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Licensed auto and home insurance agent
4+ years in content creation and marketing
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Licensed auto and home insurance agent
4+ years experience in insurance and personal finance editing
NPN: 20564519
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Licensed property and casualty insurance agent
10+ years editing experience
NPN: 20461358
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Updated
Under California’s Fair Claims Settlement Practices Regulations, insurance companies in California must follow set timelines when investigating claims. Insurers must acknowledge and begin investigating your claim within 15 days and either accept or deny it within 40 days of receiving proof of claim.[1]
In some cases, insurers can extend their investigation, but they must provide you with notice in writing and update you on the claim investigation status every 30 days.
Exact deadlines depend on California state law, policy terms, and other factors, such as claim complexity. The more complex the claim, the longer it may take for the insurer to investigate.
Here’s what you should know about insurance claim investigations in California.
In theory, insurers in California should settle your claim within 40 days. In reality, a typical auto claims investigation can take longer if the insurer says it needs more time to fully investigate your claim.[2]
Exactly how long your auto claims investigation takes depends on a few factors, including the type of claim and the severity of the incident.
Here are several other factors your insurer will review and confirm during the claims process:
Claim’s legitimacy
If your policy covers the claim
Accuracy of listed damages and repair costs
Determination of liability and fault
Review of police reports and medical records
Average liability quotes start at $65/mo.
Make sure you understand California’s auto insurance claims investigation rules so you know what to expect during the process. If you want guidance on your specific situation, consult a licensed California auto attorney.
Here are California’s general rules surrounding auto insurance claims, but keep in mind that your policy may dictate additional terms.
Claims Process Step  | Typical Duration in CA | Potential Outcome |
|---|---|---|
| Acknowledge receipt of claim | Within 15 calendar days | Confirmation of claim and reception of required forms |
| Begin investigation | Within 15 calendar days | Insurer starts gathering evidence and information |
| Request additional information | When necessary during the investigation | Insurer asks for proof of claim and supporting documents |
| Notify policyholder of delay | Within 40 days of proof of claim, must be in writing | Insurer explains reason for delay |
| Approve or deny claim | Within 40 calendar days of receiving proof of claim | Insurer accepts or denies claim |
| Issue payment after approval | Within 30 calendar days of settlement | Policyholder receives claim payout |
| Notify policyholder how to appeal | Provided during claim denial | Policyholder can dispute the decision or file an appeal with the California Department of Insurance |
The claim investigation comes before the claim settlement, determining the outcome of your settlement. The investigation phase is when the insurer gathers evidence and reviews your claim to ensure that it’s legitimate, decides fault, and determines the value of your loss. The claim settlement is the insurer’s decision on whether to approve or deny your claim.
For example, if you’re involved in a rear-end collision, your insurer will investigate who was at fault, then determine your settlement. If the insurer determines you were at fault, it will deny your claim. If it determines the other driver was at fault, your claim settlement will include a claim payout.
California insurance companies investigate auto claims by default. It’s not a sign that something with your claim is wrong, but rather a necessary step to accurately understand the incident and determine the proper claim. In fact, state regulations require insurers to conduct investigations to protect both you, the policyholder, and the insurer.
The typical goals of an insurance claim investigation include:
Confirming you had active coverage
Determining whether your policy covers the claim
Assessing the damages
Determining liability
Verifying police reports and medical records
Remember, investigations are not a sign of suspicion on the insurer’s part. They’re a necessary, routine part of the auto insurance claims process.
Once you file an auto insurance claim in California, the insurer must acknowledge it has received it within 15 calendar days and send you the necessary claim forms and instructions. The insurer will then assign a claims adjuster to your case, who will review your insurance policy, conduct the claims investigation, and determine your settlement.
Once your insurer has assigned an adjuster to your case, they will begin to gather evidence, such as police reports, photos of damage, repair estimates, witness statements, and more. They’ll also inspect your vehicle to determine damage and make their own repair or replacement cost estimates.
From there, the insurance adjuster will determine your claim settlement within 40 days of proof of claim. If it takes longer, the insurer must notify you in writing every 30 days with an update.
Your insurer may request additional information from you during the investigation to thoroughly understand the situation. The insurance company or your adjuster may ask you for the following:
Photos of the car accident
Policy report
Repair estimates
Medical bills and records
Proof of loss (a statement with evidence detailing what happened)
A few things can cause insurance claim investigation delays in California. Typically, delays occur because the insurer needs more information. Some of the most common reasons are:
Missing or incomplete information
Unclear liability
Complex or extensive vehicle damages
Multiple involved parties or insurance companies
Difficulty reaching witnesses
Yes, an insurance company can take longer than California’s deadline if the insurer genuinely needs more time. Insurers must notify the policyholder before the 40-day window has passed and must continue to update the policyholder in writing every 30 days thereafter. Your insurer must explain delays, which must be for reasons beyond the insurer’s control.
Insurers can’t delay investigations without proper justification, and they must keep you, the policyholder, in the loop. If your insurer’s investigation goes past the deadline without explanation, this could qualify as bad faith. If you suspect your insurer of this, document it and consider filing a complaint with the California Department of Insurance if the delays continue.
The best thing you can do if your insurance claim is taking too long is to work closely with your adjuster. Make sure they have all the documents they need as soon as they request them.
Delays often come from incomplete or missing information or unanswered questions, so don’t withhold any important information. If your claim is still moving slowly, follow these steps:
Review your policy closely. Make sure you fully understand your coverage, your responsibilities, and any conditions or deadlines dictated for the claims process.
Check California’s deadlines. Confirm the state’s regulations and timelines to determine if your insurer is actually behind schedule.
Request a status update from your insurer. Ask your insurer to send you a written explanation of your claim’s status and why it’s taking longer than expected.
Escalate to a supervisor. If your adjuster isn’t answering you, you can ask to speak with a supervisor to understand what’s going on.
File a complaint. As a last resort, if your insurer is completely unresponsive or avoiding your questions, you can file a complaint with the California Department of Insurance.[3]
You can also file a complaint with the National Association of Insurance Commissioners (NAIC). Start at the NAIC consumer page, choose your state, then follow the link to California’s complaint page. You’ll then fill out an online or paper form with your complaint details and any supporting documents.
Contacting the California Insurance Department is a drastic step you should only take if you’ve completely hit a wall with your insurer. If your adjuster starts taking longer to respond, giving vague answers, or stops answering altogether, it might be time to reach out to the California Department of Insurance.
If your insurer denies your claim without providing a clear explanation of why and refuses to elaborate when you ask, you should contact the California Department of Insurance. Before you file a complaint, gather your policy number, records of your communications with the insurer, copies of claim documents, photos, estimates, and bills.
Insurify partners with 120+ top insurers for real quotes
California drivers can prevent delays by filing claims promptly. File your claim right away, document damages thoroughly, and stay organized. Here’s how to keep your California auto insurance claim moving along:
File your claim right away. Let your insurer know about the car accident right away so it can begin investigating.
Take extensive photos of the damage. Make sure to photograph all vehicle damage before repairs are completed. Take photos of relevant road conditions and the scene of the incident.
Gather necessary documentation right away. Don’t make your adjuster wait for the files they need. Have the police report, medical bills, and repair estimates ready to go.
Respond quickly. Provide your adjuster with timely responses or additional information right away so they can continue their investigation.
Follow up. Check in with your adjuster regularly to see how the process is coming along. Don’t be demanding or imply that they are causing the delay; just tell them you want to be kept in the loop.
Understanding California’s claim timelines can help you reduce investigation delays. Check out these answers to some of the most commonly asked questions about car insurance claims investigations in California.
The longest an insurance claim can take in California is generally 40 days from the date of proof of claim, though insurers can file for extensions if circumstances beyond their control cause delays. Insurers must inform policyholders of delays within 40 days, and must provide written updates every 30 days.
Filing an auto insurance claim triggers an auto claim investigation, as they’re standard practice. Insurers do investigations by default, and aren’t a sign of suspicion on the insurer’s part.
State National has the most complaints of any car insurance company in California, according to the California Department of Insurance.[4]
Insurance companies in California have 15 days to respond to a claim, and 40 days to accept or deny it. They can extend claims investigations if circumstances beyond their control cause delays.
California state law doesn’t have a firm maximum time limit for how long a car insurance claim can stay open, as insurers can extend claims investigations if genuine reasons outside of their control cause delays. That said, insurers must provide policyholders with a written status update on their claim every 30 days.
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Licensed auto and home insurance agent
4+ years in content creation and marketing
Featured in
Licensed auto and home insurance agent
4+ years experience in insurance and personal finance editing
NPN: 20564519
Featured in
Licensed property and casualty insurance agent
10+ years editing experience
NPN: 20461358
Featured in
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