What Your Insurance Company Is Required to Do — The Cheat Sheet

Your insurance company has legal obligations. They are not doing you a favor by processing your claim — they are performing a duty imposed by the contract you paid for and the regulations that govern their license. Here is exactly what they must do, when they must do it, and what regulation requires it.

Print this. Keep it next to your claim file. Every time a deadline passes without action, document it.

The Deadlines

What They Must Do at Each Stage

When You Report a Claim

• Acknowledge the claim within 15 days (in writing, or documented in the claim file).
• Provide you with claim number and adjuster contact information.
• Tell you what documentation they need from you.
• Begin investigating within 15 days.

During Investigation

• Conduct a reasonable and thorough investigation.
• Not deny a claim without first conducting an adequate investigation (10 CCR §2695.7(d)).
• Not request documentation that is irrelevant to the claim.
• Provide written status updates every 30 days if investigation is ongoing.
• Complete the investigation and accept or deny within 40 days of receiving your proof of claim.

When They Make a Decision

• If denied: provide a written denial citing the specific policy provision, statute, or factual basis (10 CCR §2695.7(b)(1)).
• If partially denied: pay the undisputed portion immediately and explain in writing why the rest is disputed.
• If accepted: pay undisputed amounts within 30 days of agreement.
• Explain in writing how the payment amount was calculated (10 CCR §2695.9).

When They Pay

• Provide itemized documentation showing how the amount was determined.
• Not condition payment on release of the entire claim if amounts remain in dispute.
• Not delay payment of undisputed amounts to pressure you on disputed amounts (Insurance Code §790.03(h)(5); 10 CCR §2695.7(h)).
• On replacement cost policies: pay ACV promptly, then pay the depreciation holdback after repairs are completed.

What They Are Prohibited From Doing

Under California Insurance Code §790.03 and 10 CCR §2695, the insurer may not:

• Misrepresent policy provisions to you.
• Fail to acknowledge and act promptly on your claim.
• Deny a claim without conducting a reasonable investigation.
• Offer substantially less than the reasonable value to force you into litigation.
• Delay payment to influence settlement of disputed amounts.
• Require unreasonable documentation demands not relevant to the claim.
• Force you to use their preferred contractor.
• Retaliate against you for hiring a Public Adjuster or attorney.
• Refuse to communicate with your authorized representative.

What to Do When They Violate a Deadline

1. Document it. Note the date the deadline expired and what action was due. Save any evidence (or absence of evidence — the letter that never came).
2. Send a written reminder. Email the adjuster and their supervisor. Cite the specific regulation and the date it was violated. Request immediate compliance.
3. If no response within 7 days: File a complaint with the California Department of Insurance (CDI). See How to File a CDI Complaint.
4. Keep a running log. Multiple violations create a pattern. A pattern of violations is evidence of bad faith.

After a Declared Disaster

After a state or federal disaster declaration, additional requirements apply:

• Minimum 24-month ALE period for state-of-emergency losses (Insurance Code §2060(b)(1)).
• Cannot impose policy-deadline restrictions on collecting the depreciation holdback that are shorter than the statutory minimums in Insurance Code §2051.5 (12 months standard; 36 months for state-of-emergency losses, with 6-month extensions for good cause). Whether the insurer can also condition the holdback on a signed construction contract is policy-language specific — consult an attorney if your carrier insists on a contract you have not yet signed.
• Must offer a contents payment of at least 30% of the dwelling limit (up to $250,000) without requiring an itemized claim after a total loss from a state of emergency (Insurance Code §10103.7).
• Must provide an advance payment of at least 4 months of living expenses upon request after a total loss (CDI Bulletin 2025-2).