California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 3 - Insurers › Article 9.7 - Workers' Compensation Insurance Procedural Requirements and Standards Applicable to Employers, Insurers, and Rating Organizations in the Initiation of and Response to Requests for Review, Requests for Policyholder Information, and Requests for Reconsideration Provided in Insurance Code Sections 11737(f), 11752.6(c), 11753.1(a) and 11753.1(b), and, Rules of Practice and Procedure for Appeals to the Insurance Commissioner Pursuant to Insurance Code Sections 11737(f), 11752.6(c), 11753.1(a), 11753.1(b) and 11753.1 › Section 2509.44 - Acknowledgment of Receipt and Notice of Review

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Within thirty (30) days after service of
				  a Complaint and Request for Action, the insurer or rating organization shall
				  serve the applicant with a written acknowledgment of receipt of the Complaint
				  and Request for Action and a notice either granting or denying review of the
				  Complaint and Request for Action. If the insurer or rating organization fails
				  to grant or reject review of the Complaint and Request for Action within thirty
				  (30) days after the request is served, the applicant may proceed in the same
				  manner as if the Complaint and Request for Action had been rejected. Time
				  limitations for an appeal to the Commissioner shall not begin to run until this
				  acknowledgment and notice has been served, unless a decision has been served
				  pursuant to Section
				  2509.45, below. The acknowledgment
				  shall include the information specified in Section
				  2509.45(d) and
				  include the following statements:
(1) The
				  insurer or rating organization's failure to grant or reject review of the
				  Complaint and Request for Action within thirty (30) days of service of such
				  Complaint and Request for Action constitutes a rejection of the Complaint and
				  Request for Action.
(2) The insurer
				  or rating organization's failure to grant or reject the Complaint and Request
				  for Action within sixty (60) days after the insurer or rating organization has
				  served the applicant with a notice granting the request for review constitutes
				  a rejection of the Complaint and Request for Action.
(3) An appeal may be taken to the
				  Commissioner from:
(A) a written rejection of
				  review of the Complaint and Request for Action;
(B) a written rejection of the Complaint and
				  Request for Action;
(C) failure of
				  an insurer or rating organization to grant or reject a review of a Complaint
				  and Request for Action or failure to grant or reject a Complaint and Request
				  for Action within the time specified.
(4) Time limitations for an appeal to the
				  Commissioner do not begin to run until this acknowledgment and notice have been
				  served on the applicant, unless a decision on the Complaint and Request for
				  Action has been served on the applicant, in which case an appeal to the
				  commissioner must be filed within 30 days of service of the decision. If an
				  acknowledgment and notice have been served, but no decision has been served
				  within the time limits specified, an appeal may be taken to the Commissioner
				  within 120 days after service of the Complaint and Request for Action on the
				  insurer or rating organization.