§ 2696.3. Determination of Eligibility.

(a) The following will not be referred to mediation under this subchapter:

(1) Disputes that turn on a question of major insurance coverage as that term is defined in Section 2696.2(b) of this subchapter;

(2) Disputes involving a purely legal interpretation as that term is defined in Section 2696.2(c) of this subchapter;

(3) Disputes involving the actions or conduct of an agent or broker, unless there are allegations that the insurer is responsible for the actions or conduct;

(4) Disputes in which a party is alleged to have committed fraud as defined in Section 2696.2(f) of this subchapter;

(5) Disputes involving allegations of bad faith, or other claims for extra contractual damages;

(6) Disputes concerning which a lawsuit has already been filed;

(7) Those requests for mediation determined by the Department to be frivolous or to have been filed in bad faith.

(b) Notwithstanding subsection (a), should a claim involve more than one disputed issue and one or more of those issues are not eligible for referral to mediation, nothing in this subchapter shall preclude the commissioner from referring to mediation only those issues eligible for mediation. However, the Commissioner shall not refer to mediation those issues which are rendered moot by the determination that a question of major insurance coverage or purely legal interpretation exists.

HISTORY

1. New section filed 10-15-96; operative 10-15-96 (Register 96, No. 42). A Certificate of Compliance must be transmitted to OAL by 2-12-97 or emergency language will be repealed by operation of law on the following day.

2. Repealed by operation of Government Code section 11346.1(g) (Register 97, No. 10).

3. New section filed 3-4-97 as an emergency; operative 3-4-97 (Register 97, No. 10). A Certificate of Compliance must be transmitted to OAL by 7-2-97 or emergency language will be repealed by operation of law on the following day.

4. Certificate of Compliance as to 3-4-97 order, including amendments to subsections (b)(5) and (c), transmitted to OAL 7-3-97 and filed 8-13-97 (Register 97, No. 33).

5. Amendment of section and Note filed 12-29-2006; operative 1-28-2007 (Register 2006, No. 52).

Note

Note: Authority cited: Section 10089.83, Insurance Code. Reference: Sections 10089.7, 10089.72 and 10089.74, Insurance Code.