurer a full compliance with all the provisions of this code.

Section § 12926.1

Explanation

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.

(a)CA Insurance Code § 12926.1(a) In any matter involving compliance with or enforcement of any of the provisions of this code or the other laws of this state involving any entity subject to the jurisdiction or authority of the commissioner, whether the matter is a formal administrative accusation or adjudication, a formal or potential judicial action, or other enforcement tool, and whether or not the matter is settled or prosecuted to resolution, the use of any funds that are imposed as fines or penalties of any sort, or collected by means of settlement, or paid or reserved in any manner as a result of the action, shall be subject to the limitations of this section.
(b)CA Insurance Code § 12926.1(b) Fines, penalties, fees, and costs shall be deposited in the appropriate fund as provided by law.
(c)CA Insurance Code § 12926.1(c) Any funds ordered, or allocated by a settlement, to be used for public outreach of any sort, shall be subject to all of the following limitations:
(1)CA Insurance Code § 12926.1(c)(1) The commissioner’s name, likeness, or voice shall not be used in any printed, audio, or visual material that is released either for general distribution or to specific recipients unless a court finds good cause to do so.
(2)CA Insurance Code § 12926.1(c)(2) The message shall be limited to information relevant to the enforcement action or compliance issues that generated the funds.
(3)CA Insurance Code § 12926.1(c)(3) The primary focus of any public outreach where the purpose is to advise members of the public of rights affecting pecuniary or property interests shall be to provide specific information needed by the affected persons to obtain or protect those rights.
(4)CA Insurance Code § 12926.1(c)(4) No funds subject to this subdivision shall be used for general education of the public about insurance issues, except to the extent that the education relates to the type of violations that caused the enforcement or compliance action, and otherwise complies with the limitations of this section.
(5)CA Insurance Code § 12926.1(c)(5) No funds subject to this subdivision shall be spent or otherwise disposed of unless the expenditure or disposal has been approved by a court of competent jurisdiction.
(d)Copy CA Insurance Code § 12926.1(d)
(1)Copy CA Insurance Code § 12926.1(d)(1) This section may be enforced by an affected individual with an interest in the matter or a policyholder of an insurer that is a party to a settlement with the department, a city attorney, a district attorney, or the Attorney General, who may bring an action against the commissioner in the superior court in any county where a violation of this section has occurred.
(2)CA Insurance Code § 12926.1(d)(2) A court may issue injunctions or provide other equitable remedies as appear to the court to be appropriate, and shall order payment by the commissioner from nonpublic funds to a prevailing party who has brought an action under this section of an amount sufficient to compensate the party for all attorneys’ fees, costs of litigation, and expenses incurred in bringing and prosecuting the action. For the purposes of this section, “nonpublic funds” does not include assets of an insurer or other party to a settlement that are not part of a valid and voluntary settlement with the department or commissioner.
(e)CA Insurance Code § 12926.1(e) The commissioner may not increase fees or assessments against insurers in order to comply with this section.

Section § 12926.2

Explanation

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.

(a)CA Insurance Code § 12926.2(a) As used in this section, “extraordinary circumstances” means circumstances outside of the control of a licensee that severely and materially affect the licensee’s ability to conduct normal business operations.
(b)CA Insurance Code § 12926.2(b) In determining noncompliance with this code and regulations adopted pursuant to this code, and appropriate penalties, if any, the commissioner may consider evidence concerning the existence of extraordinary circumstances.
(c)CA Insurance Code § 12926.2(c) A settlement agreement between the commissioner and an insurer may not contain a provision referencing the existence of extraordinary circumstances relative to the subject matter at issue, unless the agreement specifies the precise period of time during which extraordinary circumstances were in existence. Except as provided in subdivision (d), extraordinary circumstances may not be stated to exist for a duration of more than six months.
(d)CA Insurance Code § 12926.2(d) A settlement agreement may concede the existence of extraordinary circumstances for a period of time exceeding six months if all of the following conditions are met:
(1)CA Insurance Code § 12926.2(d)(1) The commissioner makes a finding in the agreement that extraordinary circumstances existed for more than six months, and documents in that finding facts supporting that conclusion.
(2)CA Insurance Code § 12926.2(d)(2) The finding identifies the public purpose justifying the extension of extraordinary circumstances beyond the six-month period.
(3)CA Insurance Code § 12926.2(d)(3) The beginning and ending date, by month and year, of the commencement and termination of the extraordinary circumstances are identified.

Section § 12927

Explanation

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.

All statements, estimates, percentages, payments, and calculations, required by this code to be made, either by the commissioner or insurers, shall be made on the basis of lawful money of the United States.

Section § 12928

Explanation

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.

Whenever the commissioner ascertains that any insurer or any of its agents, officers or employees or any other person is guilty of violating any of the penal provisions of this code or of other laws he shall certify the facts of the violation to the district attorney of the county in which such offense was committed.

Section § 12928.5

Explanation

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.

Whenever facts exist by reason of which, under any provision of this code, or other laws the commissioner may suspend, revoke, or deny any license or certificate of authority granted under any provision of this code, if the making or maintenance in force of a contract of insurance is one of the circumstances out of which facts arise, or, if, by reason of the existence of those facts, or in connection therewith a contract of insurance is made or maintained in force, the commissioner may, in lieu of or in addition to, the suspension, revocation, or denial of license or certificate, by order require the immediate cancellation of the contract, unless the contract, by its terms, is not subject to cancellation by the insurer and the insured did not knowingly participate in the wrongful acts.
The commissioner may also notify the insured, stating the reason why the cancellation was required.
In such a case, whether or not the particular contract is thus required to be canceled or is subject to cancellation, the commissioner may order the insurer, insurance agent, broker, solicitor, surplus line broker, or life agent soliciting, negotiating, or effecting the insurance to refrain from effecting insurance upon the property, risk, or insured under the contract for not exceeding five years from the date of the order.
The commissioner may suspend or revoke, or deny an application for, any license or certificate of authority granted under any provision of this code to any applicant or licensee violating any order issued by the commissioner pursuant to this section.

Section § 12928.6

Explanation

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.

(a)CA Insurance Code § 12928.6(a) Whenever the commissioner believes, from evidence satisfactory to the commissioner, that a person is violating or about to violate this code or an order or requirement of the commissioner issued or promulgated pursuant to authority expressly granted the commissioner by this code or by law, the commissioner may bring an action in the name of the people of the State of California in the superior court of the State of California against the person to enjoin that person from continuing the violation or engaging therein or doing any act in furtherance thereof. In that action, an order or judgment may be entered awarding the preliminary or final injunction as is proper.
(b)Copy CA Insurance Code § 12928.6(b)
(1)Copy CA Insurance Code § 12928.6(b)(1) The commissioner may apply to the clerk of the superior court for a judgment to enforce an order requiring a person to pay restitution, a monetary penalty, or reimburse the department for costs incurred by the department in prosecuting a matter. The commissioner’s application shall include a certified copy of the order and any associated decision.
(2)CA Insurance Code § 12928.6(b)(2) Subject to the requirements of paragraph (3), the order and decision shall constitute a sufficient showing to warrant issuance of a judgment in the amount ordered by the commissioner, plus interest. The clerk of the court shall accordingly enter a judgment within five court days.
(3)CA Insurance Code § 12928.6(b)(3) For an order to qualify for a judgment pursuant to this section, the application shall be accompanied by a declaration given by the legal counsel for the commissioner affirming on information and belief that a petition for mandamus or other legal action for relief from the order has either been denied, or the time for the filing of a petition or action has lapsed.
(4)CA Insurance Code § 12928.6(b)(4) A judgment entered under this section has the same force and effect as, and is subject to all the laws relating to, a judgment in a civil action, and may be enforced in the same manner as any other judgment of the court in which it is entered.

Section § 12928.7

Explanation

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.

(a)CA Insurance Code § 12928.7(a) The commissioner may order a respondent to provide restitution for a loss arising from the respondent’s conduct. If the facts and equity permit, with a restitution order, the commissioner may issue an order of rescission enforceable on any person subject to the commissioner’s jurisdiction.
(b)CA Insurance Code § 12928.7(b) A restitution order under this section shall meet all of the following requirements:
(1)CA Insurance Code § 12928.7(b)(1) The respondent shall be subject to the commissioner’s jurisdiction.
(2)CA Insurance Code § 12928.7(b)(2) The restitution order shall be ancillary to another proceeding authorized by this code in which the commissioner does both of the following:
(A)CA Insurance Code § 12928.7(b)(2)(A) Determines the respondent violated this code or the standards of conduct applicable to persons acting in the capacity the respondent was acting in or purporting to act in when the loss occurred.
(B)CA Insurance Code § 12928.7(b)(2)(B) Issues an order imposing a cease and desist order, an order for a monetary penalty, or another sanction with respect to the respondent’s conduct.
(3)CA Insurance Code § 12928.7(b)(3) The restitution order shall cite the factual basis for the restitution order.
(4)CA Insurance Code § 12928.7(b)(4) The restitution order shall state the persons, or classes of persons, who suffered a loss.
(5)CA Insurance Code § 12928.7(b)(5) The restitution order shall state the amount to be paid or property to be returned as restitution.
(c)CA Insurance Code § 12928.7(c) A rescission or restitution order shall be subject to judicial review in the same manner and at the same time as the order to which it is ancillary.
(d)CA Insurance Code § 12928.7(d) A rescission or restitution order may be judicially enforced in an action brought by the commissioner, the Attorney General, a district attorney, a city attorney, or any person owed restitution pursuant to the order. In that action, the court may award attorney’s fees and court costs to a prevailing plaintiff.
(e)CA Insurance Code § 12928.7(e) This section does not apply to an insurer authorized to transact business in this state or to a placement of insurance with an insurer that was in compliance with Section 1765.1 or 1765.2 at the time of the placement. This section does not apply to a person with respect to acts within the scope of a license issued under Chapter 5 (commencing with Section 1621), Chapter 5A (commencing with Section 1759), or Chapter 6 (commencing with Section 1760) of Part 2 if the person holds that license at the time of those acts or at the time an initial pleading seeking restitution is issued.
(f)CA Insurance Code § 12928.7(f) The commissioner may order a respondent who is ordered to provide restitution pursuant to this section to reimburse the commissioner for the commissioner’s costs of implementing and enforcing this section, including attorney’s fees. The commissioner shall not credit any funds received from a respondent towards payment of a monetary penalty until restitution has been tendered to all persons to whom restitution is owed, or to the commissioner on their behalf, as required by a restitution order.
(g)CA Insurance Code § 12928.7(g) This section does not limit or restrict actions, remedies, or procedures otherwise available to the commissioner, the department, or any person pursuant to an administrative or civil action to enforce any law. It is not a defense in an administrative or civil action that the commissioner did not order a person to pay restitution.
(h)CA Insurance Code § 12928.7(h) This section does not expand, limit, or otherwise affect the commissioner’s authority to seek or to have sought restitution, refunds, or penalties against insurers, except as expressly provided.
(i)CA Insurance Code § 12928.7(i) As used in this section, “restitution” means the full amount that will compensate each person for their direct and indirect financial and nonfinancial losses proximately caused by the respondent’s violations.
(j)CA Insurance Code § 12928.7(j) Money received by the commissioner for distribution to persons as restitution pursuant to this section or Section 12928.6 or 12976 shall be deposited into the Insurance Fund.

Section § 12929

Explanation

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.

Irrespective of any provision in any law of this state the commissioner, pursuant to this code, has been and is authorized to correct: by amendment, by partial deletion, or by partial addition, any record, finding, determination, order, rule, or regulation made by the commissioner upon becoming satisfied that it is fair, just, and equitable to make the correction and that any record, finding, determination, order, rule, or regulation would have included the correction except for mistake, clerical error, inadvertence, surprise, or excusable neglect.
The correction shall only be made within a period of six months following the original action.
When the facts are within the commissioner’s personal knowledge, the commissioner may, upon the commissioner’s own motion and ex parte, enter an order making the correction.
Otherwise the commissioner shall enter an order of correction only after receipt and consideration of a written petition of a person described in Section 12923 or an employee of the Department of Insurance, accompanied in either case by a sworn affidavit of the facts constituting the mistake, clerical error, inadvertence, surprise, or excusable neglect relied upon to justify the correction requested. In such case the order may be made ex parte.
In either case the order shall recite the grounds and bases for the correction and shall be promptly given the same distribution, publicity, and circulation as was given the matter being corrected.
If, within 60 days following the making of the order of correction anyone objects thereto in writing, the commissioner shall set the matter for hearing, giving the same notice thereof, if any, as was given to the proceeding which gave rise to the original record, finding, determination, order, rule, or regulation.

Section § 12930

Explanation

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.

Offenses under this code, or under other laws relating to insurers, shall be prosecuted and tried in all respects as provided in the Penal Code for public offenses. For the purpose of evidence the commissioner shall furnish to any district attorney, without cost to the county, certified copies of any papers or records of the office of the commissioner.

Section § 12931

Explanation

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.

(a)CA Insurance Code § 12931(a) Service of legal process, notices, or other papers described in or referred to by Section 1452, 1605, 1610, 1612, 11104, or 11105 may be made upon the commissioner in the instances enumerated in this section and under the circumstances prescribed in this section by delivering to the commissioner, the commissioner’s deputy, or the commissioner’s designated agent for service of process two copies thereof for each person or party defendant so served accompanied by payment of a substituted service fee as determined pursuant to Section 12978 for each person or party, and by complying with the other provisions of this section.
(b)CA Insurance Code § 12931(b) The situations under which such service may be so made and the circumstances under which these provisions apply are:
(1)CA Insurance Code § 12931(b)(1) Where for any reason the person desiring to have service so made elects to serve the commissioner instead of the attorney in fact, as stipulated pursuant to Section 1323, of a reciprocal or interinsurance exchange, domestic, foreign, admitted, or nonadmitted.
(2)CA Insurance Code § 12931(b)(2) Where service is to be made on an admitted foreign or alien insurer, when service cannot be made on the principal statutory agent of such insurer duly appointed pursuant to Article 3 (commencing with Section 1600) of Chapter 4 of Part 2 of Division 1 for reasons specified in Section 1604 or otherwise recognized by law.
(3)CA Insurance Code § 12931(b)(3) In actions against nonadmitted insurers, including nonadmitted fraternal benefit societies and reciprocals, under the circumstances described in Article 4 (commencing with Section 1610) of Chapter 4 of Part 2 of Division 1. This provision shall not apply to actions brought under insurance policies or certificates issued by nonadmitted insurers placed by surplus line brokers or special lines surplus line brokers where such insurance contract names a resident of this state as agent for service of process.
(4)CA Insurance Code § 12931(b)(4) In actions involving admitted and formerly admitted fraternal benefit societies as described in Section 11104.
(c)CA Insurance Code § 12931(c) Upon receipt of two copies of the process, notice, or papers to be served and the fee above prescribed, the commissioner shall promptly mail one of the copies by certified mail (or by registered mail if it is addressed to an area outside of the United States where certified mail service is not available) to the defendant or person to be served at the last principal place of business of the defendant or person to be served, known to the commissioner by the commissioner’s official records in the case of a licensee; otherwise, in the case of a nonadmitted insurer, to its last principal place of business known to the commissioner from national directories or reference books or other reliable information available in the commissioner’s office. The commissioner shall keep a record of all services made upon the commissioner pursuant to this section. The other copy of the process, notice, or papers shall be retained among the commissioner’s official public records for a period not to exceed two years, absent special circumstances which in the commissioner’s judgment compel longer retention.
(d)CA Insurance Code § 12931(d) Service made in the manner provided for in this section is valid and sufficient and gives jurisdiction over the person of a nonadmitted or unauthorized defendant, provided notice of such service and a copy of the process, notice, or papers being served are sent within 10 days thereafter by certified mail (or by registered mail if it is addressed to an area outside of the United States where certified mail service is not available) by plaintiff or plaintiff’s attorney to the defendant at its last known principal place of business, and the receipt or the receipt of defendant’s agent for such copy, showing the name of the sender and the name and address of the addressee-defendant thereon, and the affidavit of plaintiff or plaintiff’s attorney showing compliance with this section, are filed with the clerk of the court in which such action is pending on or before the date the defendant is required to appear, or within further time as the court may allow.
In case of service made pursuant to this section upon a licensee of the commissioner required by law to keep the licensee’s current business address or that of its agent for service of process on file with the commissioner, the service shall be valid if the commissioner mailed, postage prepaid, a copy of the process, notice, or papers to the defendant or licensee intended to be served to the licensee’s current address as shown by the commissioner’s records, or, in the case of an insurer, to its manager, president, or secretary, and an affidavit of compliance by plaintiff or plaintiff’s attorney at law is made and filed at the place and within the time mentioned in this subdivision.
(e)CA Insurance Code § 12931(e) A plaintiff or complainant shall not be entitled to a judgment by default in any action, suit, or proceeding in which service of process is effected in the manner provided in this section until the expiration of 30 days from the date on which the affidavit of compliance is filed.
(f)CA Insurance Code § 12931(f) This section does not limit or abridge the right to serve any process, notice, papers, or demand upon any insurer in any other manner now or hereafter permitted by law.

Section § 12935

Explanation

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.

(a)CA Insurance Code § 12935(a) The commissioner, by January 1, 1997, shall develop and make available to the general public, in the two most common non-English languages spoken in the state, which are Spanish and Vietnamese, informational sheets that provide a general explanation in those languages, of the terms most commonly used in passenger automobile and pickup truck liability insurance policies.
(b)CA Insurance Code § 12935(b) These informational sheets are intended to provide only the general explanation of these insurance terms, and in the case of a dispute between an insurer and an insured, the policy as written in English will prevail. The development of informational sheets or the use of these informational sheets by insureds, insurers, agents, brokers, or the state shall not be interpreted as creating a duty or obligation to provide additional information or insurance policies in a non-English language.
(c)CA Insurance Code § 12935(c) An informational sheet developed by the commissioner shall include a disclaimer, prominently displayed in 24-point type print at the beginning of the informational sheet, in the non-English language, that contains all of the following information:
(1)CA Insurance Code § 12935(c)(1) The informational sheet is for informational purposes only.
(2)CA Insurance Code § 12935(c)(2) The actual terms of an insurance policy prevail over the information provided in the informational sheet.
(3)CA Insurance Code § 12935(c)(3) In the case of a dispute, the insurance policy is controlling and a court will rely on the policy as it is written in English to resolve the dispute.
(4)CA Insurance Code § 12935(c)(4) The policy is the sole source of rights and obligations of the insurer and the insured.
(5)CA Insurance Code § 12935(c)(5) The information contained in the informational sheets does not create rights or obligations on the part of the insured, the insurer, the agent, the broker, or the state.
(6)CA Insurance Code § 12935(c)(6) The informational sheet is not intended to be a substitute for the actual policy written in English.
(d)CA Insurance Code § 12935(d) The commissioner may develop informational sheets regarding other forms of insurance.
(e)CA Insurance Code § 12935(e) The commissioner may develop informational sheets in foreign languages, other than Spanish and Vietnamese, as needed.
(f)CA Insurance Code § 12935(f) Once developed by the commissioner, he or she may produce public service announcements concerning the availability of these informational sheets, to be utilized in those communities that the commissioner deems would benefit from the information.
(g)CA Insurance Code § 12935(g) This section does not prevent an insurer or licensee from advertising an insurance policy, or the availability of a foreign language informational sheet, or the availability of a translation of an insurance policy, in a language other than English if the advertisement clearly states that the insurance policy is only available in English. However, in the case of a dispute, the insurance policy is controlling and any of those advertisements for insurance policies, informational sheets, or translations shall not be construed to modify or change the insurance policy.

Section § 12936

Explanation

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.

(a)Copy CA Insurance Code § 12936(a)
(1)Copy CA Insurance Code § 12936(a)(1) Escheated funds deposited in the Insurance Fund pursuant to subdivision (a) of Section 1523 of the Code of Civil Procedure shall be transferred to the General Fund on June 30, 1998, to repay the principal and interest on the General Fund loan provided pursuant to Item 0845-001-0001 of the Budget Act of 1996, and such funds are hereby continuously appropriated for that purpose.
(2)CA Insurance Code § 12936(a)(2) If the Director of Finance determines that funds subject to escheat for the 1997–98 fiscal year are insufficient to repay the General Fund loan plus the interest owed, funds subject to escheat in the 1998–99 fiscal year, up to the amount necessary to repay the General Fund loan plus the interest owed, shall be available for expenditure by the commissioner to repay the principal and interest on the General Fund loan. Notwithstanding the loan repayment date specified in Item 0845-001-0001 of the Budget Act of 1996, such a determination by the Director of Finance shall trigger an extension of the loan repayment date to June 30, 1999.
(b)CA Insurance Code § 12936(b) A policyholder who was entitled to a rebate pursuant to settlement or order of the commissioner and who has not received the escheated rebate may submit a claim to the Controller. The Controller shall pay the claim from among the Proposition 103 refunds that have escheated to the state and been deposited in the Unclaimed Property Fund upon verification that the claim is valid.

Section § 12937

Explanation

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.

(a)CA Insurance Code § 12937(a) Escheated funds deposited in the Insurance Fund pursuant to subdivision (b) of Section 1517 of the Code of Civil Procedure shall be available for expenditure by the commissioner to fund proceedings and to pay expenses on nonasseted estates for which liabilities have been or will be incurred.
(b)CA Insurance Code § 12937(b) A policyholder who was entitled to funds described in subdivision (a) pursuant to an order of distribution and who has not previously received an appropriate distribution may submit a claim to the commissioner. The commissioner shall pay the claim from the escheated funds deposited in the Insurance Fund pursuant to subdivision (a) upon verification that the claim is valid.
(c)CA Insurance Code § 12937(c) The department shall not be required to conduct outreach programs to attempt to locate policyholders described in subdivision (b).

Section § 12938

Explanation

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.

Notwithstanding any other provision of law, the department shall make available for public inspection and publish on its Internet Web site all of the information described in subdivisions (a) and (b). This information shall be maintained in a current, up-to-date condition. All identifying and privileged information regarding individual policyholders shall be redacted from documents available for public inspection and on the Internet Web site.
(a)CA Insurance Code § 12938(a) All fully executed stipulations, orders, decisions, settlements, or other forms of agreement resolving market conduct examinations, whether the examinations were finalized, terminated, or suspended, that pertain to unfair or deceptive practices in the business of insurance as defined in Section 790.03.
(b)Copy CA Insurance Code § 12938(b)
(1)Copy CA Insurance Code § 12938(b)(1) Every adopted report of a market conduct examination of unfair or deceptive practices in the business of insurance as defined in Section 790.03 that is adopted as filed, or as modified or corrected, by the commissioner pursuant to Section 734.1.
(2)CA Insurance Code § 12938(b)(2) The commissioner upon adopting the report shall transmit a copy of the report, either electronically or by certified United States mail, to a representative that the examined insurer designated by that insurer to receive the report, or in the case of an examination of more than one insurer in an insurer group, to a single representative of the group designated to receive the report on behalf of all examined insurers. Within 20 business days after the transmittal, the examined insurer may submit comments to the commissioner relating to the adopted report. The comments shall be in a form and length as provided by regulation.
(3)CA Insurance Code § 12938(b)(3) Twenty business days after the transmittal the commissioner shall publish on the department’s Internet Web site the adopted report and any comments submitted by the examined insurer unless a court of competent jurisdiction has stayed the publication of the report.
(c)CA Insurance Code § 12938(c) This section may not be construed to require the disclosure of company workpapers or other company documents discovered during the course of an examination or any preliminary report of the examination, except as otherwise permitted by law.