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 | 179 | 87 | 73 | 19 | 52 |
| 2022 | 155 | 68 | 74 | 13 | 31 |
| 2021 | 154 | 53 | 91 | 10 | 27 |
| Violation Study |
| Year | Line of Coverage | Law | Section | Summarized Description of Law | # of Alleged Violations |
|---|---|---|---|---|---|
| 2023 | Disability | CCR | 2695.7(d) | Insurer shall conduct a thorough, fair and objective investigation. Cannot seek unnecessary information from claimant. | 1 |
| 2023 | Disability | CIC | 790.03h2 | Failing to acknowledge and act promptly upon communications. | 1 |
| 2023 | Disability | CCR | 2695.7(b) | Upon receiving proof of claim, insurer shall immediately but in no event more than 40 calendar days accept or deny claim. | 2 |
| 2023 | Disability | CCR | 2694a3 | In contravention of own rules, policies, procedures, guidelines | 2 |
| 2023 | Disability | CIC | 880 | Failure of insurer to use own name | 13 |
| 2023 | Disability | CIC | 790.03h5 | Not attempting to effectuate prompt, fair, & equitable settlement when liability clear. | 6 |
| 2023 | Disability | CCR | 2695.5(e)(2) | Must supply forms, instructions and assistance within 15 calendar days of claim notification. | 1 |
| 2023 | Disability | CCR | 2695.5(a) | Must respond to the California Department of Insurance within 21 calendar days. | 6 |
| 2023 | Disability | CCR | 2695.11(b) | With each life and disability insurance claim payment the insurer shall provide to the claimant and assignee an EOB | 1 |
| 2023 | Disability | CIC | 790.03h3 | Failing to adopt & implement standards for the prompt investigation & processing of claims | 17 |
| 2023 | Disability | CCR | 2695.5(b) | Must provide complete response to claimant inquiries within 15 calendar days. | 6 |
| 2023 | Disability | CCR | 2695.7(h) | Must pay within 30 calendar days of accepting claim-exceptions apply- see Regulations. | 4 |
| 2023 | Disability | CIC | 10232.1(a) | LTC ins contract shall prominently display & print on pg 1 of policy form, on outline of cov & app the notice prescirbed by sec. | 1 |
| 2023 | Disability | CIC | 790.03h1 | Misrepresenting facts or policy provisions. | 4 |
| 2023 | Disability | CIC | 10235.95b | 10 percent per year interest is payable to claimants on accepted but unpaid Long Term Care claims | 4 |
| 2023 | Disability | CCR | 2695.5(e)(1) | Must acknowledge notice of claim within 15 calendar days unless payment is made. | 1 |
| 2023 | Disability | CCR | 2695.7(b)(3) | Must notify claimant that claim denial can be reviewed by the California Department of Insurance. | 4 |
| 2023 | Disability | CCR | 2694a5 | Failed to respond or did not provide a complete response | 1 |
| 2023 | Disability | CIC | 10111.2 | Disability Income claims paid in 30 calendar days of receiving requirements or interest due | 12 |
| 2023 | Life/Annuity | CIC | 10509.955(b)(1) | When using an illustration in a sale, it is prohibited to represent the policy as anything other than a life insurance policy. | 1 |
| 2023 | Life/Annuity | CCR | 2695.7(b) | Upon receiving proof of claim, insurer shall immediately but in no event more than 40 calendar days accept or deny claim. | 2 |
| 2023 | Life/Annuity | CIC | 781 | Twisting (misrepresentation of policies) | 1 |
| 2023 | Life/Annuity | CIC | 790.03h5 | Not attempting to effectuate prompt, fair, & equitable settlement when liability clear. | 2 |
| 2023 | Life/Annuity | CCR | 2695.3(b)(2) | Must record in the file the date the licensee received, processed, and/or transmitted or mailed all relevant documents. | 1 |
| 2023 | Life/Annuity | CCR | 2695.5(b) | Must provide complete response to claimant inquiries within 15 calendar days. | 1 |
| 2023 | Life/Annuity | CCR | 2695.7(c)(1) | Must notify in writing every 30 calendar days if more time is required to investigate claim. | 2 |
| 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 | 5 |
| 2023 | Life/Annuity | CIC | 790.03h3 | Failing to adopt & implement standards for the prompt investigation & processing of claims | 1 |
| 2023 | Life/Annuity | CIC | 790.02 | Engaging in trade practice defined as unfair method of competition prohibited | 1 |
| 2023 | Life/Annuity | CIC | 10113.71 | 60 day grace period notice must be sent to policyholder, named designee, for unpaid premium | 2 |
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 | Group Life | .09 | .271 | 3.85 | 14.17 |
| 2023 | Annuities | .00 | .357 | .00 | .00 |
| 2023 | Individual Life | 2.42 | 5.820 | 11.57 | 1.99 |
If complaint data does not appear for this company, this link will provide you with an explanation.
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