Calif. Recovers $63.8M in Insurance Investigations, Exams

February 7, 2011

The California Department of Insurance announced it has recovered $63.8 million for consumers through consumer complaint investigations and market conduct examinations of insurance companies in the past year.

The CDI’s Consumer Services and Market Conduct Branch has two divisions –one focused on helping consumers directly and the other focused on examinations of insurance company’s actions through an examination/audit process. The consumer services division operates the Consumer Communications Bureau, which handles the (800) 927-HELP consumer hotline; the Claims Services and Rating and Underwriting Services bureaus, which investigates and resolves complaints, filed with the Department by consumers and others. The consumer hotline annually receives approximately 200,000 calls. $52,356,121 was recovered from complaint investigations in 2010.

The Consumer Services Division recovered $89.1 million in 2009. Approximately 20 percent of that came from closing cases started in 2007 and 2008 after devastating wildfires. Due to the complexity of the issues that must be investigated, it may take a year or more to resolve complaints resulting from wildfire disasters.

The Market Conduct Division consists of the Field Claims Bureau and a Field Rating and Underwriting Bureau. These bureaus are tasked with performing examinations of insurance company claims, underwriting, rating and marketing practices to ensure they are complying with the law and regulations. $565,000 in penalties was recovered in 2010, and those penalties go to the state’s general fund.

Through the diligence of the Market Conduct Division, $10.97 million was recovered and 207 exams were adopted by the commissioner.

Source: CDI

Topics California

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