When To Complain About a California Auto Insurance Carrier

When you file an auto insurance claim, you will be contacted by an insurance adjuster who will evaluate your claim. Adjusters work for the insurance company and their job is to minimize the loss, yet still be fair to their customer, you. They know a lot more claims state insurance laws than most claimants. California has specific laws regarding how insurers must settle claims.

Fully disclose covered items

Car Insurance policies are sometimes hard to read. You may not know all the benefits available to you. If you have rental vehicle or loss of use benefits available on your policy, your insurer must fully disclose covered benefits (Fair Claims Settlement Regs. Sec. 2695.4), since it's illegal to conceal or withhold covered benefits from a policyholder.

Time to respond

Car Insurers are not permitted to just deny valid claims, since they are required to respond to claimants in 15 days. This applies whether or not you hold a policy with the insurer you are claiming against. Insurers must also respond to requests from the department of insurance in 21 calendar days.

Time to deny

The car insurance company must accept or deny your claim within 40 days after you file (Fair Claims Settlement Regs, Sec. 2695.7). This time period is used for any investigations that must occur as part of the claim, and the number of days can be extended by notifications in writing from the insurer as to the reasons for the delay and any information required from the claimant to move the claim forward. In the insurer denies your claim, it has do so in writing, stating the reasons and citing the applicable section of the policy.
When to complain (to the California DOI)
Where to complain

Before you file a complaint with the California Department of Insurance, you should first contact the insurance company, agent or broker in writing to fix the problem. If you don't get satisfaction complete the correct DOI form or contact them at:

California Department of Insurance Consumer Communications Bureau
300 South Spring Street, South Tower
Los Angeles, CA 
90013 1-800-927-HELP (4357) or

Requesting a mediator
When you complain about a California auto insurer, don't forget to consider requesting mediation. The total value of the unresolved claims must be greater than $7,500 and the difference in dispute must exceed $2,000. So if your claim is $9,500, but the insurer is only offering you $7,500, you could use California's mediation program. You must file a complaint with the California DOI, then request mediation. The department will assign a mediator to your case.

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