California Insurance Code & EthicsQuestion 53 of 158
Under the claims file documentation rule in Title 10 CCR §2695.3, an insurer must maintain claim file documents in a form that:
a.Allows redaction of any internal notes before regulatory review
b.Permits accurate reconstruction of all activities undertaken on the claim
c.May be discarded one year after closing the file
d.Is shared with the claimant's attorney every 30 days
Explanation
Title 10 CCR §2695.3 requires every licensee's claim files to contain all documents, notes, and work papers (including communications) which reasonably pertain to the claim, in such detail that pertinent events and the dates of such events can be reconstructed. The retention period is at least five years (or longer where required by law).
Law Reference: CCR Title 10 §2695.3Practice all 158 questions free — no signup required.
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