(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 § 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 § 1.]