The Fair Claims Settlement Practices Regulations sit in Title 10 of the California Code of Regulations, starting at §2695.1. The CDI outline cites some of them as Insurance Code sections, but they are regulations. Key definitions (10 CCR §2695.2):
Claimant (c): includes an attorney directly. An adjuster, a public adjuster or a family member acts for the claimant only with a written designation.
Proof of claim (s): any evidence or documentation in the insurer's possession, whether submitted by the claimant or obtained in the insurer's own investigation, that reasonably supports the amount of the loss.
Notice of legal action (o): a defined term; once it is given, some of the insurer's response duties stop.
Files (§2695.3): the insurer keeps claim data and files for the current year and the four preceding years. In 2026 that reaches back to 2022, not 2023. Each file holds all documents, notes and work papers, in enough detail that the events and dates of the claim can be reconstructed.
Communications (§2695.5):
(b) A communication that reasonably suggests a response is expected gets a complete response immediately, and in no event more than 15 calendar days after receipt. This includes a letter from the claimant's attorney. Inquiries from the Department of Insurance get 21 days. The duty does not continue after notice of legal action.
(e) A notice of claim must be acknowledged within 15 calendar days.
Settlement standards (§2695.7):
- (b) Accept or deny the claim within 40 calendar days after receiving proof of claim. Proof of claim can come from the insurer's own investigation, so the clock can start even if the claimant has sent nothing.
- (c)(1) If more time is needed, the insurer must tell the claimant in writing.
- (h) Pay an accepted claim within 30 calendar days of acceptance.
The sequence to remember: acknowledge in 15, decide in 40, pay in 30.
Health and disability exception: §2695.7(b)(4) and (h)(1) exclude disability policies subject to Ins. Code §10123.13 and disability income policies subject to §10111.2 from the 40-day and 30-day limits. Those sections set their own claim-payment rules, so on the exam read carefully whether a question is asking about the general regulation.