ursapro

The California Fair Claims Settlement Practices Regulations establish strict deadlines that insurers must follow. When they violate these deadlines, they are breaking the law .

Strict Deadlines Insurers Must Follow

15 days. Upon receiving notice of a claim, every insurer must immediately provide the insured with a written notice containing information about their rights and claims settlement practices. This must happen no more than 15 calendar days after receipt of the claim .

40 days. California Insurance Code Section 790.03(h) and the Fair Claims Settlement Practices Regulations require insurers to adopt and implement reasonable standards for the prompt investigation and processing of claims . If the insurer needs more time, they must explain the reason in writing before the deadline expires and continue providing status updates every 30 days.

30 days. After a claim is approved, payment must be issued within 30 days. Its a rule

Insurers Must Investigate, Not Dismiss

California Insurance Code Section 790.03(h) requires insurers to conduct thorough, fair, and objective investigations of every claim . An insurer cannot simply dismiss a claim by saying they do not see damage.

Section 2695.7(d) of the Fair Claims Settlement Practices Regulations explicitly requires every insurer to conduct and diligently pursue a thorough, fair, and objective investigation of a claim . This applies to all claims, including smoke damage claims .

Important: Insurers cannot require you to pay for your own investigation. If professional testing is warranted, the insurance company must contract and pay for these services .

Smoke Damage Is Physical Damage

For years, some insurance companies used a loophole, arguing that smoke was simply an odor and not real damage. The California Department of Insurance has closed this loophole.

Bulletin 2025-7 states that insurers must fully and fairly investigate smoke damage claims . The California Supreme Court confirmed in Another Planet Entertainment v. Vigilant Insurance Company that physical damage does not need to be visible to the naked eye or structural to be real .

What this means:

Smoke that penetrates walls, insulation, and ventilation systems is direct physical damage.

Smoke damage does not need to be visible or structural to be covered.

If your insurer says «you have no visible damage, only odor,» that may be a violation of California law .

If Your Claim Is Delayed, Do Not Stay Silent

If your claim is stuck, the insurer must provide a written explanation. No explanation means a violation.

Key provisions:

60% advance payment. Insurers must pay 60% of personal property coverage limits, capped at $350,000, without requiring a detailed inventory of lost items .

Extended timeline. The deadline to submit a Proof of Loss is extended to 100 days after the loss .

This law was authored by Senator Ben Allen, who represents Pacific Palisades, and sponsored by Insurance Commissioner Ricardo Lara . It doubles the previous requirement of 30% with a $250,000 cap .

Insurers are prohibited from:

Misrepresenting facts or policy provisions

Ignoring communications without reasonable cause

Denying coverage without conducting an investigation

Requiring you to pay for expert testing

Need Help With Your Insurance Claim?

Ursa Pro Restoration prepares all fire damage scope estimates in Xactimate format, with site photos, emergency mitigation records, and rebuild continuity documentation that supports your adjuster from day one. We provide direct insurance billing and adjuster communication support, handling both the mitigation and the full reconstruction