Cal. Code Regs. tit. 10 § 2623.2
Name
Address
Telephone Number of Petitioner or Attorney
BEFORE THE INSURANCE COMMISSIONER OF THE STATE OF CALIFORNIA
| In the Matter of | ) | |||
| ) | ||||
| Insurance Company, | ) | REQUEST FOR FINDING | ||
| ) | OF ELIGIBILITY TO | |||
| Applicant (or | ) | SEEK COMPENSATION | ||
| Respondent). | ) | |||
| ) | ||||
____________________ hereby requests that the Insurance Commissioner find it eligible to seek compensation in Departmental proceedings. In support of its request, ____________________alleges:
I
____________________ represents a consumer interest not otherwise adequately represented, representation of which is necessary for a fair determination of the proceeding because
___________________________
II
The individuals policyholder's economic interest or the economic interest of the members represented by a group or organization is small in comparison to the cost of effective participation because
___________________________
III
The other interests Petitioner represents are as follows (or) Petitioner represents no other interests.
Wherefore, ____________________ requests that the Insurance Commissioner find it eligible to seek compensation in Departmental proceedings based on this petition and the attached exhibits.
DATED:
Respectfully Submitted,
__________
Signature
Cal. Code Regs. Tit. 10, § 2623.2
Note: Authority cited: Sections 1861.10, 12921 and 12926, Insurance Code. Reference: Section 1861.10(a), Insurance Code; and CalFarm Insurance Company, et al. v. George Deukmejian, et al., 48 Cal.3d 805 (1989).