Launch service
Department website
Contact
Description
Today, California Department of Insurance, CDI is the largest consumer protection agency in the state. With annual direct premiums of $340 billion, California is the largest insurance market in the United States and the fourth largest insurance market in the world. Nearly 1,400 dedicated employees work at CDI to oversee more than 1,400 insurance companies and license more than 425,000 agents, brokers, adjusters, and business entities. In the normal course of business,
All of CDI's functions, including overseeing insurer solvency, licensing agents and brokers, conducting market conduct reviews, resolving consumer complaints, and investigating and prosecuting insurance fraud, are to protect consumers.
Phone:
800-927-4397
Frequently Asked Questions
As a consumer, does my health insurer have to waive cost sharing for COVID-19
testing and related diagnostic items and services?
Yes. On March 5, 2020, Insurance Commissioner Ricardo Lara released a COVID-19 Screening
and Testing Bulletin1 directing health insurers to waive cost sharing amounts for certain COVID19 related screening and testing. Since that date, two federal laws were passed, which require
coverage for COVID-19 related diagnostic testing and screening, without patient cost sharing,
including deductibles, coinsurance, and copays.
Section 6001 of the federal Families First Coronavirus Response Act (FFCRA) (PL 116-127)
§ 6001, as amended by § 3201 of the federal Coronavirus Aid, Relief, and Economic Security
Act (CARES Act) (PL 116-136),2 applies to a “group health plan,” including insured3 and selfinsured group health plans, private employment-based group health plans (ERISA plans), nonfederal governmental plans, and church plans.4 It also applies to “individual health insurance
I’m a provider and I’m having a problem with insurers reimbursing, denying or
contesting the claim I submitted in a timely manner. Can they do that?
No. Health insurers have a legal obligation to promptly pay claims. Insurance Code §§ 10123.13
and 10123.147 require insurers to pay claims as soon as possible but no later than 30 working
days after receipt of a complete claim, unless the insurer notifies the provider in writing that the
claim has been denied or is being contested. Insurers must pay interest on a completed claim if
the claim has not been reimbursed, contested or denied within the 30 working-day deadline.11
Failure to comply with the claims handling deadlines in state law may also be considered an
unfair claims settlement practice under Insurance Code § 790.03(h). Providers should contact
the Department’s Provider Complaint Center if a health insurer is not paying claims in
compliance with these deadlines.
What kind of background review check does the CDI perform on each application?
Prior to license issuance, the California Department of Insurance (CDI) completes detailed background checks on all license applications. This includes the receipt and review of criminal offender record information (CORI) from the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI) resulting from the fingerprints submitted on each applicant. The National Association of Insurance Commissioner's (NAIC's) Regulatory Information Retrieval System (RIRS), State Producer Licensing Data Base (SPLD), and Special Activities Data Base (SAD) are also checked for any disciplinary actions.
Related services
California Low Cost Auto
California Senior Gateway
Keywords
Commissioner Ricardo Lara,
auto insurance,
CLCA,
denied insurance,
insurance,
insurance claims,
insurance fraud,
low cost auto insurance,
insurance issues,
