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CA Department of Insurance

Hearings - Frequently Asked Questions

Frequently Asked Questions (FAQ)

The following are brief answers to questions frequently posed to the Administrative Hearing Bureau. For further information, you should consult the Insurance Code and Regulations for the laws specific to your hearing.

General Questions

  1. What is an Administrative Law Judge (ALJ)?
  2. What is an administrative hearing?
  3. How do I file an appeal?
  4. Is there a fee for requesting a hearing and if so, may it be waived?
  5. Do I need an attorney or can I represent myself?
  6. If I need an interpreter, is one provided?
  7. Will the hearing be accessible to persons with disabilities?
  8. May I contact an ALJ to discuss my case?
  9. May the hearing be held by telephone or by video conference?
  10. May I settle my case without a hearing?
  11. How may I request a copy or a transcript of the recording of the hearing?

Pre-Hearing

  1. How do I prepare for my hearing?
  2. How do I subpoena witnesses and documents?
  3. Where and how do I file any pre-trial motions?
  4. How do I request a postponement or continuance?

Hearing

  1. May I bring a witness or documents?
  2. What may I expect at the hearing?
  3. What is the "burden of proof"?

Post-Hearing

  1. When will a decision be issued?
  2. What may I do if I disagree with the ALJ's decision?

General Questions

  1. What is an Administrative Law Judge (ALJ)?
    An ALJ is retained by the Department pursuant to civil service rules and is employed within the Administrative Hearing Bureau to conduct administrative hearings. In order to ensure the ALJs are independent, the Insurance Code mandates that the ALJs cannot be supervised directly by the Commissioner or supervised directly or indirectly by an employee in the Department's legal branch.
  2. What is an administrative hearing?
    An administrative hearing is a fair, impartial and an independent opportunity to be heard on the issue(s) in question. The ALJ assigned to hear your case determines facts, based on the evidence and argument presented at the hearing, reviews the relevant law, and issues a decision on the issues in question. Procedure at hearings is generally governed by the Administrative Procedures Act beginning in Government Code at section 11425.10 and in the Regulations governing the type of your case.
  3. How do I file an Appeal?
    An appeal from a decision on a Complaint and Request for Action issued by your workers' compensation insurer or the Workers' Compensation Insurance Rating Bureau may be appealed to the Insurance Commissioner. Begin by submitting a completed Appeal Form and supporting documents to the AHB as instructed.
  4. Is there a fee for requesting a hearing?
    No, there is no fee for requesting a hearing.
  5. Do I need an attorney or can I represent myself?
    An individual may represent him/herself in any administrative hearing and no individual is required to have an attorney. If you choose to be represented, that representative does not have to be an attorney.
  6. If I need an interpreter, is one provided?
    If you need an interpreter, please contact the AHB as far in advance of any hearing or mediation as possible.
  7. Will the hearing be accessible to persons with disabilities?
    If you or your witnesses need special accommodations to be able to access the AHB hearings, please contact the AHB as far in advance of the hearing as possible, and let us know what assistance you need so that access can be ensured.
  8. May I contact an ALJ to discuss my case?
    No. If you have a matter that needs to be addressed by the ALJ prior to the hearing, you may raise your question at the telephone status conference or contact the AHB to schedule a pre-hearing conference.
  9. May the hearing be held by telephone or videoconference if it is difficult to attend the hearing at the AHB's hearing rooms located San Francisco and Los Angeles?
    If you would like all or part of your hearing conducted by telephone or videoconference, you may discuss your request with the ALJ at a telephone status conference. Please notify the ALJ of your request as far in advance of the evidentiary hearing as possible and also notify the opposing party. The ALJ assigned to hear your case will make a ruling on your request.
  10. May I settle my case without a hearing?
    The AHB encourages parties to settle their cases. It offers two methods of alternative dispute resolution. Participation in both is voluntary. An ALJ that is not assigned to hear your case may act as a settlement judge or as a mediator. As a settlement judge, the ALJ will assist the parties in settlement discussions, but will also give the parties a realistic assessment of their case. As a mediator, the ALJ will facilitate a discussion between the parties about ways to resolve their case without providing an assessment. If you would like the assistance of an ALJ for either form of dispute resolution, please notify the ALJ assigned to your case as far in advance of your hearing as possible. The ALJ assigned to help you with settlement discussions will not hear or discuss your case with the ALJ who is ultimately assigned to conduct the hearing. Your case will not be postponed because you are engaged in mediation or settlement discussions.
  11. How may I request a transcript or a recording of the hearing?
    A transcript is made of every hearing. Please contact the court reporter transcribing your hearing for further information.

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Pre-Hearing

  1. How do I prepare for my hearing?
    The ALJ will conduct a pre-hearing status conference by phone shortly after your case is filed with the AHB. At the status conference, the ALJ will discuss pre-hearing and hearing procedures and answer all your questions about hearing procedures and clarify what issues remain in dispute. It is possible the ALJ will set the matter for an evidentiary hearing at the status conference. The evidentiary hearing is your chance to tell the ALJ your side of the dispute. You should bring any witnesses or documents that you believe support your case. Typically, prior to the hearing you will submit to the AHB and exchange with the other parties all documents and names of witnesses you intend to bring to the evidentiary hearing to support your case. If you bring additional documents to the hearing, be sure to include a copy for the ALJ, the witness and the other parties.
  2. How do I subpoena witnesses and documents?
    You may discuss how to subpoena witnesses and documents with the ALJ at the telephone status conference. Instructions for how to subpoena witnesses and documents will be set out in the Notice of Hearing.
  3. Where and how do I file any pre-trial motions?
    Not all cases require pre-trial motions. Motions are written requests to have the ALJ take a particular action. For example, motions can ask the judge to exclude evidence, give the parties more time to complete a task or schedule a hearing. Questions regarding how and when to file pre-hearing motions can be addressed to the ALJ at the initial status conference and instruction regarding the filing of motions, if they are necessary, will be explained by the ALJ and set out in the Notice of Hearing.
  4. How do I request a postponement or continuance?
    If you cannot attend your hearing, you must send a written request asking the ALJ to continue the hearing. Depending on your case, the Regulations will set out the time limits for making the request. Typically, you should request a continuance as soon as you know of the problem. You should send a copy of your request to the other party(ies) at the same time you send it to the AHB. The request must establish good cause for your inability to attend the hearing.

Hearing

  1. May I bring witness or documents?
    The hearing is your chance to tell the ALJ your side of the dispute. You should bring any witnesses or documents that you believe support your case. At the status conference, the ALJ will discuss hearing procedures and answer any questions you may have concerning the hearing. The Notice of Hearing will provide specific instructions for identifying your witnesses and for submitting your documents before and during the hearing. Typically, you will need copies of any documents you bring to the hearing; one for you, one that may be referred to by a witness, one for the ALJ, and one copy for each of the other parties.
  2. What may I expect at the hearing?
    At the beginning of the hearing, the presiding ALJ will generally give an introduction that includes the procedure that will be followed in the hearing. Each party may be permitted to present an opening statement and then witnesses may be called. Each party has the right to question his or her own witness. The opposing party then has the right to conduct cross-examination of that witness. Documents may be presented through witnesses. The ALJ will rule on the admissibility of evidence. After each party has presented witnesses, the party who bears the burden of proof may have the right to present rebuttal evidence. At the end of the hearing, each party may be permitted to present a closing argument.
  3. What is the "burden of proof"?
    The "burden of proof" is the responsibility to prove a disputed charge or allegation. Typically a burden of proof is met by the preponderance of the evidence. If the party bearing the burden of proof fails to carry that burden, that party may lose his or her case. The ALJ will establish who bears the burden of proof at the beginning of the hearing and who will present his or her case first.

Post-Hearing

  1. When will a decision be issued?
    The law applicable to each case type specifies the time within which a decision will be issued. Typically, the ALJ will inform you of the time applicable to your case at the end of the hearing. Following the live evidentiary hearing, the ALJ will issue an Order closing the record. Then the ALJ will write a proposed decision containing findings of fact and conclusions of law. The proposed decision is forwarded to the Insurance Commissioner who will issue the final decision in each case.
  2. What may I do if I disagree with the Commissioner's decision?
    The law which is applicable to each case type specifies the method of review of a Commissioner's decision. An explanation of the review process applicable to your case is included in the Order accompanying the decision that the Commissioner will send to you.

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