Washington OICState DOIWA

Quicker responses, more transparency for consumers added to claims process

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{ "summary": "Starting October 18, 2026, insurance companies in Washington must respond faster and be more transparent when handling claims. This change affects anyone who files a claim, ensuring they receive timely updates and clear communication about their claims. The new rules set specific timeframes for responses, investigations, and payments, and require insurers to explain any claim denials clearly. Additionally, consumers can now access their claim files and request more information about how their claims were handled. Insurance agents should familiarize themselves with these new rules to better assist their clients and ensure compliance.", "tags": ["claims", "consumer-protection", "compliance", "auto-insurance", "transparency"], "translations": { "es": { "title": "Respuestas más rápidas y mayor transparencia para los consumidores añadidas al proceso de reclamaciones", "summary": "A partir del 18 de octubre de 2026, las compañías de seguros en Washington deben responder más rápido y ser más transparentes al manejar reclamaciones. Este cambio afecta a cualquier persona que presente una reclamación, asegurando que reciban actualizaciones oportunas y una comunicación clara sobre sus reclamaciones. Las nuevas reglas establecen plazos específicos para respuestas, investigaciones y pagos, y requieren que los aseguradores expliquen claramente cualquier denegación de reclamación. Además, los consumidores ahora pueden acceder a sus archivos de reclamaciones y solicitar más información sobre cómo se manejaron sus reclamaciones. Los agentes de seguros deben familiarizarse con estas nuevas reglas para ayudar mejor a sus clientes y garantizar el cumplimiento.", }, "pt": { "title": "Respostas mais rápidas e mais transparência para consumidores adicionadas ao processo de reclamações", "summary": "A partir de 18 de outubro de 2026, as seguradoras em Washington devem responder mais rapidamente e ser mais transparentes ao lidar com reclamações. Essa mudança afeta qualquer pessoa que apresente uma reclamação, garantindo que recebam atualizações em tempo hábil e comunicação clara sobre suas reclamações. As novas regras estabelecem prazos específicos para respostas, investigações e pagamentos, e exigem que as seguradoras expliquem claramente qualquer negativa de reclamação. Além disso, os consumidores agora podem acessar seus arquivos de reclamações e solicitar mais informações sobre como suas reclamações foram tratadas. Os agentes de seguros devem se familiarizar com essas novas regras para ajudar melhor seus clientes e garantir a conformidade." } } }

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October 19, 2026 OLYMPIA, Wash. — If you file an insurance claim in Washington, you can expect faster responses and more transparency from your insurance company, thanks to updated claim handling rules from Insurance Commissioner Patty Kuderer. The rules, which took effect on Oct. 18, clarify and update the standards that apply to insurance companies in the process of handling a claim . That includes the timeframes for responding to your questions, completing claim investigations, and determining the amount you are owed. “Most claims are processed without incident, but sometimes policyholders are left without a clear understanding of their claim’s progress,” Kuderer said. “The new rules will maintain a fair claim environment for consumers and provide transparency into the process that affects their financial recovery.” The rules hadn’t changed since they were adopted in 1978. The updates: Reinforce that any unfair claims practice can violate state law (RCW 48.30.010) by removing language about the frequency of the violations. Establish specific timelines and documentation requirements for communication, investigations, denials, and payments. Insurance companies can’t deny a claim before conducting an investigation that doesn’t solely rely on the use of a database. They must notify you within 30 days if your claim has been accepted or denied, and provide updates every 30 days if your claim is delayed. Set detailed standards for auto damage and total loss claims, including inspection requirements, communication standards, data sources for valuations, and how additional damage must be handled. If an insurance company uses a database to account for pricing or labor rates, it must give you details about that database when you ask for it. You can also request an in-person inspection if your insurance company uses virtual photos you don’t think are accurate. Improve transparency by requiring insurance companies to explain denials, provide policy references, share valuation reports, and disclose data sources used for the valuation of your vehicle. Strengthen your right to access your own claim file and require your insurance company to explain what they redact. Background The Office of the Insurance Commissioner held a workshop in 2023 in response to a historic increase in auto claims complaints . More than 80% of the complaints filed with the OIC leading up to the workshop cited claim handling issues. OIC staff considered input from hundreds of consumers, consumer advocates, the defense and plaintiffs’ bar, and the insurance industry during the rulemaking process.