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Category Archives: Insurance Commissioner

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CBS’ 60 Minutes Segment “Denied” Highlights Insurers’ Wrongful Denial of Mental Health Claims

Posted in Health Insurance, Insurance Commissioner
On Sunday December 14, 2014, CBS’ 60 Minutes program contained a segment entitled “Denied” which highlights that insurers routinely deny, based on lack of medical necessity, treatment for patients with mental illnesses, especially those for long-term in-patient care at mental health facilities.  This segment was an indictment of health insurance companies’ actions (especially Anthem Blue … Continue Reading

Court Allows Mandamus Claim Against the California Department of Insurance Regarding Disability Insurance Dispute

Posted in Case Updates, Disability Insurance, Insurance Commissioner
There is a commonly held belief that every disability insurance policy sold to the public has been actually reviewed and approved by the California Department of Insurance.  Indeed, California Insurance Code section 10291.5 requires the Insurance Commissioner to reject a proposed new disability insurance policy form if it does not meet certain requirements set forth … Continue Reading

CIGNA Forced to Re-evaluate Long-Term Disability Insurance Claims Handled Between 2008 to 2010, and Set Aside $77 Million to Pay Previously Denied Claims

Posted in Disability Insurance, Insurance Commissioner
Following an investigation conducted by the California Department of Insurance via a market conduct examination, as well as insurance regulators from Connecticut, Maine, Massachusetts and Pennsylvania, CIGNA and these states’ insurance regulators, reached a settlement over its improper handling of claims for long-term disability (“LTD”) insurance.  This resulted in a Regulatory Settlement Agreement (“Agreement”) between … Continue Reading

Governor Jerry Brown Signs Law Changing Lapse Requirements For Life Insurance Policies

Posted in Insurance Commissioner, Life Insurance
Insurance Commissioner Dave Jones last week announced that Governor Jerry Brown has signed AB 1747, authored by Assembly Member Mike Feuer (D-Los Angeles).  The bill was strongly supported by Commissioner Jones and the California Department of Insurance and provides important consumer safeguards for life insurance policyholders.  AB 1747, which will be effective January 1, 2013, … Continue Reading

MetLife Pays $40 Million To Settle Allegations That It Failed To Properly Identify And Pay Life Insurance Beneficiaries

Posted in Insurance Commissioner, Life Insurance
The California Department of Insurance, along with five other state insurance departments, reached a settlement with Metropolitan Life Insurance Company, Inc. (“MetLife”) over allegations that the company failed to properly utilize the Social Security Administration’s Death Master File database to identify deceased life insurance policyholders and pay their beneficiaries.  In addition to promising to enact … Continue Reading

Insurance Commissioner Jones Highlights 2011 Important Achievements

Posted in Insurance Commissioner, News
Insurance Commissioner Dave Jones marked his first full year in office this week by looking back on the California Department of Insurance’s (CDI) major accomplishments during 2011.  Some of these achievements were very important for insurance consumers.  Here’s what his press release said: “A little over a year ago, I took my oath as Insurance … Continue Reading

California Bans the Inclusion of Policy Provisions Giving Insurance Companies Discretionary Authority to Decide Claims

Posted in ERISA, Insurance Commissioner, Legislation, News, Standard of Review
In a major victory for consumers, Governor Jerry Brown signed a bill that makes discretionary clauses – typically contained in ERISA-governed life, health and disability insurance policies/ERISA plans void and unenforceable in new or renewed policies.  SB 621 was authored by Senate Insurance Committee Chair Ron Calderon (D-Montebello) and sponsored by Insurance Commissioner Dave Jones, … Continue Reading

New California Law Requires That Insurers and Agents Verify that an Annuity is Suitable for the Consumer

Posted in Agent/Broker, Annuities, Insurance Commissioner, Legislation
California Governor Jerry Brown recently signed a new law that will provide increased protection to seniors and other consumers who are interested in purchasing an annuity.  AB 689, which was sponsored by the California Department of Insurance and authored by Assembly Budget Committee Chair Bob Blumenfield (D-San Fernando Valley), requires that insurers verify that an … Continue Reading

Insurance Commissioner Jones Charges that Blue Shield Improperly Denied Health Insurance Coverage for Necessary Autism Treatment

Posted in Health Insurance, Insurance Commissioner
California Insurance Commissioner Dave Jones recently announced that the California Department of Insurance is investigating whether Blue Shield of California Life and Health Insurance Company (“Blue Shield”) failed to comply with the California Mental Health Parity Act.  Specifically, Blue Shield is required to respond to an Order to Show Cause regarding its handling of claims … Continue Reading

Consumer Protection Insurance Bills Sponsored by Insurance Commissioner Jones Clear Hurdles

Posted in Insurance Commissioner
An important package of strong consumer protection bills, sponsored by Insurance Commissioner Dave Jones, passed through their respective houses of the Legislature, clearing a major hurdle toward passage.  Jones stated in his recent press release: “When I took office in January, I vowed we would work to strengthen our consumer protection laws,” said Commissioner Jones.  … Continue Reading

California Announces Investigation of MetLife for Failure to Pay Life Insurance Benefits

Posted in Annuities, Insurance Commissioner, Life Insurance, News
On April 25, 2011, California Insurance Commissioner Dave Jones and California State Controller John Chiang announced that they are investigating Metropolitan Life Insurance Company (“MetLife”) for a failure to pay out life insurance benefits after learning of an insured’s death.  It appears that while MetLife learned of its insured’s deaths through a database prepared by … Continue Reading

Certain Health Insurance Reforms Go Into Effect as of September 23

Posted in Health Insurance, Insurance Commissioner, Legislation
On September 23, 2010, the Patient Protection and Affordable Care Act, part of the recently enacted health care reform law, went into effect for insurance plans that begin on or after this date.  Health care reforms beginning Sept. 23, 2010 include: No pre-existing condition exclusions for children under age 19: requires insurers to cover children … Continue Reading

Insurance Commissioner Poizner Publicly Denounces Lawsuit Over Rescission Regulations

Posted in Insurance Bad Faith, Insurance Commissioner, News
On July 19, 2010, Insurance Commissioner Poizner promulgated regulations designed to limit the practice of rescissions in the health insurance industry.  See our blog article, New Regulations Take Aim at Policy Rescissions, on this.  Last Monday, an insurance industry trade group filed a lawsuit in San Francisco to block the regulations, which would have been … Continue Reading