In California, insurance consumers have a right to their claims file when dealing with a loss and encounter issues during the claims process after a loss. As an attorney, most insureds do not contact me until after something has gone wrong or there have been substantial delays in their claims process causing a lack of or minimal payment of policy premiums. However, when I speak to an insured, they are surprised to find out that under the California Insurance Code, they have a right to review everything within their claims file. Although an insurer will “notify every claimant that they may obtain, upon request, copies of claim-related documents…” insureds do not realize that the claims file is the insurance company’s record and documentation regarding how the file is progressing.
Under the insurance code, this means that insureds have a right to construction estimates, photographs and the documentation backing up their estimates and “all other valuation” that the insurance company is using to evaluate and pay the claim. During the claims process, insureds are often asked for recorded statements and before an examination under oath is taken, insurers and their attorneys are reluctant to provide a copy of the recorded statement. However, unless that recorded statement is actually attorney-client privileged (which means that the insurer is working under the advisement or direction of their attorneys) that the recorded statement should be provided to the insured pre- examination under oath.
If you are an insured, whether a homeowner or a corporation who suffers a loss and there are questions regarding how the insurance company is handling your claim, it’s a very good idea to assert your rights under California Insurance Code 2071 and obtain a copy of your entire claims file. It’s not only allowed, it’s the right of the insured to have these materials and a review of these materials, reveals if the insureds’ claim is properly handled and evaluated. It’s rare that an insured requests these documents and even realizes that the whole claims file is available for review and that if it is obtained, can help insureds guide themselves and their attorneys through the claims process because it demonstrates how a claim is proceeding. If documents are withheld when an Insurance Code 2071 request is made, it is pertinent to inquire whether or not those withheld documents, such as a recorded statement transcript, are being withheld due to the attorney-client privilege. Such assertion allows the insured to know that an attorney for the insurer is already involved and that seeking legal help of their own may be the best way to forward their own claim.
California is one of those states that affords consumers generous rights. In the world of insurance, where a simple property claim is not so simple, knowing and asserting the rights provided by the Insurance Code can make a difference whether or not a claim is paid or if problems in your claim exist to indicate that help is needed.