Section 2695.2. Definitions

As used in these regulations:

(b) “Calendar days” means each and every day including Saturdays, Sundays, Federal and California State Holidays, but if the last day for performance of any act required by these regulations falls on a Saturday, Sunday, Federal or State Holiday, then the period of time to perform the act is extended to and including the next calendar day which is not a Saturday, Sunday, or Federal or State holiday;

(c) “Claimant” means a first or third party claimant as defined in these regulations, any person who asserts a right of recovery under a surety bond, an attorney, any person authorized by operation of law to represent the claimant, or any of the following persons properly designated by the claimant in the manner specified in subsection 2695.5(c): an insurance adjuster, a public adjuster, or any member of the claimant’s family.

(d) “Claims agent” means any person employed or authorized by an insurer, to conduct an investigation of a claim on behalf of an insurer or a person who is licensed by the Commissioner to conduct investigations of claims on behalf of an insurer. The term “claims agent”, however, shall not include the following:

1) an attorney retained by an insurer to defend a claim brought against an insured;

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(f) “First party claimant” means any person asserting a right under an insurance policy as a named insured, other insured or beneficiary under the terms of that insurance policy….;

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(i) “Insurer” means a person licensed to issue or that issues an insurance policy … in this state, or that otherwise transacts the business of insurance in the state…. The term insurer, for purposes of these regulations includes non-admitted insurers….

(j) “Insurance policy” or “policy” means the written instrument in which any … contract of insurance … is set forth….;

(k) “Investigation” means all activities of an insurer or its claims agent related to the determination of coverage, liabilities, or nature and extent of damages afforded by an insurance policy, … and other obligations or duties arising from an insurance policy….

(l) “Knowingly committed” means performed with actual, implied or constructive knowledge, including, but not limited to, that which is implied by operation of law.

(m) “Licensee” means any person that holds a license or Certificate of Authority from the Insurance Commissioner, or any other entity for whom the Insurance Commissioner’s consent is required before transacting business in the State of California or with California residents….

(n) “Notice of claim” means any written or oral notification to an insurer or its agent that reasonably apprises the insurer that the claimant wishes to make a claim against a policy or bond issued by the insurer and that a condition giving rise to the insurer’s obligations under that policy or bond may have arisen. For purposes of these regulations the term “notice of claim” shall not include any written or oral communication provided by an insured or principal solely for informational or incident reporting purposes.

(o) “Notice of legal action” means notice of an action commenced against the insurer with respect to a claim, or notice of action against the insured received by the insurer …, and includes any arbitration proceeding;

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(q) “Person” means any individual, association, organization, partnership, business, trust, corporation or other entity;

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(s) “Proof of claim” means any documentation in the claimant’s possession submitted to the insurer which provides any evidence of the claim and that supports the magnitude or the amount of the claimed loss.

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