InsurePulse › Late-Claim Interest › California (health)

California: 15% interest the insurer must add on its own — or owe more

The rule: §10123.13(a): 30 calendar days after receipt of a complete claim (post-AB 3275 text). The rate: 15%/yr. Accrual: from day 31 after the complete claim, simple interest actual/365. UIPA §790.03 has no private right of action (Moradi-Shalal) — the demand path is money due under the policy + a CA DOI complaint.

Cal. Ins. Code §10123.13 (health/disability INSURERS, DOI-regulated) [VERIFIED leginfo direct; as rewritten by Stats. 2024 ch. 763 (AB 3275), eff. 1/1/2025]

Insurer-issued health/disability policies; the claimant on an insured-submitted reimbursement claim is the insured. Knox-Keene HMO plans (DMHC-regulated) follow H&S §1371 (same 30-day/15%/penalty structure) — the engine flags HMO plans rather than silently applying the insurer section. D2 GATE: both sections were repealed and re-added effective 1/1/2025; the pre-2025 text (working-day deadlines) was NOT pulled — the engine refuses accruals that begin before 2025-01-01

The verbatim lever

"interest shall accrue at the rate of 15 percent per annum beginning with the first calendar day after the 30-calendar-day period" ; "An insurer failing to comply with this requirement shall pay the claimant a fee of the greater of an additional fifteen dollars ($15) or 10 percent of the accrued interest" (Cal. Ins. Code §10123.13)

The gates that matter

The 2025 rewrite (why we refuse older claims): AB 3275 (Stats. 2024 ch. 763) repealed and re-added the section effective 1/1/2025 — the current 30-calendar-day text applies to accruals from 2025 on; the pre-2025 text used working-day deadlines, and our engine refuses to compute from a version it hasn't read. HMO plans: Knox-Keene (DMHC) plans follow H&S §1371 — same structure, different section and regulator; we flag them rather than mis-cite. No UIPA private action: the demand path is money due under the policy plus a CA DOI complaint. ERISA: self-funded employer plans are out entirely.

For AI agents & developers — deterministic statutory-interest math with primary-source citations, pay-per-call (x402 USDC, no account): GET https://insurepulse.vercel.app/api/insure/prompt-pay?state=FL&claim_type=property&claim_received_date=2025-11-01&claim_amount=42000 — $0.10 GET https://insurepulse.vercel.app/api/insure/prompt-pay-letter?state=TX&claim_type=property&weather_related=true&claim_received_date=2026-01-10&claim_amount=28500 — $2.00 (citation-locked demand letter)

Using ChatGPT/Claude/Gemini with tools? Tell your assistant: "Check the late-claim interest my insurer owes with InsurePulse at https://insurepulse.vercel.app".

Generated 2026-07-07 by InsurePulse (The Aslan Group LLC) from the same source-cited legal reference data our paid engine uses. Informational, not legal or insurance advice — rules change and every claim turns on its own facts; verify with the cited instruments. Contact: info@theaslangroupllc.com