Company Complaint Information

Company Profile



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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	13	9	2	2	8
2022	4	4	0	0	1
2021	7	5	1	1	5

Violation Study

The following table represents number and type of violations found, by reference to the line of insurance and law allegedly violated.

Year	Line of Coverage	Law	Section	Summarized Description of Law	# of Alleged Violations
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	3
2023	Disability	CIC	10123.135h4	Decisions to approve, deny, delay or modify services must be in writing and communicated as prescribed	1
2023	Disability	CCR	2694a6	Facts of the complaint merit remedial action	3
2023	Disability	CIC	10123.135h5	If insurer cannot make decision within time frame due to incomplete information, insurer must send written notification	1
2023	Disability	CIC	790.03h5	Not attempting to effectuate prompt, fair, & equitable settlement when liability clear.	1
2023	Disability	CIC	790.03h1	Misrepresenting facts or policy provisions.	1
2023	Disability	CIC	10169i	Must prominently display information concerning the right of the insured to request an independent medical review	3
2023	Disability	CCR	2695.5(a)	Must respond to the California Department of Insurance within 21 calendar days.	1
2023	Disability	CIC	10123.135h2	In approval or contestation of Medical Necessity insurer must be made within 72 hours if imminent and serious health condition	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

If complaint data does not appear for this company, this link will provide you with an explanation.