California Insurance Code & EthicsQuestion 50 of 53194% of test-takers answer this correctly

Under the Fair Claims Settlement Practices Regulations, an insurer's claim adjuster must do which of the following at the beginning of the claim?

a.Disclose only the policy limits, but no other provisions
b.Wait until the insured retains counsel before disclosing policy benefits
c.Disclose to first-party claimants all benefits, coverages, time limits, or other provisions that may apply
d.Disclose nothing until the claim is formally accepted

Explanation

10 CCR §2695.4(a) requires the insurer to disclose to a first-party claimant all benefits, coverages, time limits, or other provisions of any policy that may apply to the claim. Waiting for counsel, partial disclosure, or no disclosure is a violation of the regulation.

Law Reference: 10 CCR §2695.4(a)

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