Insurance Commissioner Alleged To Be Asleep At The Switch.

A woman claims she should have been, but was not, provided with disability benefits under a group disability policy issued to her employer, a County. The insurer based its denial on language in the policy, which language the woman contends makes it “substantially easier than is permissible under settled California law for the insurer to deny benefits.” Thus, the woman brought a mandamus claim against the Department of Insurance [DOI], contending the DOI breached its mandatory duty under Insurance Code sections 12921.5(a), 12926 and 10291.5(b), to review a new group disability policy form for compliance with the law prior to approving the policy for distribution in the state. The trial court sustained DOI’s demurrer without leave to amend. In reversing, the appellate court concluded the woman states a viable claim for writ of mandate based on her allegation the DOI failed to review the group disability policy prior to approving it as required by the Insurance Code. (Ellena v. Department of Insurance (Cal. App. First Dist., Div. 2; October 1, 2014) 230 Cal.App.4th 198, [178 Cal.Rptr.3d 435].)