Health Administration Responsibility Project

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Discovery in Insurance Bad Faith Cases

• Claim File.
  Required by Calif. Code of Regs, Art. X, Ch. 5, Subch. 7.5, sec.2965.3
  There may be files at local, regional and home offices.
• Underwriting File.
• E-mail or computer-generated information.
• Insurer's records relating to Agency issues.
• Reserves and Reinsurance Materials.
  see Lipton v. Sup.Ct, 48 CalApp4th 1599 (1996) re discoverability.
• Claims Manual.
  see Glenfed v. Sup.Ct., 53 CalApp4th 1113 (1997)
• Underwriting Manual.
• Policy Language (Insurer's copy) and its drafting history.
• HMO's Advertising Documents and Promotional Material
• Extra Contractual Liability Insurance.
• Contract between HMO and IPA
• Contract between IPA and the Treating Physicians
• Info about Other Similar Claims and Suits. Re admissibility see:
  Colonial Life v. Sup.Ct.(Perry) 31 Cal3d 785 (1982) to show "regular business practice"
  Moore v. Amer. United Ins., 150 CalApp3d 610 (1984) to show insurer knew standards to use
  Carey-Canada v. Calif. Union Ins., 118 FRD 242(DDC 1986) to show interpretation of terms
  Neal v. Farmers, 21 Cal3d 910 (1978), re proof of malice
• Dept. of Insurance or Dept. of Managed Care records.
• SEC records
• Records of Agent or Broker.
• Get help from your Experts with reviews of documents.

• Claims Handler/Adjuster
• Claims Supervisor/Manager
• Underwriter
• Coverage Counsel for Insurer
• Agent or Broker