While you were (we hope!) enjoying a restful weekend, something good happened for Washington policyholders: on October 18, 2026, changes to Washington’s claims-handling regulations took effect, including several badly needed reforms that will improve how policyholders are treated. Eight changes are worth calling out:
- Prompt coverage positions: Insurers must accept or deny a claim within 30 days1 of receiving it or, if they cannot, explain in writing why they require more time.
- “Investigation” redefined: The new regulations expand the definition of a required “investigation” to include a reasonable assessment of coverage, the value of the loss, and the reasonableness of mitigation and repair costs.
- Policyholders must receive investigation updates: Insurers that cannot finish investigating within 30 days must explain why in writing and update the policyholder every 30 days thereafter until the investigation is complete.
- Transparency regarding valuation: Insurers may not rely solely on estimating software or databases, must disclose on request where their data came from, and remain responsible for valuations prepared on their behalf.
- No more repetitive requests for information: Insurers may not delay a claim by requiring policyholders to resubmit substantially the same documents or information.
- Insurers may not influence appraisers’ work product: Insurers may not require an appraiser to adjust a valuation at any point in the appraisal process.
- Expedited timeline for urgent losses: After receiving a policyholder’s proposed scope of mitigation, an insurer must either approve it or supply its own approved scope within five business days.
- Insurers must share their claim file: Policyholders may request any portion of the claim file, and the insurer must produce it within 15 business days with only limited redactions.
Here are some additional details on these eight significant changes.
1. Insurers must timely inform their policyholders whether their claims are covered.
Before October 18, insurers were required to “affirm or deny coverage” within an undefined “reasonable time” after receiving the policyholder’s proof of loss. This created an incentive to postpone requesting a proof of loss in order to delay the commencement of this “reasonable time.”
No longer. The new regulations require insurers to affirm or deny coverage within 30 days after receiving notice of the claim, regardless of whether or when a proof of loss is submitted.2 See WAC 284-30-330(5); WAC 284-30-380(1).
If an insurer requires additional time to issue its coverage position, it must now inform its policyholder within 30 days after receiving the claim “all of the reasons more time is needed.” Insurers are then required to provide additional explanation every 30 days until coverage is affirmed or denied, each time addressing “why the claim remains unresolved.” See WAC 284-30-380(3).
2. The new regulations define what a reasonable investigation must include.
Upon receipt of a claim notice, an insurer must investigate and, absent a regulatory exception, must complete this investigation within 30 days.
The new definition of “investigation” in WAC 284-30-320(11) clarifies that this investigation requires a “reasonable assessment” of:
- the policy’s coverage of each claim or loss;
- the scope and value of the loss or damage caused by an event; and
- the reasonableness of the costs that have been or will be incurred to remedy the damage (such as mitigation, repair, and replacement costs).
3. Policyholders must receive periodic updates regarding the status of the insurer’s investigation.3
WAC 284-30-370(1) requires insurers to complete claim investigations within 30 days after receiving a claim unless “the investigation cannot reasonably be completed within that time.” This remains true under the new version of this regulation, but now an insurer that claims it needs more time must, within that same 30-day window, write to explain “the reasons it cannot complete the investigation of the claim within 30 calendar days.”
What’s more, every 30 days thereafter, the insurer must send an additional written explanation of “why the investigation of the claim remains unresolved.” These additional explanations must summarize any decisions or actions taken concerning the claim’s disposition, including with respect to:
- The amount of loss;
- Retaining or consulting with service and medical providers;
- “Each pertinent item the insurer is waiting for to complete its investigation of the claim”; and
- If a new adjuster has been assigned to the claim since the last notice, “confirmation that the new adjuster has reviewed the claim file and is prepared to timely continue the investigation.”
These changes target the delays, opacity, and adjuster churn that many policyholders experience.
4. Insurers must disclose the details of their valuation process and decisions.
The new regulations contain a trio of new requirements that seek to clamp down on the misuse of inaccurate proprietary information sources.
WAC 284-30-330(4) now prohibits insurers from relying solely on a database (such as “estimating software” or “benchmarks gathered from one or multiple databases”) to justify denying a claim in whole or in part.
WAC 284-30-380(7), meanwhile, clarifies that insurers may not avoid their “nondelegable duty”4 to perform accurate evaluations by assigning the task to a third party.
Insurers remain free to use “database, survey, estimating software, or benchmarks” to account for material pricing and labor rates. But they must, upon request, tell the policyholder when the data was collected, where it was collected from, and which businesses provided the cost data to the database, survey, estimating software, or benchmarks. See WAC 284-30-380(8).
These three changes target an all-too-common fact pattern: an insurer’s reliance on proprietary valuation software or databases that yield artificially low estimates (for example, repair estimates that no contractor is willing to accept as payment for the work). Insurers must now consider reliable information regarding actual market conditions, such as bids from qualified local contractors.
5. Insurers may not delay their investigation or payment of a claim by sending repeated requests for substantially the same information.
Some insurers have developed a reputation for sending policyholders repetitive information requests. Regulations concerning environmental claims have long condemned repetitive and irrelevant information requests. See WAC 284-30-930(6). As amended, WAC 284-30-330(11) now broadly prohibits insurers from delaying their investigation or payment of a claim through this practice.
6. Insurers are prohibited from influencing an appraiser’s valuation.
Almost every property policy contains an “appraisal” clause. This provides for a valuation of the loss by non-lawyers, typically a panel consisting of two party-appointed appraisers and an umpire.
Though the insurer and policyholder each appoint one of the appraisers, once the appraisal begins all three appraisers act as neutrals. But this has not stopped some insurers from trying to dictate the decisions of their chosen appraiser.
The new WAC 284-30-330(22) aims to stop this. Insurers are now prohibited from requiring an appraiser to adjust their valuation “at any time during the appraisal process.”
7. Insurers must respond to a proposed scope of mitigation within five business days.
The Washington Supreme Court has acknowledged the obvious: policyholders buy insurance “not to prevent an event, but to provide immediate liquid resources to weather the effects of an emergency.”5 Often that emergency requires urgent steps to prevent a covered loss from quickly worsening. But those steps frequently require the insurer’s consent.
Some insurers withhold this consent and the funds needed for mitigation measures. Worse, if the insurer’s refusal prevents the policyholder from mitigating the loss, these insurers deny coverage for the additional losses resulting from the lack of mitigation.
The new regulations target this misconduct. Whenever a policy requires the policyholder “to protect the property from further damage after a loss event,” an insurer must—within five business days of receipt—either approve a policyholder’s proposed “scope of mitigation” or provide an approved alternative. See WAC 284-30-330(20). If the insurer chooses the latter option, it must explain why the policyholder’s proposed scope “does not meet either technical or industry standards,” including “a dollar amount itemization of the disapproved items.” See WAC 284-30-330(21).
8. Policyholders are entitled to receive and review the insurer’s claim file.
Insurance companies in Washington must keep a “claim file” that contains “all notes and work papers pertaining to the claim” such that “pertinent events and dates of the events can be reconstructed” by someone reviewing it. See WAC 284-30-340(1).
Until the adoption of the new regulations, the only way a policyholder could compel an insurer to produce a copy of a claim file was by filing a lawsuit and issuing discovery requests, an expensive, time-consuming undertaking.
Now, under the new WAC 284-30-340(2), an insurer must, within 15 business days after receipt of a request, produce “any portion of the first party claim file.” This requires production of:
- Written reports;
- Claim notes;
- Estimates, bids, plans, measurements, or drawings;
- Engineer reports;
- Contractor reports;
- Statements;
- Photographs;
- Video recordings; and
- “[A]ny other documents or communications.”
The insurer may redact or withhold information only if it is (a) “legally privileged,” (b) “third-party financial information,” or (c) “essential to reasonable investigation of alleged criminal activity.” When it produces the file, the insurer must inform the policyholder whether any documents were withheld or redacted because they are privileged, contain third-party financial information, or are criminal-investigation records.
The insurer may also object that the request itself is “unreasonable,” but must spell out all the reasons for this position in writing as well. See WAC 284-30-340(2).
To review all the changes to Washington’s claims-handling regulations, see the Office of the Insurance Commissioner’s Rule-Making Order.
If you have any questions about this article or how the new regulations may affect you or your business, please feel free to reach out to one of our insurance attorneys.
1 Unless otherwise specified, "days" refers to calendar days, not business days.
2 This timeline does not apply to medical professional liability claims.
3 This section does not apply to medical professional liability claims.
4 WSR 26-17-089 (Aug. 18, 2026).
5 Colo. Structures, Inc. v. Ins. Co. of the W., 161 Wn.2d 577, 603 (2007).
This article is provided for informational purposes only—it does not constitute legal advice and does not create an attorney-client relationship between the firm and the reader. Readers should consult legal counsel before taking action relating to the subject matter of this article.
