SECTIONS 755-758.7 - California Statutes

INSURANCE CODE

SECTION 755-758.7

755. If at the time of the solicitation and issuance of a policy of
life or disability insurance, or of a surety bond which by its terms
continues until canceled, a person may lawfully receive commissions
on it, that person, or in the event of that person's death, his or
her estate or heirs may continue to receive commissions on it during
the continuance in force or renewal of the policy or bond without
being licensed under the provisions of Chapter 5 (commencing with
Section 1621) of Part 2 if all of the following requirements are met:
(a) The recipient does not transact insurance in connection with
the policy or bond while not so licensed.
(b) The payment is made pursuant to a contract entered into,
before that solicitation and issuance, between the insurer paying or
allowing the commission and that person.

756. When the premium on a policy insuring an employer is based
upon the amount or segregation of the employer's payroll, and the
employer, personally or knowingly through his or her employee,
procures a lower premium by willfully misrepresenting the amount or
segregation, that misrepresentation is an unlawful act as to the
employer.
In addition to any penalty provided by law, the employer in that
case is liable to the state in an amount 10 times the difference
between the lower premium paid and the premium properly payable. The
commissioner shall collect the amount so payable and may bring a
civil action in his or her name as commissioner to enforce collection
unless the misrepresentation is made to, and the lower premium
procured from the State Compensation Insurance Fund. In the latter
case the liability to the state under this section shall be enforced
in a civil action in the name of the State Compensation Insurance
Fund and any amount so collected shall become a part of that fund.

757. When a statement of the amount or segregation of a payroll is
materially false, and an insurer, through a person employed by it in
a managerial capacity, accepts the statement as the basis for the
premium on a policy, the acceptance is an unlawful act if the
accepting employee knows of the falsity.

758. (a) It is unlawful for an insurer to require an auto body
repair shop registered pursuant to Sections 9884 and 9889.52 of the
Business and Professions Code, as a condition of participation in the
insurer's direct repair program, to pay for the cost of an insured's
rental vehicle that is replacing an insured vehicle damaged in an
accident, or to pay for the towing charges of the insured with
respect to that accident. However, the insurer and the auto body
repair shop may agree in writing to terms and conditions under which
the rental vehicle charges become the responsibility of the auto body
repair shop when the shop fails to complete work within the
agreed-upon time for repair of the damaged vehicle.
(b) A registered auto body repair shop that is denied
participation in an insurer's direct repair program may report a
denial to the department, which shall maintain a record of all those
denials for the purposes of gathering market conduct information. An
insurer, upon the request of the department, shall disclose the fact
that a denial was made.
(c) Any insurer that conducts an auto body repair labor rate
survey to determine and set a specified prevailing auto body rate in
a specific geographic area shall report the results of that survey to
the department, which shall make the information available upon
request. The survey information shall include the names and addresses
of the auto body repair shops and the total number of shops
surveyed.

758.5. (a) No insurer shall require that an automobile be repaired
at a specific automotive repair dealer, as defined in Section 9880.1
of the Business and Professions Code.
(b) (1) No insurer shall suggest or recommend that an automobile
be repaired at a specific automotive repair dealer unless either of
the following applies:
(A) A referral is expressly requested by the claimant.
(B) The claimant has been informed in writing of the right to
select the automotive repair dealer.
(2) An insurer may provide the claimant with specific truthful and
nondeceptive information regarding the services and benefits
available to the claimant during the claims process. This may
include, but is not limited to, information about the repair
warranties offered, the type of replacement parts to be used, the
anticipated time to repair the damaged vehicle, and the quality of
the workmanship available to the claimant.
(3) If an insurer's recommendation of an automotive repair dealer
is accepted by the claimant, the insurer shall cause the damaged
vehicle to be restored to its condition prior to the loss at no
additional cost to the claimant other than as stated in the policy or
as is otherwise allowed by law. If the recommendation of an
automotive repair dealer is done orally, and if the oral
recommendation is accepted by the claimant, the insurer shall provide
the information contained in this paragraph, as noted in the
statement below, to the claimant at the time the recommendation is
made. The insurer shall mail or provide the notice required by this
paragraph within five calendar days from the acceptance of the
recommendation. The written notice required by this paragraph shall
include the following statement plainly printed in no less than
10-point type in a separate and freestanding document:

"WE ARE PROHIBITED BY LAW FROM REQUIRING THAT REPAIRS BE DONE AT A
SPECIFIC AUTOMOTIVE REPAIR DEALER. YOU ARE ENTITLED TO SELECT THE
AUTO BODY REPAIR SHOP TO REPAIR DAMAGE COVERED BY US. WE HAVE
RECOMMENDED AN AUTOMOTIVE REPAIR DEALER THAT WILL REPAIR YOUR DAMAGED
VEHICLE. WE RECOMMEND YOU CONTACT ANY OTHER AUTOMOTIVE REPAIR DEALER
YOU ARE CONSIDERING TO CLARIFY ANY QUESTIONS YOU MAY HAVE REGARDING
SERVICES AND BENEFITS. IF YOU AGREE TO USE OUR RECOMMENDED AUTOMOTIVE
REPAIR DEALER, WE WILL CAUSE THE DAMAGED VEHICLE TO BE RESTORED TO
ITS CONDITION PRIOR TO THE LOSS AT NO ADDITIONAL COST TO YOU OTHER
THAN AS STATED IN THE INSURANCE POLICY OR AS OTHERWISE ALLOWED BY
LAW. IF YOU EXPERIENCE A PROBLEM WITH THE REPAIR OF YOUR VEHICLE,
PLEASE CONTACT US IMMEDIATELY FOR ASSISTANCE."

(c) Except as provided in subparagraph (A) of paragraph (1) of
subdivision (b), or as to information of the kind authorized by
paragraph (2) of subdivision (b), after the claimant has chosen an
automotive repair dealer, the insurer shall not suggest or recommend
that the claimant select a different automotive repair dealer.
(d) Any insurer that, by the insurance contract, suggests or
recommends that an automobile be repaired at a particular automotive
repair dealer shall also do both of the following:
(1) Prominently disclose the contractual provision in writing to
the insured at the time the insurance is applied for and at the time
the claim is acknowledged by the insurer.
(2) If the claimant elects to have the vehicle repaired at the
shop of his or her choice, the insurer shall not limit or discount
the reasonable repair costs based on charges that would have been
incurred had the vehicle been repaired by the insurer's chosen shop.
(e) For purposes of this section, "claimant" means a first-party
claimant or insured, or a third-party claimant who asserts a right of
recovery for automotive repairs under an insurance policy.
(f) The powers of the commissioner to enforce this section shall
include those granted in Article 6.5 (commencing with Section 790) of
Chapter 1 of Part 2 of Division 1.
(g) The changes to this section made by the act enacted during
the 2009-10 Regular Session that amended this section shall only
apply to actions filed on or after January 1, 2010.

758.6. Insurers shall not engage in capping. For the purposes of
this section, "capping" means offering or paying an amount that is
unrelated to a methodology used in determining paint and materials
charges that is accepted by automobile repair shops and insurers.

758.7. An insurer, upon receiving notice from an insured, shall
reimburse any fees and extra premium charged to an insured due to a
late premium payment or a lapse in coverage under the policy if the
late payment or lapse in coverage was the result of fraud committed
by an agent or broker licensed pursuant to this code and one of the
following has occurred:
(a) The agent or broker has been convicted of fraudulent activity
in court.
(b) An administrative penalty has been imposed on the agent or
broker for fraudulent activity.
(c) The agent or broker has been charged with fraud in court or in
an administrative action and has agreed to plead guilty to a lesser
charge for the fraudulent activity of which he or she is accused.