Homeowners Insurance Dog Bite Lawyer in Los Angeles, CA Deadlines Set by Regulation

Two different policies, one incident

In a city where the owner-occupied housing unit rate stands at 36.3 percent for 2019 to 2023 with 1,419,663 households (QuickFacts, Los Angeles city), the dog and the building frequently belong to different people, each with separate insurance. A resident's renters policy may respond for the animal's owner. A building owner's policy responds for the building owner, on the different duty stated in Civil Code section 1714 rather than the statutory rule in Civil Code section 3342, which speaks only to the dog's owner. Identifying which carrier is answering for which person, in writing, prevents a single conversation from being treated as coverage for everyone involved.

What the regulations require in the first weeks

California's Fair Claims Settlement Practices Regulations set deadlines. Under title 10, section 2695.5 of the California Code of Regulations, an insurer receiving notice of claim must, immediately but in no event more than fifteen calendar days later, acknowledge receipt unless payment is made in that period, provide necessary forms, instructions and reasonable assistance including specifying what is required for proof of claim, and begin any necessary investigation. The same section requires a licensee receiving a communication from a claimant that reasonably suggests a response is expected to furnish a complete response within fifteen calendar days, and it provides that an insurer may not require written notice of claim unless the policy or an endorsement says so.

The forty-day decision, and the thirty-day updates

Section 2695.7 requires that, upon receiving proof of claim, an insurer accept or deny the claim in whole or in part immediately but in no event more than forty calendar days later, with the amounts accepted or denied documented in the file unless the claim is denied entirely. Where more time is needed, written notice of the need for additional time must go out within that same period, specifying the additional information required and any continuing reasons for the inability to decide, and that written notice must then be provided every thirty calendar days until a determination is made or notice of legal action is served. A denial or rejection of a third party claim, or a dispute about liability or damages, must be in writing.

Payment timing after acceptance

The same section addresses what happens after a claim is accepted. Upon acceptance in whole or in part and, when necessary, upon receipt of a properly executed release, the insurer must tender payment or otherwise act to perform its claim obligation immediately but in no event more than thirty calendar days later, and the amount tendered is the amount the insurer accepted. Where multiple coverage is involved and the payee is known, accepted amounts are to be paid within the same thirty days if payment would terminate the insurer's known liability under that coverage, unless impairment of the insured's interests would result.

The regulation on offers that are too low

Subdivision (g) of section 2695.7 states that no insurer shall attempt to settle a claim by making a settlement offer that is unreasonably low, and lists factors considered in that assessment: the extent to which the insurer considered evidence submitted by the claimant to support the value of the claim, legal authority or evidence made known to it or reasonably available, the advice of its claims adjuster as to the amount of damages, the advice of counsel about a substantial likelihood of recovery in excess of policy limits, the procedures used to determine property damage, and the probable liability of the insured together with the likely jury verdict or other final determination. The statutory backdrop is Insurance Code section 790.03, which defines unfair methods of competition and deceptive acts in the business of insurance.

Records the carrier did not create

Three dated agency records commonly exist alongside a residential claim, and they were written by people with no stake in it. The County bite report, which County Veterinary Public Health explains does not itself deem an animal dangerous and must be supplemented by a separate report to local animal control if a resident believes the animal is dangerous (Reporting Animal Bites). The quarantine record, described in the County rabies manual under County Code section 11.04.210 as at least fourteen days and ten for dogs and cats, with home confinement or a licensed boarding kennel permitted under section 11.04.220 (quarantine provisions). And any City dangerous-animal file generated under Municipal Code section 53.34.4.

Two ideas that do not follow from a policy letter

First, an insurer's evaluation is not the legal measure of loss. That measure is in Civil Code section 3333, covering all the detriment proximately caused whether or not it could have been anticipated. Second, where several parties are blamed, Civil Code section 1431.2 confines each defendant's share of the non-economic damages to that defendant's own allocated percentage of fault, so two carriers evaluating one incident are not evaluating identical exposure.

Deadlines that regulation does not move

Regulatory timelines govern insurer conduct. They do not extend the time to file suit. Code of Civil Procedure section 335.1 sets two years for a personal injury action, and where a public agency is involved, the claim-presentation rule numbered 911.2 in the Government Code calls for a written claim inside six months of accrual.

Scope

This page summarizes published regulations, statutes and agency guidance for general information. It is not legal advice and does not interpret any policy. Questions about specific correspondence belong with the attorney who advertises on this site.