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 2274.55 - Submittal of Information by Insurers for Use in Determination by the Commissioner that a Cancellation, Rescission or Failure to Renew is or is Not Contrary to Existing Law
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) After the commissioner determines that a proper complaint exists pursuant to Section 2274.52 and prior to any determination by the commissioner that a cancellation, rescission or failure to renew is or is not contrary to existing law, the insurer shall submit any written information required by this article to the commissioner at the following address:
LEGAL DIVISION, HEALTH ENFORCEMENT BUREAU
CALIFORNIA DEPARTMENT OF INSURANCE
1901 HARRISON STREET, 3RD FLOOR MAILROOM
OAKLAND, CA 94612
(b) The insurer shall specify a responsible person whom Department staff may contact with questions or requests for further information. After the insurer has sent the information required by this article to the address specified in subdivision (a) of this Section 2274.55, Department staff may, under conditions consented to by the insurer's designated responsible person, agree to receive further information from the insurer by specified alternate means of delivery. Nothing in this section shall be interpreted to bar informal communication during the time period referenced in subdivision (a) of this section between Department staff and the insurer's responsible person, including by telephone, provided Department staff agrees beforehand to such informal communication.
(c) No later than 15 days after receiving from the Department a notice of a proper complaint pursuant to subdivision (d) of Section 2274.52, the insurer shall either:
(d) Upon a showing of good cause, Department staff evaluating a request for a hearing pursuant to subdivision (b) of Insurance Code section 10273.7 will provide an extension of up to 15 days for the purpose of allowing the insurer to complete the submittal of the evidence required by paragraph (c)(1) of this Section 2274.55.
(e) The insurer shall immediately notify the consumer of the action the insurer has taken pursuant to subdivision (c) of this Section 2274.55.
(f) In the event the insurer reinstates the policyholder, certificate holder or other insured, it shall send a notice to this effect to:
CALIFORNIA DEPARTMENT OF INSURANCE
RATING AND UNDERWRITING SERVICES BUREAU
300 SOUTH SPRING STREET, 11TH FLOOR
LOS ANGELES, CA 90013
1. New section
filed 11-20-2013; operative 1-1-2014 (Register 2013, No. 47).
2. Change
without regulatory effect amending subsection (a) filed 8-27-2020 pursuant to
section 100, title 1, California Code of
Regulations (Register 2020, No. 35).
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.