Jul 21st, 2020

REMINDER: Effective August 1, 2020, WAC 284-30-770: Adverse Notification Requirement

Effective August 1, 2020, Washington will require all insurers to add the following notice with any “adverse notification” issued to an insured:

“If you have questions or concerns about the actions of your insurance company or agent, or would like information on your rights to file an appeal, contact the Washington state Office of the Insurance Commissioner’s consumer protection hotline at 1-800-562-6900 or visit www.insurance.wa.gov. The insurance commissioner protects and educates insurance consumers, advances the public interest, and provides fair and efficient regulation of the insurance industry.“

Adverse notifications are defined in the regulation as follows:

–     a claim denial;

–     a final claim payment for less than the amount of the claim submitted;

–     an adverse benefit determination as defined in RCW48.43.005(2);

–     and rescission, cancellation, termination or nonrenewal of a policy unless initiated by insured.

This does not apply to the end of a scheduled policy term or cancellation due to nonpayment of premium.  To view the new regulation, see WAC 284-30-770.  Insurers are strongly advised to update their letter templates. Conceivably, failure to include this required language could constitute bad faith in Washington, especially if the omission causes damage to the insured (e.g., if the insured claims that he or she would have called the OIC to challenge the denial if properly informed of the option).