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The examiners reviewed files drawn from the category of Closed Claims for the period March 1, 2001 through February 28, 2002, commonly referred to as the "review period". The examiners reviewed 556 Allstate Property & Casualty Insurance Company claim files. The examiners cited 22 claims handling violations of the Fair Claims Settlement Practices Regulations and/or California Insurance Code Section 790.03 within the scope of this report. Further details with respect to the files reviewed and alleged violations are provided in the following tables and summaries.


The following is a brief summary of the criticisms that were developed during the course of this examination related to the violations alleged in this report. This report contains only alleged violations of Section 790.03 and Title 10, California Code of Regulations, Section 2695 et al. In response to each criticism, the Company is required to identify remedial or corrective action that has been or will be taken to correct the deficiency. Regardless of the remedial actions taken or proposed by the Company, it is the Company's obligation to ensure that compliance is achieved. The total money recovered was $696.71 within the scope of this report.

1. The Company failed to provide written notice of the need for additional time every thirty calendar days. In five instances, the Company failed to provide written notice of the need for additional time every thirty calendar days. The Department alleges these acts are in violation of CCR §2695.7(c)(1).

2. The Company failed to properly document claim files. In three instances, the Company's file(s) failed to contain all documents, notes, and work papers. The Department alleges these acts are in violation of CCR §2695.3(a).

Summary of Company Response: In the three instances noted, the Company acknowledges that documents were missing from the claim files, but states that these three instances were inadvertent errors. The Company has internal control process requirements that include the timely handling of file documents.

3. The Company failed to maintain claim data retrievable for examination. In three instances, the Company failed to maintain claim data that are accessible, legible and retrievable for examination. The Department alleges these acts are in violation of CCR §2695.3(b)(1).

4. The Company failed to provide written basis for the denial of the claim. In two instances, the Company failed to provide written basis for the denial of the claim. The Department alleges these acts are in violation of CCR §2695.7(b)(1).

Summary of Company Response: The Company acknowledges the two instances found wherein Allstate Property and Casualty Company failed to send a written explanation on partial denials, but states that these errors were inadvertent. The Company has advised that it is their normal procedure to provide in writing the basis for all claim denials.

5. The Company failed to include, in the settlement, all applicable taxes, license fees and other fees incident to transfer of evidence of ownership of the comparable automobile. In two instances, the Company failed to include in the settlement, all applicable taxes, license fees and other fees incident to transfer of evidence of ownership of the comparable automobile. The Department alleges these acts are in violation of CCR §2695.8(b)(1).

Summary of Company Response: The Company acknowledges the two instances in which an adjuster overlooked items of this type, but states that these two errors were inadvertent. Moreover, remedial action has been taken. Checks have been issued to the insureds totaling $98.00. Letters were also sent to the insureds apologizing for the oversight.

6. The Company failed to supply the claimant with a copy of the estimate upon which the settlement is based. In two instances, the Company failed to supply the claimant with a copy of the estimate upon which the settlement is based. The Department alleges these acts are in violation of CCR §2695.8(f).

Summary of Company Response: The Company has acknowledged that the files noted did not document that the claimant was supplied with a copy of the estimate upon which the settlement was based. The Company states "Allstate Property and Casualty Insurance Company acknowledges that there was no evidence in its files proving that it provided copies of estimates in the two instances noted. However, lack of such documentation does not mean that, in each instance, the claimant was not provided with a copy of the estimate - only that our file does not document that the copy was provided. Our process is to provide a copy of each estimate to the claimant. Therefore, Allstate Property and Casualty Company asserts that its process is to provide these estimates in accordance with CCR §2695.8(f) and that its failure to have documentation of providing these estimates in these two instances does not suggest a deviation from the practice of providing the estimates but, rather, a failure to maintain documentation that the estimate copies were provided".

7. The Company attempted to settle a claim by making a settlement offer that was unreasonably low. In one instance, the Company attempted to settle a claim by making a settlement offer that was unreasonably low. The Department alleges this act is in violation of CCR §2695.7(g).

8. The Company failed to document the determination of value. In one instance, the Company failed to document the determination of value. Any deductions from value, including deduction for salvage, must be discernable, measurable, itemized, and specified as well as be appropriate in dollar amount. The Department alleges this act is in violation of CCR § 2695.8(b)(1)(c).

9. The Company failed to comply with the Fair Claims Regulations Practices. In one instance each, the Company failed to comply with the following Fair Claims Regulations Practices: CCR §2695.3(b)(2), CCR §2695.3(b)(3), CCR §2695.4(a).

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