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Insurance regulator files a 432-count action over wildfire claims handling

Insurance regulator files a 432-count action over wildfire claims handling
California · Regulation

Insurance regulator files a 432-count action over wildfire claims handling

California's insurance regulator has moved from describing claims-handling standards to enforcing them, in an action alleging 432 violations arising from the January 2025 Los Angeles wildfires.

The Department of Insurance announced on May 4, 2026 that it had filed an Accusation and Order to Show Cause against State Farm General — the first step toward a public hearing before an administrative law judge.1

The predicate was a Commissioner-ordered Market Conduct Examination, opened on consumer complaints after the fires.

What the examination found

398 violations across 114 of 220 claims sampled — a majority of the sample — plus 34 further violations arising from consumer complaints. 432 alleged violations in total.

The claims are brought under the Unfair Insurance Claims Practices Act, with penalties available under Insurance Code section 790.035 of up to $5,000 per violation, or $10,000 per willful violation.

The conduct alleged

Investigations delayed past the 15-day requirement. Failure to accept or deny within 40 days. Unreasonably low offers. Repeated adjuster reassignment — what the Department called “adjuster roulette.” Improper denial and misclassification of smoke damage claims, which made up nearly half of the complaints. Failed status communications.

For context on scale: State Farm policyholders filed roughly 11,300 residential claims out of 38,835 total in the fire area.

Why it matters to associations

The allegations are unadjudicated, and it is worth being clear about that — an Accusation is a charging document, not a finding.

What is not in doubt is the standard being enforced. The 15-day investigation and 40-day accept-or-deny clocks are the same regulations that govern a claim on an association's master policy. They are not residential-only, and they do not depend on the size of the loss.

One honest limit: the Department's announcement does not mention condominium, homeowners association, loss-of-use or additional living expense claims specifically. The relevance here is the standard and the enforcement posture, not a finding about association claims.

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What it changes for boards and managers

There is now a named benchmark for documenting insurer delay. An association manager handling a large loss has always been able to point to the claims regulations. What is new is a live enforcement action in which the regulator has quantified what non-compliance looks like — 398 violations in 220 claims — and the Department's complaint channel is the route that produced the examination.

For a board whose master policy claim has stalled, that changes the calculus of complaining. A complaint is not merely a grievance; it is the mechanism that generated this exam.

Document the clocks from the first notice. The obligations run from dates: when notice of the claim was given, when the investigation began, when acceptance or denial came. An association that cannot evidence those dates cannot establish a breach of them. That means dated written notice, dated correspondence, and a record of each adjuster change.

“Adjuster roulette” is a documented pattern, not just a frustration. Repeated reassignment resets the institutional knowledge of a claim and is one of the practices the Department has charged. A simple log of who held the file and when it changed hands documents the pattern.

Smoke damage is the association-shaped loss. Nearly half the complaints in this exam concerned smoke. In a condominium, smoke intrusion into shared corridors, attics, elevator shafts and HVAC systems is the characteristic wildfire loss even where no unit burned — and it is the loss most likely to be denied or reclassified.

The smoke standards bill, and where it stands

AB 1795, the Smoke Damage Recovery Act, is on the Governor's desk. It was enrolled on September 4, 2026 after the Senate passed it 28–10 and the Assembly concurred 58–7 on August 31.2

The Department's announcement of the measure identifies a concrete duty: insurers must inspect a smoke-damaged property within 30 days of receiving notice of a claim or gaining access. It also assigns work to agencies — the Department and Cal OES to evaluate coverage gaps and recovery needs, and Cal/OSHA, through the Occupational Safety and Health Standards Board, to establish training and certification requirements for adjusters handling wildfire smoke damage claims. No completion dates are given for either.

It is not law. The Governor must act by September 30, 2026. If signed, a 30-day inspection clock would apply to master policy losses on condominium and multifamily buildings, and the certification requirement would change who is qualified to adjust them.

The Department's existing Bulletin 2025-7 already addresses smoke damage coverage and claims handling.

The other protection associations gained this year

Claims handling is one half of the picture. The other is whether the policy exists at renewal.

Insurance Code section 675.55, added by SB 547 effective January 1, 2026, extends the one-year post-wildfire non-renewal moratorium to commercial policies — and subdivision (d) names “Homeowners associations” and “Condominium associations” expressly, overriding the general carve-out for large commercial policies.

It has already run twice in 2026: Bulletin 2026-1 after the Gifford Fire, and Bulletin 2026-6, dated August 14, 2026, locking 22 ZIP codes for a year from the Gann Fire proclamation. The bulletin also requires insurers to offer to rescind wildfire-risk non-renewal notices issued on or after the proclamation date.

Managers in fire-affected counties should be reading those bulletins as an insurance renewal input, not only as disaster news.

What to watch next

The administrative hearing. An Accusation and Order to Show Cause begins a process before an administrative law judge, and the outcome — whatever it is — will be the first authoritative account of how these standards apply to a mass wildfire claim event in California.

Also on the desk: AB 1680, the FAIR Plan overhaul, enrolled September 4, 2026. The Department's announcement of it made no reference to associations or master policies, which leaves open whether the Plan's High Value Commercial Property program — the $20 million per building backstop many large associations now rely on — is addressed at all.

Related California HOA Topics

← All California HOA Topics

  1. California Department of Insurance, 'California takes legal action against State Farm after investigation finds widespread mishandling of LA wildfire claims' (May 4, 2026)
  2. California Department of Insurance, press release 029-2026 (September 1, 2026) — Smoke Damage Recovery Act, AB 1795, and the 30-day inspection requirement
  3. AB 1795, California Legislature — bill status (Smoke Damage Recovery Act, enrolled September 4, 2026)
  4. Bulletin 2026-6, California Department of Insurance (August 14, 2026) — one-year non-renewal moratorium and affected ZIP codes

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