(b) Upon receipt of notice from a claimant of a claim that reasonably indicates that a response is expected, each Licensee shall, without undue delay, but no later than fifteen (15) calendar days after receipt of such notice, provide the Claimant with a complete response based on the facts known to the Licensee at that time. This paragraph shall not apply to communications with an applicant upon receipt of a statement of claim by the licensee by that applicant. (g) „gross settlement amount” means the amount offered plus the amount deducted under the policy when settling a claim for total loss for motor vehicles; 2. The insurer pays the insured person the difference between the amount of the gross return and the cost of the comparable motor vehicle that the insured person located, or negotiates and purchases the vehicle for the insured person; or: (4) No insurer shall be required to take action under this subsection if its documents to the insured at the time of the final settlement offer contained written notice of the identity of a particular comparable vehicle offered for sale at the time of the final settlement offer for the gross settlement amount determined by the insurer. The documentation must include the telephone number (including area code) or address of the seller of the comparable vehicle and: (f) The insurance provisions relating to the examination, processing and settlement of claims must comply with the provisions of this Regulation or be more favourable to the insured than the provisions of this Regulation. (d) Each insurer shall conduct and conduct a thorough, fair and objective investigation and shall not insist on obtaining information that is not reasonably necessary or material for the resolution of a claim dispute. (1) The Insurer shall find a comparable vehicle for the gross settlement amount determined by the Company at the time of settlement and provide the Insured with the information set out in Section (c)(4) below or offer a replacement vehicle in accordance with § 2695.8(b)(4). Such a vehicle must be available in the local market area; (o) „notice of legal action” means the notice of an action brought against the insurer in respect of a claim or the notification of a claim against the insured received by the insurer or the notification of an action brought against the principal under a bond and includes all arbitration proceedings; (d) Where the damage is paid on the basis of a written amount and/or a written estimate by or for the insurer, the insurer shall provide the claimant with a copy of each document on which the declaration is based. The estimate made by or for the insurer must be made in accordance with the applicable insurance regulations to an amount that restores the damaged property to at least its condition before the loss and allows repairs in a way that meets recognized commercial standards for good and professional construction. The insurer shall take reasonable steps to verify that the repair or reconstruction costs incurred by the insurer or its claims intermediaries are correct and representative of the costs in the local market area. If the claimant subsequently argues, on the basis of a written estimate of the costs it receives, that the necessary repairs exceed the written estimate of the costs established by or for the insurer, the insurer must: (1) delineate certain minimum standards for the settlement of claims which, if knowingly violated or carried out with such frequency, indicate a general commercial practice: constitute an unfair claims settlement practice within the meaning of Article 790.03(h) of the Insurance Code; (g) No insurer may attempt to settle a loss by means of an unreasonably low settlement offer. The Commissioner must consider all admissible evidence available with respect to the following factors in determining whether a settlement offer is unreasonably low: (c) In the case of first-party automobile claims, each insurer must inform the insured, at the time of sending the settlement payment or final settlement offer, that this will be done by the insured within thirty-five (35) calendar days of receipt of the Payment of damages or the final settlement offer is communicated by the insured. The insurer reopens its claim file to the effect that it cannot purchase a comparable automobile for the gross amount of the settlement.
If the insurer is subsequently notified by the insured, it reopens its claim file and applies the following procedures: (c) in recognition of both the unique relationship that exists under a guarantee between the guarantor, creditor or beneficiary and the principal and the fact that the processing of guarantee claims is subject to the Unfair Practices Act; Beginning with Section 790 of the California Insurance Code, only sections 2695.1 through 2695.6 inclusive, Section 2695.10, and Sections 2695.12, 2695.13, and 2695.14 inclusive apply to the processing or settlement of warranty claims. . . .
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