Insurance Mediation Law and Legal Definition

Insurance mediation refers to the process of settling disputes arising from certain types of insurance claims. The dispute will be between the insured and the insurer.

According to Cal Ins Code § 10089.70, the claims arising under insurance mediation are: < p>

1. Claim that arises under a homeowners' insurance policy and that involves loss due to a fire.

2. Claim that arises under a policy covering earthquake damage and that involves loss due to an earthquake.

3. Claim that arises under automobile collision coverage or automobile physical damage coverage.

However, insurance mediation will not be applicable to any dispute involving the actions of an agent or broker in which the insurer is not alleged to have been responsible for the conduct, or any complaint the commissioner finds to be frivolous, or any dispute in which a party is alleged to have committed fraud.

Insurance mediation includes the following:

1. introducing, proposing or carrying out other work preparatory to the conclusion of contracts of insurance or reinsurance;

2. concluding contracts of insurance or reinsurance;

The following is an example of the state statute (California) stating who can resort to insurance mediation:

Cal Ins Code § 10089.71, any insured having a dispute with an insurer under a policy that qualifies for this program may file a written complaint with the department. The complaint shall indicate that the complainant has not been able to reach a satisfactory settlement of a claim with the insurer. The department shall, if deemed appropriate, notify the insurer against whom the complaint is made of the nature of the complaint, may request appropriate relief for the complainant, and may meet and confer with the complainant and the insurer in order to attempt resolution of the dispute.