California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 2 - Policy Forms and Other Documents
Article 10 - Commissioner's Review of Complaints of Unlawful Cancellation, Rescission or Nonrenewal of Health Insurance Policies
Section 2274.51 - The Request for Review
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) A request for review by the commissioner is any communication received from a policyholder, certificate holder or other insured by the Department of Insurance (the "Department") regarding an actual or impending nonrenewal, cancellation or rescission of health insurance coverage in connection with which communication the policyholder, certificate holder or other insured asserts that the termination of coverage was or would be wrongful.
(b) The date of the request for review is the date the Department first receives the communication in writing, which for purposes of this Section 2274.51 shall include communications received via email. The preceding sentence notwithstanding, in the event the Department first receives the communication orally, the date of the request for review shall be the date of that oral communication, provided that the Department receives written confirmation of the request for review, which may include confirmation by email, from the policyholder, certificate holder or other insured, no later than thirty days after the date of the oral communication. However, in the event that the policyholder, certificate holder or other insured mistakenly directs his or her request for review by the commissioner to the Department of Managed Healthcare (DMHC), the date of the request for review shall be the date upon which, according to DMHC, the request for review was received by DMHC, provided that the Department receives written confirmation of the request for review, which may include confirmation by email, from the policyholder, certificate holder or other insured.
1. New section filed 11-20-2013; operative 1-1-2014 (Register 2013, No. 47).
Note: Authority cited: Sections 10273.7 and 12926, Insurance Code; CalFarm Ins. Co. v. Deukmejian, 48 Cal.3d 805 (1989) and 20th Century Ins. Co. v. Garamendi, 8 Cal. 4th 216 (1994). Reference: Sections 10273.4, 10273.6, 10273.7, 10384, 10384.17 and 10713, Insurance Code.