California Insurance Code & EthicsQuestion 57 of 53178% of test-takers answer this correctly

An insurer adopts a policy of consistently failing to acknowledge claim communications within the regulatory time frame. This is most accurately characterized as:

a.Lawful as long as the claim is eventually paid in full, because the regulations treat the acknowledgment deadline as advisory only
b.A defense to a bad-faith claim
c.An isolated clerical mistake
d.A general business practice that violates the Unfair Practices Act when committed with such frequency

Explanation

Section 790.03(h) prohibits unfair claim settlement practices when committed knowingly or with such frequency as to indicate a general business practice. A repeated failure to acknowledge claims is exactly the kind of pattern the statute targets.

Law Reference: Cal. Ins. Code §790.03(h)(3)

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