WAC 284-30-370

Every insurer must complete its investigation of a claim within thirty days after notification of claim, unless the investigation cannot reasonably be completed within that time. All persons involved in the investigation of a claim must provide reasonable assistance to the insurer in order to facilitate compliance with this provision.

A violation of any of the following is hereby defined as an unfair method of competition and an unfair or deceptive act or practice of the insurer in the business of insurance, specifically applicable to the investigation of claims:

(1) Every insurer must complete its investigation of a claim within 30 calendar days after a notification of claim, unless the investigation cannot reasonably be completed within that time. All persons involved in the investigation of a claim must provide reasonable assistance to the insurer in order to facilitate compliance with this provision.

(a) If the insurer needs more time to investigate the claim, it must notify the claimant in writing of the reasons it cannot complete the investigation of the claim within 30 calendar days from the notification of claim.

(b) If needed, additional written notice must be provided to the claimant every 30 days after the notice required in (a) of this subsection explaining why the investigation of the claim remains unresolved.

For the purposes of this subsection, the additional notice must include a summary of any decisions or actions that are substantially related to the disposition of a claim including, but not limited to:

(i) The amount of loss;

(ii) The retention or consultation of service and medical providers;

(iii) Each pertinent item the insurer is waiting for to complete its investigation of the claim; and

(iv) If a new adjuster has been assigned since last notice, confirmation that the new adjuster has reviewed the claim file and is prepared to timely continue the investigation.

(2) This section does not apply to medical professional liability claims.