California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 3 - Insurers
Article 9.7 - Workers' Compensation Insurance Procedural Requirements and Standards Applicable to Employers, Insurers, and Rating Organizations in the Initiation of and Response to Requests for Review, Requests for Policyholder Information, and Requests for Reconsideration Provided in Insurance Code Sections 11737(f), 11752.6(c), 11753.1(a) and 11753.1(b), and, Rules of Practice and Procedure for Appeals to the Insurance Commissioner Pursuant to Insurance Code Sections 11737(f), 11752.6(c), 11753.1(a), 11753.1(b) and 11753.1
Section 2509.47 - Form of Appeal and Information Required
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
An appeal shall be in writing. It need not be in any particular form, but must include:
(a) The name, address, telephone number, and fax number of the appellant;
(b) The name, address, telephone number, and fax number of the appellant's representative, if any;
(c) Copies of correspondence between the appellant and the insurer and/or rating organization regarding the subject of the appeal, to include: complaints, responses, inquiries, initial decisions, requests for review and action, requests for reconsideration, requests for policyholder information, acknowledgements, notices, and the written decisions of insurers and rating organizations;
(d) A statement as to why the appellant believes the insurer's or rating organization's decision or action is wrong;
(e) Any documents which support the appellant's position, which are reasonably available to the appellant at the time of the filing of the appeal, and upon which the appellant intends to rely at the hearing. The documents should be marked consecutively by letter as provided in section 2509.62(c).
(f) A statement that the appellant has or has not filed a complaint with the Department requesting review of the same transactions, actions or omissions which constitute the subject matter of the appeal. If such a complaint has been previously filed or is pending, the appellant shall provide the Department's assigned file number.
1. New section
filed 2-22-99 as an emergency; operative 2-22-99 (Register 99, No. 9). A Certificate
of Compliance must be transmitted to OAL by 6-18-99 or emergency language will be
repealed by operation of law on the following day.
2. New section refiled
6-18-99 as an emergency; operative 6-18-99 (Register 99, No. 25). A Certificate of
Compliance must be transmitted to OAL by 10-18-99 or emergency language will be
repealed by operation of law on the following day.
3. New section refiled
10-18-99 as an emergency; operative 10-19-99 (Register 99, No. 43). A Certificate of
Compliance must be transmitted to OAL by 2-16-2000 or emergency language will be
repealed by operation of law on the following day.
4. Repealed by
operation of Government Code section
11346.1(g)
(Register 2000, No. 6).
5. New section filed 2-10-2000; operative
3-11-2000 (Register 2000, No. 6).
6. Change without regulatory effect
amending NOTE filed 6-3-2003 pursuant to section
100, title 1, California Code of
Regulations (Register 2003, No. 23).
Note: Authority cited: Section 11400.20, Government Code; and Section 11753.1, Insurance Code. Reference: Section 11415.10, Government Code; and Sections 11734, 11737(f), 11750, 11752.6(c), 11753.1(a) and 11753.1(b), Insurance Code.
