Ensured Compliance with California Insurance Claims Laws With In-App Smart Tips

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An insurance provider used Whatfix Smart Tips to ensure compliance with Proposition 103 by reminding claims adjusters to issue CL26 letters for at-fault policyholders. This intervention helped the company avoid regulatory penalties and improved operational efficiency by reducing manual checks.

Proposition 103 mandates that auto insurers in California send a CL26 letter to policyholders deemed 51% or more at fault in an accident, informing them of their right to appeal within 30 days. Previously, the insurer's claims management system, Guidewire, automatically flagged claims requiring a CL26 letter. However, a system change removed this feature, putting the company at risk of non-compliance. Non-compliance could lead to severe penalties from the Department of Insurance (DOI), including fines or even revocation of the insurer's license, as well as dissatisfied customers. With an increasing number of adjusters handling California claims, the company needed a reliable way to ensure consistent issuance of CL26 letters and avoid manual errors, which could jeopardize compliance with Prop 103.

The insurance company implemented Whatfix Smart Tips to trigger a timely reminder whenever a claim with 51-100% fault attribution was identified in Guidewire. This in-app guidance ensured that adjusters were immediately aware of the requirement to send a CL26 letter, preventing the risk of missing this critical compliance step.