Skip Ribbon Commands
Skip to main content
Navigate Up
Sign In
Home > Complaint Data Reports > State Service Center Profiles > Profile-CDI

Consumer Assistance at the California Department of Insurance

The California Department of Insurance is one of the state regulators that oversees Californians' health care coverage.

The following table outlines information the department reported to OPA about its consumer assistance service center and the complaint cases it reviewed in 2016.

California Department of Insurance
Service Center Name Consumer Services Division
Main Phone Number 1-800-927-HELP (4357) or 213-897-8921
TTY/TDD 1-800-482-4833
Hours of Operation Monday-Friday, 8:00 a.m. - 6:00 p.m.
After-hours message center 
Most Common Reasons for Complaints Filed with this Service Center
  1. Claim denial (29%)
  2. Experimental (9%)
  3. Unsatisfactory Settlement or Offer (8%)
  4. Medical Necessity Denial (8%)
  5. Out-of-Network Benefits (7%)
  6. Co-Pay, Deductible, and Co-Insurance Issues (4%)
  7. Claim Delay (3%)
  8. Pharmacy Benefits (3%)
  9. Emergency services (3%)
  10. Cancellation (2%)
Most Common Results from this Service Center's Complaint Review
  1. Health plan position substantiated (40%)
  2. Recovery (23%)
  3. Question of Fact / Contract / Provision / Legal Issue (16%)
  4. Health Plan in Compliance (8%)
  5. Additional Payment (2%)
  6. Insufficient Information (1%)
  7. Claim Settled (1%)
  8. Advised Complainant (1%)
  9. Other State-Specific Result (1%)
  10. Policy issued or restored (1%)
Average Number of Days a Complaint Review Takes 90 days
Minimum number of days to resolve a complaint: 0 days
Maximum number of days to resolve a complaint: 669 days

  • There is a faster review process for an urgent health issue.
  • The time frame noted above includes time for regulatory review after the case is closed to the consumer who filed the complaint. CDI indicated that this final regulatory review period is 30 days on average.

Find complaint information from prior years