Andrew Kim Law Firm, PLLC | Washington Legal Blog

What is the Insurance Fair Conduct Act?
The Insurance Fair Conduct Act provides remedies to policyholders whose claims are unreasonably denied by their insurance companies or whose insurance companies violate particular regulations governing claims settlement practices.  It took effect December 6, 2007.

What is covered by this law?
The law covers policyholders whose insurance company unreasonably denied their claim. It also covers a policyholder whose insurance company violated certain laws governing claims settlement practices.

• For example: Insurance companies must acknowledge their policyholders’ letters and phone calls about their claims, must promptly investigate claims, and must promptly and fairly settle valid claims.

The law applies only to claims made by insured people to their own insurance companies. It does not apply to claims made by one person to someone else’s insurance company.

• For example: If a person has been in a car accident, this law applies to a claim made by an insured under his own policy to his own insurance company. It does not apply to someone making a claim against another person’s insurance company.

Does the law cover all insurance companies?
No. It doesn't apply to claims under health insurance policies. It applies to claims under other kinds of policies, including policies that include medical costs as part of that coverage.

• For example: It applies to claims under car and homeowner’s policies, even though reimbursement for health care services may be covered by those policies.

The Patient’s Bill of Rights provides consumer protection for policyholders of health insurance coverage.

What does this law require of the policyholder?
If an insured person wants to sue his or her insurance company for violating one of these laws, the policyholder must mail written notice of the potential lawsuit to the insurance company and to the Office of the Insurance Commissioner at least 20 days before the lawsuit is filed.

What will the Office of the Insurance Commissioner do with the notice?
When the agency receives each notice, we will stamp it with the date it was received, and file it in a designated location. Then, if there is a question about whether the insured person filed the notice in accordance with the law, the custodian of the notices will be able to certify whether, and when, it was received.

For more information

RCW 48.30.010 - Unfair practices in general - Remedies and penalties

RCW 48.30.015 - Unreasonable denial of a claim for coverage or payment of benefits.