Golden Bear Insuance Company

By using this form, you may elect to exercise some of your privacy rights as a California resident. You may also submit a request to exercise these rights by calling us at 888-374-8867 or by mailing us a request form as described here.

Consent

  • Obtaining Meaningful Consent: Golden Bear Insurance Company ("Golden Bear", "we", "us", or "our") is committed to obtaining meaningful consent from individuals before collecting, using, or disclosing personal information. To make consent meaningful, we ensure that individuals understand the nature, purpose, and consequences of the collection, use, or disclosure of their personal information.
  • Understanding Consent: We provide clear, concise information about what individuals are consenting to, ensuring it is reasonable to expect that they will understand the implications of their consent.
  • Withdrawing Consent: Individuals have the right to withdraw their consent at any time, subject to legal or contractual restrictions and reasonable notice. To withdraw consent, individuals can contact their dedicated HR manager or the general counsel acting as the privacy officer. We will inform individuals of the potential implications of withdrawing their consent, such as how it may affect the services and benefits we can provide.
  • Escalation Procedures: If you are not satisfied with the response to your request, you may escalate the matter. Please contact the General Counsel or Privacy Officer, at:

Instructions: Please complete the required fields below. In the event of multiple accounts, please provide all numbers to which your request relates. We will use and retain the information collected on this form only to process your request.


This request is not available in other jurisdictions.

Note: If you are requesting information about more than one account number, please specify each account. You may specify ALL.

How would you like us to contact you in regards to this request? *


  • If you provided an email address to us as part of submitting this request, you consent to receive electronic communications (email) from us regarding your request.

Note: If Golden Bear becomes aware that one form of communication is not functioning (e.g. email bounce-back) correspondence should then default to another form of communication.

I am: *

Please select the type of request you wish to make: *

Fill out this page if you selected 'Request to know about personal information collected'

Please let us know what information you are requesting: *

We will comply with your request to access your personal information unless the personal information you request is outside the scope of California's privacy laws, is otherwise exempt from disclosure, or we cannot confirm your identity. Note that California law prohibits us from disclosing any Social Security numbers, driver’s license numbers or other government-issued identification numbers, financial account numbers, health insurance or medical identification numbers, an account password, security questions and answers, or unique biometric data.

Please confirm your identity.

In order to protect your information and your privacy, please provide the following information so that we can verify your identity:

If we cannot confirm your identity using this information, we will contact you for additional information. If we are unable to verify your identity, we may be prohibited from fulfilling your request.

Delivery of Specific Pieces of Information

If you are requesting to know the specific pieces of information we have collected about you, please let us know how you would like to receive that information: *

Submit a request on behalf of some else

If you are requesting personal information on behalf of someone else, please e-mail a copy of your signed authorization letter to privacy@goldenbear.com. We may require the person to verify their identity with us directly and that you have been authorized to submit a request on their behalf. If we verify that you are authorized to know the requested personal information, we will contact you to collect additional information.

Declaration under penalty of perjury

By submitting this form, you agree, on penalty of perjury or other criminal offense under applicable law, either that you are the individual about whom this request for personal information relates, or that you are authorized by that individual to make this request on their behalf.

Fill out this page if you selected 'Request deletion of personal information'

When you submit a request to delete, we will delete all personal information that we have collected about you, unless: (i) we must or are permitted to keep the information by law or regulation; (ii) your request to delete personal information is outside the scope of California's privacy laws; or (iii) we cannot confirm your identity. We will maintain a record of your request to delete.

Please confirm your identity.

In order to protect your information and your privacy, please provide the following information so that we can verify your identity:

If we cannot confirm your identity using this information, we will contact you for additional information. If we are unable to verify your identity, we may be prohibited from fulfilling your request.

Submit a request on behalf of some else

If you are requesting personal information on behalf of someone else, please e-mail a copy of your signed authorization letter to privacy@goldenbear.com. We may require the person to verify their identity with us directly and that you have been authorized to submit a request on their behalf. If we verify that you are authorized to know the requested personal information, we will contact you to collect additional information.

Declaration under penalty of perjury

By submitting this form, you agree, on penalty of perjury or other criminal offense under applicable law, either that you are the individual about whom this request for personal information relates, or that you are authorized by that individual to make this request on their behalf.

Fill out this page if you selected 'Request correction of personal information'

When you submit a request to correct, we will correct the personal information that we have collected about you in the manner requested. Please note that the right to correction under the law is not absolute and we may deny your request if: (i) we determine that the contested personal information is more likely than not accurate based on the totality of the circumstances; (ii) we have denied a request to correct the same alleged inaccuracy in the past 6 months and you have not provided additional documentation to support the request; or (iii) we have a good faith, reasonable and documented belief that the request is fraudulent or abusive.

Please confirm your identity.

In order to protect your information and your privacy, please provide the following information so that we can verify your identity:

If we cannot confirm your identity using this information, we will contact you for additional information. If we are unable to verify your identity, we may be prohibited from fulfilling your request.

Please describe the information to be corrected

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Note that we may request further documentation to support your request before we can fullfill your correction request.

Submit a request on behalf of some else

If you are requesting personal information on behalf of someone else, please e-mail a copy of your signed authorization letter to privacy@goldenbear.com. We may require the person to verify their identity with us directly and that you have been authorized to submit a request on their behalf. If we verify that you are authorized to know the requested personal information, we will contact you to collect additional information.

Declaration under penalty of perjury

By submitting this form, you agree, on penalty of perjury or other criminal offense under applicable law, either that you are the individual about whom this request for personal information relates, or that you are authorized by that individual to make this request on their behalf.