Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a)
Purpose.
This section implements and interprets Insurance Code Section
1874.6.
(b) Automobile Theft and Loss Reporting.
All insurers issuing private passenger automobile insurance in
California shall report, either directly or through an authorized representative, to
the National Insurance Crime Bureau (NICB), formerly the National Automobile Theft
Bureau, all private passenger automobiles involving in total losses as
follows:
1. All total thefts of a private
passenger automobile, having a wholesale value in excess of $2000.00, shall be
reported within five (5) working days from the receipt of sufficient information
from the insured.
2. All total losses
involving private passenger automobile salvage where the vehicle is of the current
model year or the four immediately preceding model years, however sustained,
including claimant, shall be reported to the NICB within five (5) working days after
he sale of salvage; or, if the insured, or third party claimant, is permitted to
retain salvage, within five (5) working days after the date of loss
payment.
3. The information reported to
the NICB shall include the vehicle's Vehicle Identification Number (VIN), the
vehicle's make, model, model year and any other information, as required by the
NICB. Where possible, this information shall be obtained from the Automobile
Inspection Report completed pursuant to Section
2191 of this
Article.
(c) Theft Loss
Verification Procedures.
Notwithstanding any provision of the Unfair Practices Act
(Insurance Code Sections
790 et seq.) and
Regulations to the contrary:
1. No insurer
shall pay a claim filed by an insured, or a third party claimant, under
comprehensive or other coverage for the total theft of a private passenger
automobile with a wholesale market value in excess of $2000.00, unless the claim has
first been reported to and either acknowledged by the NICB or no information
indicating unresolved questionable circumstances about the claim has been received
from the NICB within 10 working days from the date the insurer transmitted the
report to the NICB.
2. Notwithstanding
any provision of the Unfair Practices Act (Insurance Code Sections
790 et seq.) and
Regulations to the contrary, an insurer may defer payment of a total theft loss
claim filed under comprehensive or other coverage in accordance with the following:
(A) An insurer may defer the payment of such a
claim for five (5) calendar days following receipt of an acknowledgement from the
NICB of the Insurer's report. If no further communication is received from the NICB
during this five (5) day period indicating unresolved questionable circumstances,
the insurer shall continue with the processing of the claim in accordance with the
provisions of this section and other provisions of the Unfair Practices Act
(Insurance Code section
790 et seq.) and
Regulations.
(B) If the NICB indicates
in its acknowledgement or response to the insurer that coverage is in effect by more
than one insurer for the same private passenger automobile or that the private
passenger automobile has been previously reported as stolen and unrecovered, or that
previous claims on the automobile have been reported, the insurer shall promptly
investigate, attempt to resolve any discrepancy and report to the Fraud Division of
the Department of Insurance, as required by Section
1872.4 of the
Insurance Code.
(C) If the NICB
discovers an erroneous vehicle identification number (VIN) and the NICB is unable to
resolve the discrepancy internally, the NICB shall send a standardized inquiry to
the insurer. A response to the inquiry shall be returned within five (5) working
days by the insurer and the insurer shall notify the Fraud Division as required by
Section
1872.4 of the
Insurance Code. If the NICB and the insurer are unsuccessful, after due diligence in
resolving the VIN error after a thirty-day (30-day) period from the date of the
receipt by the insurer of sufficient information from the insured, the insurer shall
proceed with the final processing of the claim.
(D) If the NICB indicates in its response to the
insurer its belief, or if the insurer believes, that a fraudulent claim is being
made by any claimant, the insurer shall report this information to the Fraud
Division of the Department of Insurance as required by Section
1872.4 of the
Insurance Code, suspend the processing of the claim and promptly begin an
investigation. The insurer shall promptly provide such information to the NICB and
shall cooperate fully with the NICB and the Department of Insurance in any
investigation of potentially criminal or fraudulent
acts.
(d)
Definitions.
1. As used in this section, "private
passenger automobile" means a motor vehicle of the private passenger or station
wagon type, any four-wheel vehicle with a load capacity of 1,500 pounds or less, or
a motorcycle.
2. As used in this
section, and as provided in Section
544 of the Vehicle
Code, "total salvage loss" means a private passenger automobile which has been
wrecked, destroyed, or damaged, to such an extent that the owner, leasing company,
financial institution, or the insurance company which has insured the vehicle,
considers it uneconomical to repair the vehicle and because of this, the vehicle is
not repaired by or for the person who owned the vehicle at the time of the event
resulting in the damage.
3. As used in
this section, "total theft" means the theft of a private passenger
automobile.
1. New section
filed 4-1-93; operative 5-1-93 (Register 93, No. 14).
Note: Authority cited: Section
1874.6,
Insurance Code. Reference: Section
1874.6,
Insurance Code.