Article 1 False and Fraudulent Claims
Article 2 Bureau of Fraudulent Claims
Article 3 Insurance Fraud Reporting
Article 4 Motor Vehicle Theft and Motor Vehicle Insurance Fraud Reporting
Article 4.5 Insurer Inspections
Article 4.6 Auto Insurance Fraud Crisis Areas
Article 5 Arson Investigations
Article 5.5 Insurance Claims Analysis Bureaus
Article 5.6 Insurer Fraud Investigation
Article 6 Deposit of Automobile Insurance Claims Information
Article 7 Workers’ Compensation Insurance Fraud Reporting
Article 8 Insurance Fraud Prevention

Terms Used In California Codes > Insurance Code > Division 1 > Part 2 > Chapter 12

  • Action: includes a civil action and a special proceeding of a civil nature. See California Government Code 14172
  • Adjourn: A motion to adjourn a legislative chamber or a committee, if passed, ends that day's session.
  • Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Alcohol and drug abuse records: means patient records, or discrete portions thereof, specifically relating to evaluation and treatment of alcoholism or drug abuse. See California Insurance Code 11624.4
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Amortization: Paying off a loan by regular installments.
  • Ancillary benefit plan: means a policy or contract written or administered by a participating carrier that covers dental or vision benefits for the covered eligible employees of an employer or small employer and their dependents. See California Insurance Code 10810
  • Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Associated equipment: means any of the following, excluding radio equipment:

    California Insurance Code 1140

  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Authorized agency: means any of the following officers or agencies, or their duly authorized representatives, when investigating or prosecuting arson in connection with a specific fire: the State Fire Marshal, the Director of the Department of Forestry and Fire Protection, the chief of any city or county fire department, the chief of any fire protection district, the Attorney General, any district attorney, or any peace officer, the Department of Insurance, and any federal agency. See California Insurance Code 1875
  • authorized governmental agency: means the Department of the California Highway Patrol, the Department of Motor Vehicles, the Department of Insurance, the Department of Justice, the police department of a city, or a city and county, the sheriff's office or department of a county, the district attorney of any county, or city and county, those agencies employing officers designated in subdivisions (a) and (b) of Section 830. See California Insurance Code 1873.3
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Board: means the governing body of the purchasing alliance. See California Insurance Code 10810
  • Carrier: means any licensed disability insurance company or licensed health care service plan or any other entity that writes, issues, or administers any health benefit plan or ancillary benefit plan to employers or small employers in this state. See California Insurance Code 10810
  • Catastrophic health insurance: means a supplementary insurance contract that indemnifies a California resident for medical expenses, including at least the costs of the basic health care services that result from an illness, injury, or disease, and that are greater than fifty thousand dollars ($50,000), subject to a lifetime benefit limit of one million dollars ($1,000,000). See California Insurance Code 11629.731
  • City: includes city and county and "incorporated town" but does not include "unincorporated town" or "village. See California Education Code 5092
  • City: includes city and county. See California Education Code 19480
  • City: includes "city and county. See California Education Code 25018.6
  • Commission: means the Public Utilities Commission created by Section 1 of Article XII of the California Constitution, and "commissioner" means a member of the commission. See California Education Code 5093
  • Commissioner: means the Insurance Commissioner, who shall have regulatory jurisdiction over purchasing alliances. See California Insurance Code 10810
  • compensation: means workers' compensation insurance. See California Insurance Code 11551
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • County: includes "city and county. See California Education Code 32284
  • County: includes "city and county. See California Education Code 17389
  • County: includes city and county. See California Education Code 5091
  • County: includes city and county. See California Education Code 19479
  • County: includes "city and county. See California Education Code 25018.5
  • Court: means the trial court in which the action is pending, unless otherwise specified. See California Government Code 14172
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Department: means the Department of Motor Vehicles or any successor agency thereto which registers vehicles. See California Insurance Code 1874.8
  • Dependent: A person dependent for support upon another.
  • Deposition: An oral statement made before an officer authorized by law to administer oaths. Such statements are often taken to examine potential witnesses, to obtain discovery, or to be used later in trial.
  • Director: means Director of Industrial Relations. See California Education Code 32390
  • Director: means "State Director of Health Services. See California Education Code 24944
  • Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
  • Docket: A log containing brief entries of court proceedings.
  • Electronic: means relating to technology having electrical, digital, magnetic, wireless, optical, electromagnetic, or similar capabilities. See California Government Code 14172
  • Electronically stored information: means information that is stored in an electronic medium. See California Government Code 14172
  • Eligible employee: means any permanent employee who is actively engaged on a full-time basis in the conduct of business of the employer or small employer and, who has satisfied any employer or small employer waiting period requirements. See California Insurance Code 10810
  • Employer: means any corporation, partnership, sole proprietorship, or other business entity doing business in this state that may be eligible to participate in a purchasing alliance. See California Insurance Code 10810
  • Enrichment: means providing objects or activities, appropriate to the needs of the species, as well as the age, size, and condition of the pet, that stimulate the pet and promote the pet's well-being. See California Insurance Code 10873
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Ex officio: Literally, by virtue of one's office.
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Felony: A crime carrying a penalty of more than a year in prison.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Foreign: means not organized under the laws of this State, whether or not admitted. See California Education Code 32032
  • Goods: includes wares or merchandise. See California Education Code 19520
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Health benefit plan: means a policy or contract written or administered by a participating carrier that arranges or provides health care benefits for the covered eligible employees of an employer or small employer and their dependents. See California Insurance Code 10810
  • Health care provider: means any of the following:

    California Insurance Code 11624.4

  • Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Insurance agent: means a person authorized, by and on behalf of an insurer, to transact all classes of insurance other than life, disability, or health insurance, on behalf of an admitted insurance company. See California Education Code 32041
  • Insurer: as used in this chapter includes a disability insurer that covers hospital, medical, or surgical expenses, and a nonprofit hospital service plan. See California Insurance Code 11629.731
  • Insurer: includes the California FAIR Plan. See California Insurance Code 1875
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • liability: means liability and common carrier liability insurance. See California Insurance Code 11550
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • Mail: means first-class mail, postage prepaid, unless registered mail is specified. See California Insurance Code 1874.8
  • Mental health records: includes , but is not limited to, all alcohol and drug abuse records. See California Insurance Code 11624.4
  • Mortgagee: The person to whom property is mortgaged and who has loaned the money.
  • Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
  • Oath: includes an affirmation or declaration. See California Education Code 17389
  • Oath: includes affirmation. See California Education Code 19482
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • operator: means a person who owns or operates, or both, a pet boarding facility. See California Insurance Code 10873
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Owner: is a person having all the incidents of ownership, including the legal title, of a vessel whether or not that person lends, rents, or pledges the vessel. See California Insurance Code 1140
  • Participating carrier: means a carrier that contracts with a purchasing alliance to provide coverage to enrollees under a health benefit plan or ancillary benefit plan. See California Insurance Code 10810
  • partnership: means the School/Law Enforcement Partnership established by this section. See California Education Code 32262
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Patient: means a patient or former patient of a health care provider. See California Insurance Code 11624.4
  • Patient records: includes only records pertaining to the patient requesting the records or whose representative requests the records. See California Insurance Code 11624.4
  • Permanent or fixed enclosure: means a structure, including, but not limited to, an exercise run, kennel, or room, used to restrict a pet, that provides for the effective separation of a pet from the pet's waste products. See California Insurance Code 10873
  • Person: means any person, association, organization, partnership, business trust, limited liability company, or corporation. See California Education Code 32289
  • Person: includes a corporation as well as a natural person. See California Education Code 17389
  • Person: means any person, firm, association, organization, partnership, limited liability company, business trust, corporation, or company. See California Education Code 19500
  • Personal property: All property that is not real property.
  • Pet: means any nonhuman animal housed in the pet boarding facility, including, but not limited to, mammals, birds, reptiles, and amphibians. See California Insurance Code 10873
  • Pet boarding facility: means any lot, building, structure, enclosure, or premises, or a portion thereof, whereupon four or more dogs, cats, or other pets in any combination are boarded at the request of, and in exchange for compensation provided by, their owner. See California Insurance Code 10873
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
  • Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Probate: Proving a will
  • Process: signifies a writ or summons issued in the course of a judicial proceeding. See California Education Code 17389
  • Property: includes both personal and real property. See California Education Code 17389
  • Purchasing alliance: means a non-risk-bearing entity issued a certificate of registration pursuant to this chapter to provide health benefits through multiple unaffiliated participating carriers to multiple participating employers, small employers and their employees within this state as authorized by the commissioner. See California Insurance Code 10810
  • Quorum: The number of legislators that must be present to do business.
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
  • representative: means any of the following:

    California Insurance Code 11624.4

  • Resident: means any individual who lives in California for at least 90 consecutive days. See California Insurance Code 11629.731
  • Resident: means residing in this State, "nonresident" means not residing in this State. See California Education Code 32040
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Service region: means that portion of the state, designated by the commissioner pursuant to regulations as described in this chapter in which each purchasing alliance must fairly and affirmatively offer, market, and sell all of the health benefit plan designs offered through the purchasing alliance that are sold or offered to a small employer to all small employers. See California Insurance Code 10810
  • Services: means the making of repairs or performing labor upon or to, and the furnishing of supplies or materials for, any vessel or any trailer used in connection with a vessel. See California Insurance Code 1874.8
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Spouse: includes "registered domestic partner" as required by Section 297. See California Education Code 24935
  • State: includes the District of Columbia and the territories when applied to the different parts of the United States, and the words "United States" may include the district and territories. See California Education Code 17389
  • State: means the State of California, unless applied to the different parts of the United States. See California Education Code 5090
  • State: means a state of the United States, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the District of Columbia. See California Insurance Code 1140
  • State: means the State of California, unless applied to the different parts of the United States. See California Education Code 19510
  • Statute: A law passed by a legislature.
  • Storage: means the safekeeping, mooring, berthage, wharfage, or anchorage of a vessel and the providing of parking space for any trailer used in connection with the vessel. See California Insurance Code 1874.8
  • Subdivision: means a subdivision of the section in which that term occurs unless some other section is expressly mentioned. See California Education Code 5028
  • Subpoena duces tecum: A command to a witness to produce documents.
  • subscription: includes mark when the signer or subscriber can not write, such signer's or subscriber's name being written near the mark by a witness who writes his own name near the signer's or subscriber's name. See California Education Code 25021
  • Summons: Another word for subpoena used by the criminal justice system.
  • Temporary enclosure: means a structure used to restrict a pet, including, but not limited to, a crate or cage, that does not provide for the effective separation of a pet from the pet's waste products. See California Insurance Code 10873
  • Temporary restraining order: Prohibits a person from an action that is likely to cause irreparable harm. This differs from an injunction in that it may be granted immediately, without notice to the opposing party, and without a hearing. It is intended to last only until a hearing can be held.
  • Testify: includes any mode of oral statement made under oath or affirmation. See California Education Code 17389
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
  • Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Use: means operate, navigate, or employ. See California Insurance Code 1140
  • vessel: includes any trailer used in connection with the vessel which is in the possession of the lienholder at the time the lien arises. See California Insurance Code 1874.8
  • Vessel: includes every description of a watercraft or other artificial contrivance used or capable of being used as a means of transportation on water, except either of the following:

    California Insurance Code 1140

  • Vessel: includes ships of all kinds, steamboats, steamships, canal boats, barges, sailing vessels, and every structure adapted to be navigated from place to place for the transportation of merchandise or persons. See California Education Code 19511
  • war: shall mean : (a) whenever Congress has declared war and peace has not been formally restored. See California Education Code 1000
  • Writ: means an order or precept in writing, issued in the name of the people, or of a court or judicial officer. See California Education Code 17389
  • Writ: A formal written command, issued from the court, requiring the performance of a specific act.
  • Writing: includes printing and typewriting. See California Education Code 17389