What is Section 10123.147 of the California Insurance Code?
If the reason is based solely on facts or solely on law, the insurer is required to provide only the factual or legal basis for its reason to deny the claim.
The notice shall include the name and address to which the dispute should be submitted and a statement that Section 10123.145 of the Insurance Code requires a provider to reimburse the insurer for an overpayment within 30 working days of receipt by the provider of the notice of overpayment unless the provider contests ...
An Action Notice of Solicitor, Form LIC 417-31, authorizes the licensee to act as an insurance solicitor. An insurance solicitor is a natural person employed to aid an insurance agent or insurance broker in transacting insurance coverage on the direct or consequential loss or damage to property of every kind.
Section 10113.5 of the California Insurance Code requires every life insurance policy issued or delivered in the state to contain a provision stating that the policy is incontestable after it has been in force, during the lifetime of the insured, for two years from the date of issue.
(1) Any impairment of minimum “paid-in capital” or “capital paid in,” as defined in Section 36, required in the aggregate of an insurer by the provisions of this code for the class, or classes, of insurance that it transacts anywhere. (2) An inability of the insurer to meet its financial obligations when they are due.
The California Insurance Code requires that an insurer must have enough assets to cover its liabilities and for reinsurance of all outstanding risks.
(a) A health care provider shall not charge a fee to a patient for filling out forms or providing information responsive to forms that support a claim or appeal regarding eligibility for a public benefit program.
To operate in California, all insurers must gain admittance by obtaining a Certificate of Authority.
- Express Authority. Express authority is the authority that an agent has in writing in the contract with the insurer that the agent represents. ...
- Implied Authority. Implied authority is authority that is given not in writing but that is necessary for the agent to transact insurance. ...
- Apparent Authority.
Final answer: Advising a claimant to hire an attorney is not considered an unfair claim settlement practice since is not deceitful or detrimental to the claimant. It can even be beneficial in complex cases that require legal expertise.
What is Section 12413.1 of the California Insurance Code?
California's good funds laws, Section 12413.1 of the California Insurance Code, require that an escrow company and title company have in possession sufficient good funds in order to close the transaction.
12340.5. “Underwritten title company” means any corporation engaged in the business of preparing title searches, title examinations, title reports, certificates or abstracts of title upon the basis of which a title insurer writes title policies.
(a) Any person having an insurable interest in real or tangible personal property who, after diligent effort, has been unable to obtain basic property insurance through normal channels from an admitted insurer or a licensed surplus line broker, shall be entitled upon application to the facility to an inspection of the ...
Section 678 - Offer of renewal or notice of nonrenewal prior to policy expiration (a) (1)At least 45 days before the policy expiration, an insurer shall deliver to the named insured or mail to the named insured at the address shown in the policy, either of the following: (A)An offer of renewal of the policy contingent ...
A policy insuring against losses set forth in subdivision (a) shall not be issued or delivered to any person in this state unless it contains the provisions set forth in subdivision (b).
Section 213 of the Insolvency Act 1986 provides that if, in the case of a company's winding-up, it appears that any company business has been carried on with intent to defraud its creditors or creditors of any other person, or for any fraudulent purpose, then the court may, on the liquidator's application, declare that ...
every driver and every owner of a motor vehicle shall at all times be able to establish financial responsibility pursuant to §16021, and shall at all times carry in the vehicle evidence of the form of financial responsibility in effect for the vehicle.”
A document or identification card from your insurance company. A DMV authorization letter, if you are a cash depositor or are self-insured. California Proof of Insurance Certificate (SR 22) form for broad coverage or owner's policy.
Insurance codes are used by your health plan to make decisions about your prior authorization requests and claims, and to determine how much to pay your healthcare providers. Typically, you will see these codes on your Explanation of Benefits and medical bills.
(HSC §103900): (a) Every physician and surgeon shall report immediately to the local health officer in writing, the name, date of birth, and address of every patient at least 14 years of age or older whom the physician and surgeon has diagnosed as having a case of a disorder characterized by lapses of consciousness.
What is Section 17920.3 of the California Health and Safety Code?
As defined by California Health and Safety Code (H&SC), Section 17920.3, a substandard building is any building or portion thereof in which certain conditions exist to the extent that it endangers the health and safety of its occupants or the public.
(a) Every contract between a plan and a provider of health care services shall be in writing, and shall set forth that in the event the plan fails to pay for health care services as set forth in the subscriber contract, the subscriber or enrollee shall not be liable to the provider for any sums owed by the plan.
An unauthorized insurer is an insurance company that is operating without the permission or oversight of its state insurance regulator. Operating an unauthorized insurer is illegal, and can result in legal or financial penalties.
Led by Insurance Commissioner Ricardo Lara, the California Department of Insurance is the consumer protection agency for the nation's largest insurance marketplace and safeguards all of the state's consumers by fairly regulating the insurance industry.
Twisting describes the act of inducing or attempting to induce a policy owner to drop an existing life insurance policy and to take another policy that is substantially the same kind by using misrepresentations or incomplete comparisons of the advantages and disadvantages of the two policies.
