What Your Insurance Company Is Required to Tell You — And What They Conveniently Forget

When you file an insurance claim, the adjuster's job is to evaluate the loss and determine what the carrier owes. But the adjuster also has another obligation — one that is frequently ignored. Under California law, insurers are required to proactively inform you about your rights, your coverages, and the benefits available to you under your policy. They do not get to sit back and hope you never ask.

This is not a suggestion. It is a legal duty imposed by statute and regulation. When your adjuster fails to mention that you are entitled to temporary housing, or neglects to tell you that claim-related documents are available on request, or never explains that your policy includes an appraisal provision — that silence is not an oversight. It is a failure to comply with California law.

This article catalogs the specific disclosure obligations California imposes on insurers — the things they are required to tell you and routinely do not.

The 790 Letter: The Disclosure Letter Your Insurer Sends (or Should Send)

In the claims industry, the “790 letter” refers to a written notice the insurance company is required to send to the insured at the outset of a claim in California. The name comes from California Insurance Code Section 790.03, which defines unfair claims settlement practices. The letter informs you of your basic consumer rights on the claim — including your right to claim-related documents, your right to a prompt investigation, applicable deadlines, and other protections under California law.

While insurers are required to send this letter, the quality varies significantly. Some are thorough. Others are boilerplate that checks a compliance box without meaningfully informing the policyholder of anything. If you received a 790 letter at the start of your claim, read it carefully — it may reference rights you did not know you had. If you did not receive one, that itself is a compliance failure. The obligations discussed below apply regardless of whether the insurer sent the letter.

For a discussion of how policyholders can send their own 790 letter to put the carrier on notice, see our article on Insurance Code 790.03 and the 790 letter.

1. The Duty to Explain All Benefits Available Under the Policy

California Code of Regulations Title 10, Section 2695.7(b)(2) requires that every insurer, upon receiving a claim, must provide the insured with “all benefits, coverages, time limits or other provisions of any insurance policy issued by that insurer that may apply to the claim presented by the claimant.”

Read that again: all benefits that may apply. The insurer is not permitted to evaluate only the coverage you specifically asked about. If your fire claim triggers Coverage A (dwelling), Coverage B (other structures), Coverage C (contents), Coverage D (loss of use), debris removal, ordinance or law, and any applicable endorsements, the adjuster is required to tell you about all of them.

In practice, this obligation is routinely violated. Here are coverages that adjusters commonly “forget” to mention:

2. The Duty to Notify You That Claim-Related Documents Are Available

California Insurance Code Section 2071 — the standard form fire insurance policy — requires insurers to notify every claimant that claim-related documents are available upon request. This is an affirmative duty. The insurer must tell you. You should not have to discover this right on your own.

The definition of claim-related documents is broad: repair and replacement estimates, bids, appraisals, scopes of loss, drawings, plans, reports by third parties, and all other valuation, measurement, and loss adjustment calculations. Once you make a written request, the insurer has 15 calendar days to produce copies. The narrow exemptions are attorney-client privilege, attorney work product, documents indicating fraud, and medically privileged information.

Most policyholders never learn this right exists because the insurer never tells them — despite being required to. For the full discussion, see our article on your right to claim documents under California law.

3. The Duty to Provide a Written Explanation for Any Denial

When an insurer denies or limits a claim, it cannot simply say “no.” California Code of Regulations Title 10, Section 2695.7(b)(1) requires the insurer to provide a written explanation that includes “all bases for such rejection or denial and the factual and legal bases for each reason given for such rejection or denial.”

This means the insurer must tell you:

• The specific policy language they are relying on
• The factual findings that support the denial
• Every reason for the denial — not just the primary one

A verbal denial over the phone does not satisfy this obligation. A denial letter that cites a general exclusion without connecting it to the facts of your claim does not satisfy this obligation. The regulation requires specificity. If the denial letter is vague, conclusory, or incomplete, the denial itself may be deficient. See our article on bad faith insurance practices in California.

4. The Duty to Acknowledge Your Claim and Respond Within Deadlines

California's Fair Claims Settlement Practices Regulations impose specific time limits on every step of the claims process:

Insurers are also required to notify you if they need more time to investigate, explaining why and providing an estimated completion date. They cannot simply go silent. For a complete timeline, see our article on California insurance claim deadlines.

5. The Duty to Make Advance Payments After a Declared Disaster

After a governor-declared disaster resulting in a total loss, California Insurance Code Section 2051.6 requires insurers to make advance payments to policyholders while the claim is being processed. These are not optional. The carrier must pay partial amounts toward dwelling, contents, and additional living expenses without waiting for a complete estimate, a full inventory, or final documentation.

Additionally, SB 495 (Insurance Code § 10103.7) requires insurers to pay at least 30% of the dwelling coverage limit toward personal property without requiring an itemized inventory during the first 100 days after a declared disaster. Many policyholders are never told this. They spend weeks or months trying to compile a complete contents inventory before seeing a dollar — when the law requires the carrier to pay up front. See our articles on advance payments after a wildfire and SB 495 and the contents payment rule.

6. The Duty to Advise You of Temporary Housing Benefits

Coverage D — Additional Living Expenses — is one of the most valuable coverages in a homeowner policy, and one of the most frequently left unexplained. When your home is uninhabitable due to a covered loss, the insurer owes the reasonable additional costs you incur to maintain your household while repairs are completed or while you find a new permanent residence.

This includes temporary rental housing, hotel costs, increased meal expenses above your normal food budget, pet boarding, laundry, storage, additional commuting costs, and other reasonable expenses. After a declared disaster in California, insurers must provide at least 24 months of ALE coverage with a 12-month extension available for delays beyond the policyholder's control.

Adjusters sometimes mention ALE in passing or authorize only a fraction of what the policyholder is entitled to. Some never mention it at all, particularly on claims where the home is partially damaged and the policyholder could arguably remain in the home during repairs but would be living in an active construction zone. Under the regulation's duty to explain all applicable benefits, the adjuster should be proactively informing you of this coverage. If they did not, that is a problem. See our article on 36-month ALE requirements in California.

7. The Duty to Inform You of Your Right to Choose Your Own Contractor

When an insurer recommends or provides a list of contractors, California Code of Regulations Title 10, Section 2695.9(b) requires that the policyholder be informed in writing that they have the right to select their own contractor. The insurer cannot simply show up with a preferred vendor and create the impression that using their contractor is required.

California Insurance Code Section 758.5 — the anti-steering statute — reinforces this by prohibiting insurers from requiring use of a specific repair facility or penalizing policyholders who choose someone else. The insurer must tell you that you have a choice. If they did not, and you ended up using their preferred vendor without knowing you had an alternative, the insurer failed its disclosure obligation. See our articles on choosing your own contractor and preferred vendor problems.

8. The Duty to Inform You of Your Right to Rebuild at a Different Location

After a total loss, California Insurance Code Section 2051.5(c) guarantees that policyholders may rebuild or purchase a replacement home at a different location without losing replacement cost benefits. Many policyholders assume — because no one tells them otherwise — that they must rebuild on the same lot to recover replacement cost. That is not the law in California.

The insurer should be proactively informing total-loss policyholders of this right. For a policyholder deciding whether to rebuild in a high-risk area or relocate, this information is critical. A failure to disclose it could lead the policyholder to make decisions based on incomplete information. See our article on rebuilding at a different location.

9. The Duty Not to Mislead You About Deadlines

California Insurance Code Section 790.03(h)(15) makes it an unfair claims practice to “knowingly misrepresent to a claimant pertinent facts or policy provisions relating to coverages at issue,” and Section 790.03(h)(14) prohibits “directly advising a claimant not to obtain the services of an attorney.” Telling a policyholder they have “missed the deadline” when equitable tolling applies, or implying that the one-year suit limitation has expired when the insurer never issued a formal denial, is the kind of misleading statement these provisions are designed to prevent.

The insurer has an obligation to be accurate about deadlines and time limits. If anything, the insurer should be advising policyholders of the time limits that apply — not weaponizing them after the fact. See our articles on equitable tolling and California claim deadlines.

10. The Duty to Inform You of Your Right to File a CDI Complaint

While this is not a specific regulatory requirement in every claim interaction, the California Department of Insurance expects policyholders to know they can file complaints — and the CDI has made clear that insurer conduct that discourages policyholders from exercising their rights is itself an unfair practice. At minimum, insurers should not be creating the impression that their determination is final and unreviewable. See our article on filing a CDI complaint.

Quick Reference: What They Must Tell You

Related Reading

• Insurance Myths Exposed: What Your Adjuster Won't Correct
• California Fair Claims Settlement Practices Regulations
• Know Your Rights as a Policyholder
• Your Rights: The Short Version
• Bad Faith Insurance Practices in California