On August 18, Washington’s Office of the Insurance Commissioner adopted Rulemaking R 2025-05, the most extensive overhaul of the state’s insurance claims-handling standards in years. It takes effect October 18 — 23 days from now.
The commissioner’s stated reason: while total auto and homeowners claim counts have held flat for six years, consumer complaints and Insurance Fair Conduct Act notices — the letters that say “we intend to sue our insurer” — have spiked. The office reads that as potential insurance code violations at scale.
Here’s what it changes for restoration work, translated from regulator language into operator language.
The provisions that matter to you
Estimating software is no longer an investigation. The rule states a reasonable investigation may not rely solely on database use — including estimating software and benchmarks gathered from one or multiple databases. When a carrier values your loss straight out of a database and calls it investigated, that’s now explicitly not enough.
Low payments need their reasons in writing. If the insurer pays less than your estimate or invoice, it must “promptly and fully” disclose all reasons for the short payment. Not a line item cut with no explanation — every reason, in writing.
Supplementals get a five-day clock. When the carrier receives your supplemental estimate and final invoice, it must respond in writing within five days regarding the determination of amounts covered. If it rejects any part, it must cite the applicable policy language. And any repair costs not covered under the policy must be documented in writing with relevant policy language cited — no more vague “not covered.”
Your homeowner can see the file. Consumers get the right to request any portion of their first-party claim file at reasonable intervals — adjuster notes, estimates, bids, measurements, engineer reports, contractor reports, photos, video — and the insurer must respond within 15 business days.
Claims can’t go quiet. If a claim can’t be completed within 30 days, the insurer must notify the consumer in writing, and every 30 days after that, with the reasons, a summary of decisions and actions, what it’s still waiting on, and whether a new adjuster was assigned.
Public adjusters are protected. A claimant cannot be treated differently for being represented by a public adjuster. The insurer must recognize the PA as the legal representative and provide requested claim information and the policy to the insured, the PA, or both.
Virtual inspection disputes get real inspections. If a virtual inspection is used and there’s disagreement on the amount of loss, the insurer must accept the consumer’s request for an in-person inspection — completed within five business days.
Appraisal pressure is restricted. Insurers can’t require an appraiser operating under the appraisal clause to adjust their actual cash value or valuation of loss during the appraisal process.
What this means for your business
Three practical reads:
- The supplement game changes. A statutory five-day response clock on supplementals and final invoices means carrier stall tactics now have a paper trail — and a deadline. Your job is making your side of the paper trail airtight: detailed scopes, dated photos, line-by-line documentation. The carrier’s clock only starts when your documentation lands.
- “The software said so” stops working. Carriers that reduce your line items against database benchmarks now have to show the actual investigation. When they push back, ask for the reasoning in writing — the rule says they owe it.
- The clock is already running. Adopted August 18, effective October 18. Claims that are open now will straddle the effective date. For anything disputed, keep your documentation current — the new standards apply to how the claim is handled from October 18 forward.
The bottom line
Regulators don’t rewrite claims-handling standards because everything was going fine. They do it when the complaint data says the system is breaking for policyholders. Washington just handed contractors a set of written obligations carriers now owe — and the contractors who document thoroughly are the ones positioned to collect on them.
Sources: WA Office of the Insurance Commissioner, R 2025-05; Repairer Driven News; Stritmatter Kessler Koehler Moore analysis.