Chapter 48.30 RCW
UNFAIR PRACTICES AND FRAUDS
Sections
HTMLPDF | 48.30.010 | Unfair practices in general—Remedies and penalties. |
HTMLPDF | 48.30.015 | Unreasonable denial of a claim for coverage or payment of benefits. |
HTMLPDF | 48.30.020 | Anticompact law. |
HTMLPDF | 48.30.030 | False financial statements. |
HTMLPDF | 48.30.040 | False information and advertising. |
HTMLPDF | 48.30.050 | Advertising must show name and domicile. |
HTMLPDF | 48.30.060 | Insurer name—Deceptive use prohibited. |
HTMLPDF | 48.30.070 | Advertising of financial condition. |
HTMLPDF | 48.30.075 | Using existence of insurance guaranty associations in advertising, etc., to sell insurance. |
HTMLPDF | 48.30.080 | Defamation of insurer. |
HTMLPDF | 48.30.090 | Misrepresentation of policies. |
HTMLPDF | 48.30.100 | Dividends not to be guaranteed. |
HTMLPDF | 48.30.110 | Contributions to candidates for insurance commissioner. |
HTMLPDF | 48.30.120 | Misconduct of officers, employees. |
HTMLPDF | 48.30.130 | Presumption of knowledge of director. |
HTMLPDF | 48.30.133 | Gifts, etc., for the referral of insurance business—Restrictions. |
HTMLPDF | 48.30.135 | Sponsoring events or making contributions—Definitions. |
HTMLPDF | 48.30.140 | Rebating—Other inducements. |
HTMLPDF | 48.30.150 | Illegal inducements. |
HTMLPDF | 48.30.155 | Life or disability insurers—Insurance as inducement to purchase of goods, etc. |
HTMLPDF | 48.30.157 | Charges for extra services. |
HTMLPDF | 48.30.170 | Rebate—Acceptance prohibited. |
HTMLPDF | 48.30.180 | "Twisting" prohibited. |
HTMLPDF | 48.30.190 | Illegal dealing in premiums. |
HTMLPDF | 48.30.200 | Hypothecation of premium notes. |
HTMLPDF | 48.30.210 | Misrepresentation in application for insurance. |
HTMLPDF | 48.30.220 | Destruction, injury, secretion, etc., of property. |
HTMLPDF | 48.30.230 | False claims or proof—Penalty. |
HTMLPDF | 48.30.240 | Rate wars prohibited. |
HTMLPDF | 48.30.250 | Interlocking ownership, management. |
HTMLPDF | 48.30.260 | Right of debtor or borrower to select insurance producer, surplus line broker, or insurer. |
HTMLPDF | 48.30.270 | Public building or construction contracts—Surety bonds or insurance—Violations concerning—Exemption. |
HTMLPDF | 48.30.300 | Unfair discrimination, generally. |
HTMLPDF | 48.30.310 | Commercial motor vehicle employment driving record not to be considered, when. |
HTMLPDF | 48.30.320 | Notice of reason for cancellation, restrictions based on disability. |
HTMLPDF | 48.30.330 | Immunity from libel or slander. |
HTMLPDF | 48.30.340 | Auto glass repair—Restrictions on insurer-owned facilities. |
HTMLPDF | 48.30.350 | Initiating arbitration of claims under the balance billing protection act with such frequency as to indicate a health carrier's general business practice. |
HTMLPDF | 48.30.360 | Performance standards—Premiums—Application—Rules. |
HTMLPDF | 48.30.900 | Construction—Chapter applicable to state registered domestic partnerships—2009 c 521. |
NOTES:
Discrimination prohibited: RCW 48.18.480.
Unfair practices in general—Remedies and penalties.
(1) No person engaged in the business of insurance shall engage in unfair methods of competition or in unfair or deceptive acts or practices in the conduct of such business as such methods, acts, or practices are defined pursuant to subsection (2) of this section.
(2) In addition to such unfair methods and unfair or deceptive acts or practices as are expressly defined and prohibited by this code, the commissioner may from time to time by regulation promulgated pursuant to chapter 34.05 RCW, define other methods of competition and other acts and practices in the conduct of such business reasonably found by the commissioner to be unfair or deceptive after a review of all comments received during the notice and comment rule-making period.
(3)(a) In defining other methods of competition and other acts and practices in the conduct of such business to be unfair or deceptive, and after reviewing all comments and documents received during the notice and comment rule-making period, the commissioner shall identify his or her reasons for defining the method of competition or other act or practice in the conduct of insurance to be unfair or deceptive and shall include a statement outlining these reasons as part of the adopted rule.
(b) The commissioner shall include a detailed description of facts upon which he or she relied and of facts upon which he or she failed to rely, in defining the method of competition or other act or practice in the conduct of insurance to be unfair or deceptive, in the concise explanatory statement prepared under RCW 34.05.325(6).
(c) Upon appeal the superior court shall review the findings of fact upon which the regulation is based de novo on the record.
(4) No such regulation shall be made effective prior to the expiration of thirty days after the date of the order by which it is promulgated.
(5) If the commissioner has cause to believe that any person is violating any such regulation, the commissioner may order such person to cease and desist therefrom. The commissioner shall deliver such order to such person direct or mail it to the person by registered mail with return receipt requested. If the person violates the order after expiration of ten days after the cease and desist order has been received by him or her, he or she may be fined by the commissioner a sum not to exceed two hundred and fifty dollars for each violation committed thereafter.
(6) If any such regulation is violated, the commissioner may take such other or additional action as is permitted under the insurance code for violation of a regulation.
(7) An insurer engaged in the business of insurance may not unreasonably deny a claim for coverage or payment of benefits to any first party claimant. "First party claimant" has the same meaning as in RCW 48.30.015.
[ 2007 c 498 s 2 (Referendum Measure No. 67, approved November 6, 2007); 1997 c 409 s 107; 1985 c 264 s 13; 1973 1st ex.s. c 152 s 6; 1965 ex.s. c 70 s 24; 1947 c 79 s .30.01; Rem. Supp. 1947 s 45.30.01.]
NOTES:
Short title—2007 c 498: See note following RCW 48.30.015.
Part headings—Severability—1997 c 409: See notes following RCW 43.22.051.
Severability—1973 1st ex.s. c 152: See note following RCW 48.05.140.
Unreasonable denial of a claim for coverage or payment of benefits.
(1) Any first party claimant to a policy of insurance who is unreasonably denied a claim for coverage or payment of benefits by an insurer may bring an action in the superior court of this state to recover the actual damages sustained, together with the costs of the action, including reasonable attorneys' fees and litigation costs, as set forth in subsection (3) of this section.
(2) The superior court may, after finding that an insurer has acted unreasonably in denying a claim for coverage or payment of benefits or has violated a rule in subsection (5) of this section, increase the total award of damages to an amount not to exceed three times the actual damages.
(3) The superior court shall, after a finding of unreasonable denial of a claim for coverage or payment of benefits, or after a finding of a violation of a rule in subsection (5) of this section, award reasonable attorneys' fees and actual and statutory litigation costs, including expert witness fees, to the first party claimant of an insurance contract who is the prevailing party in such an action.
(4) "First party claimant" means an individual, corporation, association, partnership, or other legal entity asserting a right to payment as a covered person under an insurance policy or insurance contract arising out of the occurrence of the contingency or loss covered by such a policy or contract.
(5) A violation of any of the following is a violation for the purposes of subsections (2) and (3) of this section:
(a) WAC 284-30-330, captioned "specific unfair claims settlement practices defined";
(b) WAC 284-30-350, captioned "misrepresentation of policy provisions";
(c) WAC 284-30-360, captioned "failure to acknowledge pertinent communications";
(d) WAC 284-30-370, captioned "standards for prompt investigation of claims";
(e) WAC 284-30-380, captioned "standards for prompt, fair and equitable settlements applicable to all insurers"; or
(f) An unfair claims settlement practice rule adopted under RCW 48.30.010 by the insurance commissioner intending to implement this section. The rule must be codified in chapter 284-30 of the Washington Administrative Code.
(6) This section does not limit a court's existing ability to make any other determination regarding an action for an unfair or deceptive practice of an insurer or provide for any other remedy that is available at law.
(7) This section does not apply to a health plan offered by a health carrier. "Health plan" has the same meaning as in RCW 48.43.005. "Health carrier" has the same meaning as in RCW 48.43.005.
(8)(a) Twenty days prior to filing an action based on this section, a first party claimant must provide written notice of the basis for the cause of action to the insurer and office of the insurance commissioner. Notice may be provided by regular mail, registered mail, or certified mail with return receipt requested. Proof of notice by mail may be made in the same manner as prescribed by court rule or statute for proof of service by mail. The insurer and insurance commissioner are deemed to have received notice three business days after the notice is mailed.
(b) If the insurer fails to resolve the basis for the action within the twenty-day period after the written notice by the first party claimant, the first party claimant may bring the action without any further notice.
(c) The first party claimant may bring an action after the required period of time in (a) of this subsection has elapsed.
(d) If a written notice of claim is served under (a) of this subsection within the time prescribed for the filing of an action under this section, the statute of limitations for the action is tolled during the twenty-day period of time in (a) of this subsection.
[ 2007 c 498 s 3 (Referendum Measure No. 67, approved November 6, 2007).]
NOTES:
Short title—2007 c 498: "This act may be known and cited as the insurance fair conduct act." [ 2007 c 498 s 1.]
Anticompact law.
(1) No person shall either within or outside of this state enter into any contract, understanding or combination with any other person to do jointly or severally any act or engage in any practice for the purpose of
(a) controlling the rates to be charged for insuring any risk or any class of risks in this state; or
(b) unfairly discriminating against any person in this state by reason of his or her plan or method of transacting insurance, or by reason of his or her affiliation or nonaffiliation with any insurance organization; or
(c) establishing or perpetuating any condition in this state detrimental to free competition in the business of insurance or injurious to the insuring public.
(2) This section shall not apply relative to ocean marine and foreign trade insurances.
(3) This section shall not be deemed to prohibit the doing of things permitted to be done in accordance with the provisions of chapter 48.19 RCW of this code.
(4) Whenever the commissioner has knowledge of any violation of this section he or she shall forthwith order the offending person to discontinue such practice immediately or show cause to the satisfaction of the commissioner why such order should not be complied with. If the offender is an insurer or a licensee under this code and fails to comply with such order within thirty days after receipt thereof, the commissioner may forthwith revoke the offender's certificate of authority or licenses.
[ 2009 c 549 s 7118; 1947 c 79 s .30.02; Rem. Supp. 1947 s 45.30.02.]
False financial statements.
No person shall knowingly file with any public official nor knowingly make, publish, or disseminate any financial statement of an insurer which does not accurately state the insurer's financial condition.
[1947 c 79 s .30.03; Rem. Supp. 1947 s 45.30.03.]
False information and advertising.
No person shall knowingly make, publish, or disseminate any false, deceptive or misleading representation or advertising in the conduct of the business of insurance, or relative to the business of insurance or relative to any person engaged therein.
[1947 c 79 s .30.04; Rem. Supp. 1947 s 45.30.04.]
Advertising must show name and domicile.
Every advertisement of, by, or on behalf of an insurer shall set forth the name in full of the insurer and the location of its home office or principal office, if any, in the United States (if an alien insurer).
[1947 c 79 s .30.05; Rem. Supp. 1947 s 45.30.05.]
Insurer name—Deceptive use prohibited.
No person who is not an insurer shall assume or use any name which deceptively infers or suggests that it is an insurer.
[1947 c 79 s .30.06; Rem. Supp. 1947 s 45.30.06.]
Advertising of financial condition.
(1) Every advertisement by or on behalf of any insurer purporting to show its financial condition may be in a condensed form but shall in substance correspond with the insurer's last verified statement filed with the commissioner.
(2) No insurer or person in its behalf shall advertise assets except those actually owned and possessed by the insurer in its own exclusive right, available for the payment of losses and claims, and held for the protection of its policyholders and creditors.
[1947 c 79 s .30.07; Rem. Supp. 1947 s 45.30.07.]
Using existence of insurance guaranty associations in advertising, etc., to sell insurance.
No person shall make, publish, disseminate, circulate, or place before the public, or cause, directly or indirectly, to be made, published, disseminated, circulated, or placed before the public in any newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio station or television station, or in any other way, any advertisement, announcement, or statement which uses the existence of the Washington Insurance Guaranty Association or the Washington Life and Disability Insurance Guaranty Association for the purpose of sales, solicitation, or inducement to purchase any form of insurance covered by the Washington Insurance Guaranty Association Act or the Washington Life and Disability Insurance Guaranty Association Act.
[1975-'76 2nd ex.s. c 109 s 9.]
Defamation of insurer.
No person shall make, publish, or disseminate, or aid, abet or encourage the making, publishing, or dissemination of any information or statement which is false or maliciously critical and which is designed to injure in its reputation or business any authorized insurer or any domestic corporation or reciprocal being formed pursuant to this code for the purpose of becoming an insurer.
[1947 c 79 s .30.08; Rem. Supp. 1947 s 45.30.08.]
Misrepresentation of policies.
No person shall make, issue or circulate, or cause to be made, issued or circulated any misrepresentation of the terms of any policy or the benefits or advantages promised thereby, or the dividends or share of surplus to be received thereon, or use any name or title of any policy or class of policies misrepresenting the nature thereof.
[1947 c 79 s .30.09; Rem. Supp. 1947 s 45.30.09.]
Dividends not to be guaranteed.
No insurer, insurance producer, title insurance agent, or other person shall guarantee or agree to the payment of future dividends or future refunds of unused premiums or savings in any specific or approximate amounts or percentages on account of any insurance contract.
[ 2008 c 217 s 34; 1947 c 79 s .30.10; Rem. Supp. 1947 s 45.30.10.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
Contributions to candidates for insurance commissioner.
(1) No insurer or fraternal benefit society doing business in this state shall directly or indirectly pay or use, or offer, consent, or agree to pay or use any money or thing of value for or in aid of any candidate for the office of insurance commissioner; nor for reimbursement or indemnification of any person for money or property so used.
(2) Any individual who violates any provision of this section, or who participates in, aids, abets, advises, or consents to any such violation, or who solicits or knowingly receives any money or thing of value in violation of this section, shall be guilty of a gross misdemeanor and shall be liable to the insurer or society for the amount so contributed or received.
[ 1982 c 181 s 18; 1947 c 79 s .30.11; Rem. Supp. 1947 s 45.30.11.]
NOTES:
Severability—1982 c 181: See note following RCW 48.03.010.
Misconduct of officers, employees.
No director, officer, agent, attorney-in-fact, or employee of an insurer shall:
(1) Knowingly receive or possess himself or herself of any of its property, otherwise than in payment for a just demand, and with intent to defraud, omit to make or to cause or direct to be made, a full and true entry thereof in its books and accounts; nor
(2) Make or concur in making any false entry, or concur in omitting to make any material entry, in its books or accounts; nor
(3) Knowingly concur in making or publishing any written report, exhibit or statement of its affairs or pecuniary condition containing any material statement which is false, or omit or concur in omitting any statement required by law to be contained therein; nor
(4) Having the custody or control of its books, willfully fail to make any proper entry in the books of the insurer as required by law, or to exhibit or allow the same to be inspected and extracts to be taken therefrom by any person entitled by law to inspect the same, or take extracts therefrom; nor
(5) If a notice of an application for an injunction or other legal process affecting or involving the property or business of the insurer is served upon him or her, fail to disclose the fact of such service and the time and place of such application to the other directors, officers, and managers thereof; nor
(6) Fail to make any report or statement lawfully required by a public officer.
Presumption of knowledge of director.
A director of an insurer is deemed to have such knowledge of its affairs as to enable him or her to determine whether any act, proceeding, or omission of its directors is a violation of any provision of this chapter. If present at a meeting of directors at which any act, proceeding, or omission of its directors which is a violation of any such provision occurs, he or she must be deemed to have concurred therein unless at the time he or she causes or in writing requires his or her dissent therefrom to be entered on the minutes of the directors.
If absent from such meeting, he or she must be deemed to have concurred in any such violation if the facts constituting such violation appear on the records or minutes of the proceedings of the board of directors, and he or she remains a director of the insurer for six months thereafter without causing or in writing requiring his or her dissent from such violation to be entered upon such record or minutes.
[ 2009 c 549 s 7120; 1947 c 79 s .30.13; Rem. Supp. 1947 s 45.30.13.]
Gifts, etc., for the referral of insurance business—Restrictions.
(1) An insurance producer may give to an individual, prizes, goods, wares, gift cards, gift certificates, or merchandise not exceeding one hundred dollars in value per person in any consecutive twelve-month period for the referral of insurance business to the insurance producer, if the giving of the prizes, goods, wares, gift cards, gift certificates, or merchandise is not conditioned upon the person who is referred applying for or obtaining insurance through the insurance producer.
(2) The payment for the referral must not be in cash, currency, bills, coins, check, or by money order.
(3) The provisions of RCW 48.30.140 and 48.30.150 do not apply to prizes, goods, wares, gift cards, gift certificates, or merchandise given to a person in compliance with subsections (1) and (2) of this section.
(4) Notwithstanding subsections (1) and (2) of this section, an insurance producer may pay to an unlicensed individual who is neither an insured nor a prospective insured a referral fee conditioned on the submission of an application if made in compliance with the provisions of RCW 48.17.490(4).
[ 2015 c 272 s 3.]
Sponsoring events or making contributions—Definitions.
(1) An insurance producer may sponsor events for, or make contributions to a bona fide charitable or nonprofit organization, if the sponsorship or contribution is not conditioned upon the organization applying for or obtaining insurance through the insurance producer.
(2) For purposes of this section, a bona fide charitable or nonprofit organization is:
(a) Any nonprofit corporation duly existing under the provisions of chapter 24.03A RCW for charitable, benevolent, eleemosynary, educational, civic, patriotic, political, social, fraternal, cultural, athletic, scientific, agricultural, or horticultural purposes;
(b) Any professional, commercial, industrial, or trade association;
(e) Any nonprofit organization, whether incorporated or otherwise, when determined by the commissioner to be organized and operated for one or more of the purposes described in (a) through (d) of this subsection.
NOTES:
Effective date—2021 c 176: See note following RCW 24.03A.005.
Rebating—Other inducements.
(1) Except to the extent provided for in an applicable filing with the commissioner then in effect, no insurer, insurance producer, or title insurance agent shall, as an inducement to insurance, or after insurance has been effected, directly or indirectly, offer, promise, allow, give, set off, or pay to the insured or to any employee of the insured, any rebate, discount, abatement, or reduction of premium or any part thereof named in any insurance contract, or any commission thereon, or earnings, profits, dividends, or other benefit, or any other valuable consideration or inducement whatsoever which is not expressly provided for in the policy.
(2) Subsection (1) of this section shall not apply as to commissions paid to a licensed insurance producer, or title insurance agent for insurance placed on that person's own property or risks.
(3) This section shall not apply to the allowance by any marine insurer, or marine insurance producer, to any insured, in connection with marine insurance, of such discount as is sanctioned by custom among marine insurers as being additional to the insurance producer's commission.
(4) This section shall not apply to advertising or promotional programs conducted by insurers or insurance producers whereby prizes, goods, wares, gift cards, gift certificates, or merchandise, not exceeding one hundred dollars in value per person in the aggregate in any twelve-month period, are given to all insureds or prospective insureds under similar qualifying circumstances. This subsection does not apply to title insurers or title insurance agents.
(5) This section does not apply to an offset or reimbursement of all or part of a fee paid to an insurance producer as provided in RCW 48.17.270.
(6)(a) Subsection (1) of this section shall not be construed to prohibit a health carrier or disability insurer from including as part of a group or individual health benefit plan or contract containing health benefits, a wellness program which meets the requirements for an exception from the prohibition against discrimination based on a health factor under the health insurance portability and accountability act (P.L. 104-191; 110 Stat. 1936) and regulations adopted pursuant to that act.
(b) For purposes of this subsection: (i) "Health carrier" and "health benefit plan" have the same meaning as provided in RCW 48.43.005; and (ii) "wellness program" has the same meaning as provided in 45 C.F.R. 146.121(f).
(7) Subsection (1) of this section does not apply to a payment by an insurer to offset documented expenses incurred by a group policyholder in changing coverages from one insurer to another. Insurers shall describe any such payment in the group insurance policy or in an applicable filing with the commissioner. If an implementation credit is given to a group, the implementation credit is part of the premium for the purposes of RCW 48.14.020 and 48.14.0201. This exception to subsection (1) of this section does not apply to "medicare supplemental insurance" or "medicare supplemental insurance policies" as defined in chapter 48.66 RCW.
(8) Subsection (7) of this section does not apply to small groups as defined in RCW 48.43.005.
(9) Subsection (1) of this section does not apply to products or services related to any policy of life insurance that are intended to incent behavioral changes that improve the health and reduce the risk of death of the insured.
(10) Subsection (1) of this section does not apply to a performance standard offered or provided in compliance with RCW 48.30.360.
[ 2022 c 13 s 3; 2020 c 197 s 1; 2019 c 253 s 1; 2015 c 272 s 1; 2009 c 329 s 1; 2008 c 217 s 35; 1994 c 203 s 3; 1990 1st ex.s. c 3 s 8; 1985 c 264 s 14; 1975-'76 2nd ex.s. c 119 s 3; 1947 c 79 s .30.14; Rem. Supp. 1947 s 45.30.14.]
NOTES:
Intent—2022 c 13: See note following RCW 48.30.360.
Effective date—2020 c 197: "This act takes effect July 1, 2020." [ 2020 c 197 s 5.]
Effective date—2019 c 253: "This act takes effect July 1, 2020." [ 2019 c 253 s 3.]
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
Illegal inducements.
(1) No insurer, insurance producer, title insurance agent, or other person shall, as an inducement to insurance, or in connection with any insurance transaction, provide in any policy for, or offer, or sell, buy, or offer or promise to buy or give, or promise, or allow to, or on behalf of, the insured or prospective insured in any manner whatsoever:
(a) Any shares of stock or other securities issued or at any time to be issued on any interest therein or rights thereto; or
(b) Any special advisory board contract, or other contract, agreement, or understanding of any kind, offering, providing for, or promising any profits or special returns or special dividends; or
(c) Any prizes, goods, wares, gift cards, gift certificates, or merchandise of an aggregate value in excess of one hundred dollars per person in the aggregate in any consecutive twelve-month period. This subsection (1)(c) does not apply to title insurers or title insurance agents.
(2) Subsection (1) of this section shall not be deemed to prohibit the sale or purchase of securities as a condition to or in connection with surety insurance insuring the performance of an obligation as part of a plan of financing found by the commissioner to be designed and operated in good faith primarily for the purpose of such financing, nor shall it be deemed to prohibit the sale of redeemable securities of a registered investment company in the same transaction in which life insurance is sold.
(3)(a) Subsection (1) of this section shall not be deemed to prohibit a health carrier or disability insurer from including as part of a group or individual health benefit plan or contract providing health benefits, a wellness program which meets the requirements for an exception from the prohibition against discrimination based on a health factor under the health insurance portability and accountability act (P.L. 104-191; 110 Stat. 1936) and regulations adopted pursuant to that act.
(b) For purposes of this subsection: (i) "Health carrier" and "health benefit plan" have the same meaning as provided in RCW 48.43.005; and (ii) "wellness program" has the same meaning as provided in 45 C.F.R. 146.121(f).
(4) Subsection (1) of this section does not prohibit an insurer from issuing any payment to offset documented expenses incurred by a group policyholder in changing coverages from one insurer to another as provided in RCW 48.30.140. If an implementation credit is given to a group, the implementation credit is part of the premium for the purposes of RCW 48.14.020 and 48.14.0201. This exception to subsection (1) of this section does not apply to "medicare supplemental insurance" or "medicare supplemental insurance policies" as defined in chapter 48.66 RCW.
(5) Subsection (4) of this section does not apply to small groups as defined in RCW 48.43.005.
(6) Subsection (1) of this section does not apply to products or services related to any policy of life insurance that are intended to incent behavioral changes that improve the health and reduce the risk of death of the insured.
(7) Subsection (1) of this section does not apply to a performance standard offered or provided in compliance with RCW 48.30.360.
[ 2022 c 13 s 4; 2020 c 197 s 2; 2019 c 253 s 2; 2015 c 272 s 2; 2009 c 329 s 2; 2008 c 217 s 36; 1990 1st ex.s. c 3 s 9; 1975-'76 2nd ex.s. c 119 s 4; 1957 c 193 s 18; 1947 c 79 s .30.15; Rem. Supp. 1947 s 45.30.15.]
NOTES:
Intent—2022 c 13: See note following RCW 48.30.360.
Effective date—2020 c 197: See note following RCW 48.30.140.
Effective date—2019 c 253: See note following RCW 48.30.140.
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
Life or disability insurers—Insurance as inducement to purchase of goods, etc.
No life or disability insurer shall directly or indirectly participate in any plan to offer or effect any kind or kinds of insurance in this state as an inducement to the purchase by the public of any goods, securities, commodities, services or subscriptions to publications. This section shall not apply to group or blanket insurance issued pursuant to this code. This section does not apply to products or services related to any policy of life insurance that are intended to incent behavioral changes that improve the health and reduce the risk of death of the insured.
NOTES:
Effective date—2020 c 197: See note following RCW 48.30.140.
Charges for extra services.
Notwithstanding the provisions of RCW 48.30.140, 48.30.150, and 48.30.155, the commissioner may permit an insurance producer to enter into reasonable arrangements with insureds and prospective insureds to charge a reduced fee in situations where services that are charged for are provided beyond the scope of services customarily provided in connection with the solicitation and procurement of insurance, so that an overall charge to an insured or prospective insured is reasonable taking into account receipt of commissions and fees and their relation, proportionally, to the value of the total work performed.
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
Rebate—Acceptance prohibited.
(1) No insured person shall receive or accept, directly or indirectly, any rebate of premium or part thereof, or any favor, advantage, share in dividends, or other benefits, or any valuable consideration or inducement not specified or provided for in the policy, or any commission on any insurance policy to which he or she is not lawfully entitled as a licensed insurance producer or title insurance agent. The retention by the nominal policyholder in any group life insurance contract of any part of any dividend or reduction of premium thereon contrary to the provisions of RCW 48.24.260, shall be deemed the acceptance and receipt of a rebate and shall be punishable as provided by this code.
(2) The amount of insurance whereon the insured has so received or accepted any such rebate or any such commission, other than as to life or disability insurances, shall be reduced in the proportion that the amount or value of the rebate or commission bears to the premium for such insurance. In addition to such reduction of insurance, if any, any such insured shall be liable to a fine of not more than two hundred dollars.
(3) This section shall not apply to an offset or reimbursement of all or part of a fee paid to an insurance producer as provided in RCW 48.17.270.
[ 2008 c 217 s 38; 1994 c 203 s 4; 1947 c 79 s .30.17; Rem. Supp. 1947 s 45.30.17.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
"Twisting" prohibited.
No person shall by misrepresentations or by misleading comparisons, induce or tend to induce any insured to lapse, terminate, forfeit, surrender, retain, or convert any insurance policy.
[1947 c 79 s .30.18; Rem. Supp. 1947 s 45.30.18.]
Illegal dealing in premiums.
(1) No person shall wilfully collect any sum as premium for insurance, which insurance is not then provided or is not in due course to be provided by an insurance policy issued by an insurer as authorized by this code.
(2) No person shall wilfully collect as premium for insurance any sum in excess of the amount actually expended or in due course is to be expended for insurance applicable to the subject on account of which the premium was collected.
(3) No person shall wilfully or knowingly fail to return to the person entitled thereto within a reasonable length of time any sum collected as premium for insurance in excess of the amount actually expended for insurance applicable to the subject on account of which the premium was collected.
(4) Each violation of this section which does not amount to a felony shall constitute a misdemeanor.
[1947 c 79 s .30.19; Rem. Supp. 1947 s 45.30.19.]
Hypothecation of premium notes.
It shall be unlawful for any insurer or its representative, or any insurance producer, to hypothecate, sell, or dispose of any promissory note, received in payment for any premium or part thereof on any contract of life insurance or of disability insurance applied for, prior to delivery of the policy to the applicant.
[ 2008 c 217 s 39; 1947 c 79 s .30.20; Rem. Supp. 1947 s 45.30.20.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
Misrepresentation in application for insurance.
A person who knowingly makes a false or misleading statement or impersonation, or who willfully fails to reveal a material fact, in or relative to an application for insurance to an insurer, is guilty of a gross misdemeanor, and the license of any such person may be revoked.
[ 1995 c 285 s 18; 1990 1st ex.s. c 3 s 10; 1947 c 79 s .30.21; Rem. Supp. 1947 s 45.30.21.]
NOTES:
Effective date—1995 c 285: See RCW 48.30A.900.
Destruction, injury, secretion, etc., of property.
Any person, who, with intent to defraud or prejudice the insurer thereof, burns or in any manner injures, destroys, secretes, abandons, or disposes of any property which is insured at the time against loss or damage by fire, theft, embezzlement, or any other casualty, whether the same be the property of or in the possession of such person or any other person, under circumstances not making the offense arson in the first degree, is guilty of a class C felony.
[ 1995 c 285 s 19; 1965 ex.s. c 70 s 25; 1947 c 79 s .30.22; Rem. Supp. 1947 s 45.30.22.]
NOTES:
Effective date—1995 c 285: See RCW 48.30A.900.
False claims or proof—Penalty.
(1) It is unlawful for any person, knowing it to be such, to:
(a) Present, or cause to be presented, a false or fraudulent claim, or any proof in support of such a claim, for the payment of a loss under a contract of insurance; or
(b) Prepare, make, or subscribe any false or fraudulent account, certificate, affidavit, or proof of loss, or other document or writing, with intent that it be presented or used in support of such a claim.
(2)(a) Except as provided in (b) of this subsection, a violation of this section is a gross misdemeanor.
(b) If the claim is in excess of one thousand five hundred dollars, the violation is a class C felony punishable according to chapter 9A.20 RCW.
[ 2003 c 53 s 270; 1990 1st ex.s. c 3 s 11; 1947 c 79 s .30.23; Rem. Supp. 1947 s 45.30.23.]
NOTES:
Intent—Effective date—2003 c 53: See notes following RCW 2.48.180.
Rate wars prohibited.
(1) Any insurer which precipitates, or aids in precipitating or conducting a rate war and by so doing writes or issues a policy of insurance at a less rate than permitted under its schedules filed with the commissioner, or below the rate deemed by him or her to be proper and adequate to cover the class of risk insured, shall have its certificate of authority to do business in this state suspended until such time as the commissioner is satisfied that it is charging a proper rate of premium.
(2) Any insurer which has precipitated, or aided in precipitating or conducting a rate war for the purpose of punishing or eliminating competitors or stifling competition, or demoralizing the business, or for any other purpose, and has ordered the cancellation or rewriting of policies at a rate lower than that provided by its rating schedules where such rate war is not in operation, and has paid or attempted to pay to the insured any return premiums, on any risk so to be rewritten, on which its appointed insurance producer has received or is entitled to receive a regular commission, such insurer shall not be allowed to charge back to such appointed insurance producer any portion of a commission on the ground that the same has not been earned.
[ 2008 c 217 s 40; 1947 c 79 s .30.24; Rem. Supp. 1947 s 45.30.24.]
NOTES:
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
Interlocking ownership, management.
(1) Any insurer may retain, invest in or acquire the whole or any part of the capital stock of any other insurer or insurers, or have a common management with any other insurer or insurers, unless such retention, investment, acquisition or common management is inconsistent with any other provision of this title, or unless by reason thereof the business of such insurers with the public is conducted in a manner which substantially lessens competition generally in the insurance business or tends to create a monopoly therein.
(2) Any person otherwise qualified may be a director of two or more insurers which are competitors, unless the effect thereof is to substantially lessen competition between insurers generally or tends to create a monopoly.
(3) If the commissioner finds, after a hearing thereon, that there is violation of this section he or she shall order all such persons and insurers to cease and desist from such violation within such time, or extension thereof, as may be specified in such order.
[ 2009 c 549 s 7121; 1949 c 190 s 34; Rem. Supp. 1949 s 45.30.25.]
Right of debtor or borrower to select insurance producer, surplus line broker, or insurer.
(1) Every debtor or borrower, when property insurance of any kind is required in connection with the debt or loan, shall have reasonable opportunity and choice in the selection of the insurance producer, surplus line broker, and insurer through whom such insurance is to be placed; but only if the insurance is properly provided for the protection of the creditor or lender, whether by policy or binder, not later than at commencement of risk as to such property as respects such creditor or lender, and in the case of renewal of insurance, only if the renewal policy, or a proper binder therefor containing a brief description of the coverage bound and the identity of the insurer in which the coverage is bound, is delivered to the creditor or lender not later than thirty days prior to the renewal date.
(2) Every person who lends money or extends credit and who solicits insurance on real and personal property must explain to the borrower in prominently displayed writing that the insurance related to such loan or credit extension may be purchased from an insurer, surplus line broker, or insurance producer of the borrower's choice, subject only to the lender's right to reject a given insurer, surplus line broker, or insurance producer as provided in subsection (3)(b) of this section.
(3) No person who lends money or extends credit may:
(a) Solicit insurance for the protection of property, after a person indicates interest in securing a loan or credit extension, until such person has received a commitment from the lender as to a loan or credit extension;
(b) Unreasonably reject a contract of insurance furnished by the borrower for the protection of the property securing the credit or lien. A rejection shall not be deemed unreasonable if it is based on reasonable standards, uniformly applied, relating to the extent of coverage required and the financial soundness and the services of an insurer. Such standards shall not discriminate against any particular type of insurer, nor shall such standards call for rejection of an insurance contract because the contract contains coverage in addition to that required in the credit transaction;
(c) Require that any borrower, mortgagor, purchaser, insurer, surplus line broker, or insurance producer pay a separate charge, in connection with the handling of any contract of insurance required as security for a loan, or pay a separate charge to substitute the insurance policy of one insurer for that of another. This subsection does not include the interest which may be charged on premium loans or premium advancements in accordance with the terms of the loan or credit document;
(d) Use or disclose, without the prior written consent of the borrower, mortgagor, or purchaser taken at a time other than the making of the loan or extension of credit, information relative to a contract of insurance which is required by the credit transaction, for the purpose of replacing such insurance;
(e) Require any procedures or conditions of duly licensed insurance producers, surplus line brokers, or insurers not customarily required of those insurance producers, surplus line brokers, or insurers affiliated or in any way connected with the person who lends money or extends credit; or
(f) Require property insurance in an amount in excess of the amount which could reasonably be expected to be paid under the policy, or combination of policies, in the event of a loss.
(4) Nothing contained in this section shall prevent a person who lends money or extends credit from placing insurance on real or personal property in the event the mortgagor, borrower, or purchaser has failed to provide required insurance in accordance with the terms of the loan or credit document.
(5) Nothing contained in this section shall apply to credit life or credit disability insurance.
[ 2009 c 162 s 25; 2008 c 217 s 41; 1990 1st ex.s. c 3 s 13; 1988 c 248 s 18; 1984 c 6 s 2; 1977 c 61 s 1; 1957 c 193 s 20.]
NOTES:
Effective date—2009 c 162: See note following RCW 48.03.020.
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
Public building or construction contracts—Surety bonds or insurance—Violations concerning—Exemption.
(1) No officer or employee of this state, or of any public agency, public authority or public corporation except a public corporation or public authority created pursuant to agreement or compact with another state, and no person acting or purporting to act on behalf of such officer or employee, or public agency or public authority or public corporation, shall, with respect to any public building or construction contract which is about to be, or which has been competitively bid, require the bidder to make application to, or to furnish financial data to, or to obtain or procure, any of the surety bonds or contracts of insurance specified in connection with such contract, or specified by any law, general, special or local, from a particular insurer, surplus line broker, or insurance producer.
(2) No such officer or employee or any person, acting or purporting to act on behalf of such officer or employee shall negotiate, make application for, obtain or procure any of such surety bonds or contracts of insurance, except contracts of insurance for builder's risk or owner's protective liability, which can be obtained or procured by the bidder, contractor or subcontractor.
(3) This section shall not be construed to prevent the exercise by such officer or employee on behalf of the state or such public agency, public authority, or public corporation of its right to approve the form, sufficiency or manner or execution of the surety bonds or contracts of insurance furnished by the insurer selected by the bidder to underwrite such bonds, or contracts of insurance.
(4) Any provisions in any invitation for bids, or in any of the contract documents, in conflict with this section are declared to be contrary to the public policy of this state.
(5) A violation of this section shall be subject to the penalties provided by RCW 48.01.080.
(6) This section shall not apply to public construction projects, when the actual or estimated aggregate value of the project, exclusive of insurance and surety costs, exceeds two hundred million dollars. For purposes of applying the two hundred million dollar threshold set forth in this subsection, the term "public construction project" means a project that has a public owner and has phases, segments, or component parts relating to a common geographic site or public transportation system, but does not include the aggregation of unrelated construction projects.
(7) The exclusions specified in subsection (6) of this section do not apply to surety bonds.
[ 2009 c 162 s 26; 2008 c 217 s 42; 2005 c 352 s 1; (2003 c 323 s 2 repealed by 2005 c 352 s 2); 2003 c 323 s 1. Prior: 2000 2nd sp.s. c 4 s 33; 2000 c 143 s 2; 1983 2nd ex.s. c 1 s 6; 1967 ex.s. c 12 s 3.]
NOTES:
Effective date—2009 c 162: See note following RCW 48.03.020.
Severability—Effective date—2008 c 217: See notes following RCW 48.03.020.
Unfair discrimination, generally.
Notwithstanding any provision contained in Title 48 RCW to the contrary:
(1) A person or entity engaged in the business of insurance in this state may not refuse to issue any contract of insurance or cancel or decline to renew such contract because of the sex, marital status, or sexual orientation as defined in RCW 49.60.040, or the presence of any disability of the insured or prospective insured. The amount of benefits payable, or any term, rate, condition, or type of coverage may not be restricted, modified, excluded, increased, or reduced on the basis of the sex, marital status, or sexual orientation, or be restricted, modified, excluded, or reduced on the basis of the presence of any disability of the insured or prospective insured.
(2) Except as provided in RCW 48.43.0128, 48.44.220, or 48.46.370, this subsection does not prohibit fair discrimination on the basis of sex, or marital status, or the presence of any disability when bona fide statistical differences in risk or exposure have been substantiated.
[ 2020 c 274 s 32; 2020 c 228 s 8; 2006 c 4 s 18; 2005 c 223 s 19; 1993 c 492 s 287; 1975-'76 2nd ex.s. c 119 s 7.]
NOTES:
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Commercial motor vehicle employment driving record not to be considered, when.
When an individual applies for a policy of casualty insurance providing either automobile liability coverage, uninsured motorist coverage, automobile medical payments coverage, or automobile physical damage coverage on an individually owned passenger vehicle or a renewal of such policy, an insurer shall not consider the applicant's commercial motor vehicle employment driving record in determining whether the policy will be issued or renewed or in determining the rates for the policy. An insurer shall not cancel such policy or discriminate in regard to other terms or conditions of the policy based upon the applicant's commercial motor vehicle employment driving record.
"Employment driving record" means that record maintained by the director pertaining to motor vehicle accidents or convictions for violation of motor vehicle laws while the applicant is driving a commercial motor vehicle as an employee of another.
Notice of reason for cancellation, restrictions based on disability.
Every authorized insurer, upon canceling, denying, or refusing to renew any individual life, individual disability, homeowner, dwelling fire, or private passenger automobile insurance policy, shall, upon written request, directly notify in writing the applicant or insured, as the case may be, of the reasons for the action by the insurer. Any benefits, terms, rates, or conditions of such an insurance contract which are restricted, excluded, modified, increased, or reduced because of the presence of a disability shall, upon written request, be set forth in writing and supplied to the insured. The written communications required by this section shall be phrased in simple language which is readily understandable to a person of average intelligence, education, and reading ability.
Immunity from libel or slander.
With respect to contracts of insurance as defined in RCW 48.30.320, there shall be no liability on the part of, and no cause of action of any nature shall arise against, the insurance commissioner, the commissioner's agents, or members of the commissioner's staff, or against any insurer, its authorized representative, its agents, its employees, furnishing to the insurer information as to reasons for cancellation or refusal to issue or renew, for libel or slander on the basis of any statement made by any of them in any written notice of cancellation or refusal to issue or renew, or in any other communications, oral or written, specifying the reasons for cancellation or refusal to issue or renew or the providing of information pertaining thereto, or for statements made or evidence submitted in any hearing conducted in connection therewith.
[ 1979 c 133 s 2.]
Auto glass repair—Restrictions on insurer-owned facilities.
(1) A person in this state has the right to choose any glass repair facility for the repair of a loss relating to motor vehicle glass.
(2) An insurer or its third-party administrator that owns in whole or in part an automobile glass repair facility that is processing a claim limited only to auto glass shall:
(a) Verbally inform the person making the claim of loss, of the right provided under subsection (1) of this section, at the time information regarding the automobile glass repair or replacement facilities is provided; and
(b) Verbally inform the person making the claim of loss that the third-party administrator is an entity separate from the insurer that has a financial arrangement to process automobile glass claims on the insurer's behalf.
(3) An insurer or its third-party administrator that owns an interest in an automobile glass repair or replacement facility shall post the following notice in each of its repair facilities:
"THIS AUTOMOBILE GLASS REPAIR OR REPLACEMENT FACILITY IS OWNED IN WHOLE OR IN PART BY (NAME OF INSURER OR INSURER'S THIRD-PARTY ADMINISTRATOR). YOU ARE HEREBY NOTIFIED THAT YOU ARE ENTITLED UNDER WASHINGTON LAW TO SEEK REPAIRS AT ANY AUTOMOBILE GLASS REPAIR OR REPLACEMENT FACILITY OF YOUR CHOICE."
The notice must be posted, in not less than eighteen point font, prominently in a location in which it is likely to be seen and read by a customer. If the automobile glass repair or replacement facility is mobile, the notice must be given to the person making the claim verbally by the insurer or its third-party administrator prior to commencement of the repair or replacement.
(4) A person making a claim of loss whose motor vehicle is repaired at an automotive glass repair or replacement facility subject to the notice requirements of this section may file a complaint with the office of the insurance commissioner.
(5) This section does not create a private right or cause of action to or on behalf of any person.
[ 2007 c 74 s 1.]
Initiating arbitration of claims under the balance billing protection act with such frequency as to indicate a health carrier's general business practice.
(1) It is an unfair or deceptive practice for a health carrier to initiate, with such frequency as to indicate a general business practice, arbitration under RCW 48.49.040 with respect to claims submitted by out-of-network providers for services included in RCW 48.49.020 that request payment of a commercially reasonable amount, based on payments for the same or similar services provided in a similar geographic area.
(2) As used in this section, "health carrier" has the same meaning as in RCW 48.43.005.
[ 2019 c 427 s 16.]
NOTES:
Performance standards—Premiums—Application—Rules.
(1) For purposes of this section, "performance standard" means a contractual provision in a group insurance contract that establishes a specific standard for the insurer's or health carrier's performance of an obligation in the contract, and under which the insurer or health carrier is required to remit a penalty payment, based on a percentage of the premium or a set dollar amount, to the group policyholder for the next policy term if the insurer or health carrier fails to comply with the standard. Group policyholders and insurers or health carriers may calculate the amount of the penalty based on a percentage of the overall premium owed to the insurer or health carrier by the policyholder.
(2) Remittance of a performance payment to the group policyholder in compliance with this section does not constitute a premium under RCW 48.18.170 and 48.43.005. Nothing in this section prevents the health care authority from including performance standards in contracts.
(3) If a group insurance contract includes any performance standards, the insurer or health carrier must describe the performance standards in the group insurance contract and file the contract with the commissioner.
(4) Remittance of a performance payment to the group policyholder in compliance with this section must not be considered a return premium for purposes of RCW 48.14.020 and 48.14.0201.
(5) This section does not apply to small groups as defined in RCW 48.43.005.
(6) The commissioner may adopt rules to implement this section.
(7) For the purposes of this section, "health carrier" has the meaning provided in RCW 48.43.005.
[ 2022 c 13 s 2.]
NOTES:
Intent—2022 c 13: "The legislature intends to align the insurance code and performance-based contracting to ensure the continued practice of using performance standards and performance guarantees in group insurance contracts, including those entered into by the health care authority." [ 2022 c 13 s 1.]
Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.
For the purposes of this chapter, the terms spouse, marriage, marital, husband, wife, widow, widower, next of kin, and family shall be interpreted as applying equally to state registered domestic partnerships or individuals in state registered domestic partnerships as well as to marital relationships and married persons, and references to dissolution of marriage shall apply equally to state registered domestic partnerships that have been terminated, dissolved, or invalidated, to the extent that such interpretation does not conflict with federal law. Where necessary to implement chapter 521, Laws of 2009, gender-specific terms such as husband and wife used in any statute, rule, or other law shall be construed to be gender neutral, and applicable to individuals in state registered domestic partnerships.
[ 2009 c 521 s 123.]