Company Complaint Information
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Company Performance | |||
In compliance with California Insurance Code § 12921.1, the California Department of Insurance conducted a Consumer Complaint Study of all admitted insurance carriers. The company performance table provides the complaints determined by the department to require that corrective action be taken against the insurer, or leading to insurer compromise, or other remedy for the complainant, those that are found to be without merit, those with other outcomes, and justified complaints. Justified complaints often require additional review, as violations of California insurance laws may exist. |
Year | Closed Complaints (TOTAL of Categories 1-3) |
Category 1: Complaints found to require corrective action, leading to insurer compromise, or other remedy for the complainant. |
Category 2: Complaints found to be without Merit. |
Category 3: Complaints with Other Outcomes |
Category 4: Justified Complaints |
---|---|---|---|---|---|
2023 | 156 | 73 | 60 | 23 | 31 |
2022 | 136 | 53 | 69 | 14 | 27 |
2021 | 203 | 56 | 127 | 20 | 23 |
Violation Study |
Year | Line of Coverage | Law | Section | Summarized Description of Law | # of Alleged Violations |
---|---|---|---|---|---|
2023 | Disability | CIC | 790.03h3 | Failing to adopt & implement standards for the prompt investigation & processing of claims | 13 |
2023 | Disability | CCR | 2695.5(a) | Must respond to the California Department of Insurance within 21 calendar days. | 6 |
2023 | Disability | CCR | 2695.5(b) | Must provide complete response to claimant inquiries within 15 calendar days. | 2 |
2023 | Disability | CIC | 10123.13a | Claim must be paid, contested, or denied in 30 days to insured and provider. If contested written notice must contain DOI language | 4 |
2023 | Disability | CCR | 2695.7(b)(3) | Must notify claimant that claim denial can be reviewed by the California Department of Insurance. | 2 |
2023 | Disability | CCR | 2694a5 | Failed to respond or did not provide a complete response | 2 |
2023 | Disability | CCR | 2694a3 | In contravention of own rules, policies, procedures, guidelines | 1 |
2023 | Disability | CIC | 10123.13c | Contested claims become payable in 30 days or interest at 10% per year is due, after receipt of all required information. | 1 |
2023 | Disability | CIC | 790.03h5 | Not attempting to effectuate prompt, fair, & equitable settlement when liability clear. | 1 |
2023 | Disability | CCR | 2695.11(d) | Life and Disability insurer shall affirm or deny within 30 calendar days from original notification - see CIC Section 10123.13. | 1 |
2023 | Disability | CIC | 880 | Failure of insurer to use own name | 1 |
2023 | Life/Annuity | CCR | 2695.5(a) | Must respond to the California Department of Insurance within 21 calendar days. | 5 |
2023 | Life/Annuity | CCR | 2695.7(b)(3) | Must notify claimant that claim denial can be reviewed by the California Department of Insurance. | 1 |
2023 | Life/Annuity | CIC | 790.03h1 | Misrepresenting facts or policy provisions. | 1 |
2023 | Life/Annuity | CCR | 2694a3 | In contravention of own rules, policies, procedures, guidelines | 8 |
2023 | Life/Annuity | CCR | 2694a5 | Failed to respond or did not provide a complete response | 3 |
2023 | Life/Annuity | CIC | 12921.1(e) | Insurers shall be required to submit and received complaint information through established Internet-accessible complaint response system | 1 |
If complaint data does not appear for this company, this link will provide you with an explanation.
To view the California Insurance Code (CIC), Click here
To view the California Code of Regulations (CCR), Click here
Comparison Data |
The information below is for complaints closed during the study period for this insurance company. The table provides the Justified Complaint Ratio, Market Share, Complaint Share, and Index for this company, grouped by the line of coverage the company was authorized to sell in this study period.
Year | Line of Coverage | JustifiedComplaint Ratio | Market Share | Complaint Share | Index |
---|---|---|---|---|---|
2023 | Annuities | .02 | .145 | 1.92 | 13.24 |
2023 | Individual Life | 3.09 | 1.628 | 4.13 | 2.54 |
2023 | Group Life | .01 | 18.786 | 19.23 | 1.02 |
If complaint data does not appear for this company, this link will provide you with an explanation.
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