In this installment of Know the Regs to Use the Regs, we examine additional excerpts from the California Code of Regulations’ Fair Claims Settlement Practices, Sections 2695.4 and 2695. To read more about California Code of Regulations 2695.7 in a past blog, click here, and for California Code of Regulations 2695.9, click here.
Continue Reading Know the Regs to Use the Regs – a look at California Fair Claims Settlement Practices Regulations (10 CCR 2695.4 and 10 CCR 2695.5)

This blog follows up last month’s “Know the Regs to Use the Regs” on 10 CCR 2695.9. The purpose is the same – one of the most impactful, if not the most impactful course of action a policyholder or policyholder advocate can take to add value to a claim is knowing and enforcing your legal rights.
Continue Reading Know the Regs to Use the Regs – a look at California Fair Claims Settlement Practices Regulations (10 CCR 2695.7)

We’ve all heard some iteration of the phrase, “knowledge is power.” No matter what source you attribute the quote, its application in the first-party insurance context holds true. One of the most impactful, if not the most impactful course of action a policyholder or policyholder advocate can take to add value to a claim is knowing and enforcing your legal rights. To be clear, to “add value” means to maximize payment of policy benefits owed in the most efficient manner possible, and to “enforce” means to speak up when you are being treated to the contrary, or at the onset of a claim to remind an insurer of its obligations to you. While it is important to know your rights when dealing with in-state insurance adjusters, out-of-state adjusters may pose a higher risk of being unfamiliar with your state’s rules and guidelines, especially following widespread and catastrophic disasters such as wildfires and hurricanes.
Continue Reading Know the Regs to Use the Regs – a look at California Fair Claims Settlement Practices Regulations (10 CCR 2695.9)

When a tree fell on Nazila and Bijan Neman’s home and pool in July 2019, they had no idea that they would end up in trial with their homeowners insurance carrier State Farm two years later. They were shocked in August 2021 when a federal jury awarded them not only damages for the full amount to fix their home for $446,950.46 and their attorney’s fees, but also that the jury found State Farm acted with malice, oppression, and fraud during the investigation and adjustment of the claim. For this conduct, the jury awarded the Nemans $5,000,000.00 in punitive damages.
Continue Reading Another Punitive Damages Award Struck Down by a California Court

United Policyholders (“UP”), a non-profit 501(c)(3) whose mission is to be a trustworthy and useful information resource and a respected voice for consumers of all types of insurance in all 50 states, launched its national Restoring the Insurance Safety Net Coalition (RISC) initiative in 2020. The purpose of this initiative is to reverse the trend of insurance policy re-writes that are shrinking coverage for damage to homes. One of its stated approaches is to identify wording that is causing protection gaps. I encourage you to read more about the initiative at uphelp.org/risc.
Continue Reading Beware of Avoidable Coverage Gaps with California FAIR Plan Companion Endorsements

Insurance restoration contractors play an important role in a policyholder’s, and often community’s, recovery following a disaster. Many restoration contractors have contracts calling for them to be paid what the insurance company agrees to pay on a claim. Those same contractors have Assignment of Benefit contracts (AOB’s) to ensure payment of claims monies for the repair work they do. This is a normal method of operation throughout many states after disasters happen. Policyholders want to immediately start with their repairs but have not finalized the amounts owed to do the repair work with their Insurance carriers.
Continue Reading Enforcement Action Shuts Down AOB’s and Contractor’s Negotiations For Repair Costs

CAPIA, the California Association of Public Insurance Adjusters, held its annual meeting last week, and I was fortunate enough to be given an opportunity to attend. Along with meeting some of the finest policyholder advocates in the state, there were multiple informational and thought-provoking presentations related to the industry.
Continue Reading Timing of Loss Computation, Your Policy, and the California Insurance Code

California statutory law known as the Unfair Competition Law (“UCL”) bars “any unlawful, unfair or fraudulent business act or practice” and gives courts the powers to fashion relief where money alone won’t be sufficient. Of course, this begs the question: Can an insured sue their insurer for violating the UCL? A recent federal district court ruling says no, at least when the case is a straightforward breach of contract and bad faith case.
Continue Reading Can I Sue My Insurer under the California Unfair Competition Law?

Like many states, California law makes it difficult to sue for being “underinsured.” The law places the primary responsibility for securing enough coverage and the right kinds on the insured. An insurance company, agent or broker has no duty at law to recommend any particular coverages or limits. However, they are liable if they fail to procure the agreed upon coverage, make a misrepresentation about how the coverage works, or fail to fulfill some other “special duty” they voluntarily undertook.
Continue Reading California Court Rejects Another Half-Baked Underinsurance Case

Not every insurance claim requires expert involvement. However, when a dispute arises, identifying and retaining an expert can be invaluable, not only for final resolution but in keeping a claim open and alive. For example, in Vargas v. State Farm General Insurance Company,1 the Central District of California issued an order denying State Farm’s motion for summary judgment, relying on the well-reasoned and succinctly stated opinions of Plaintiff’s expert, Sandra Watts.
Continue Reading Expert Involvement in a Dispute Can Be Beneficial at Every Mile Marker of the Claim Resolution Marathon