What is the insurance company's role in home repairs?

It’s common for consumers to call us with their concerns about their home repair or home rebuild claims and the insurer's involvement in oversight of the work. The insurer’s duty is to pay according to the terms laid out in the policy. Unless your insurance policy contains a provision, or unless your insurer has given you assurances, that obligates them to manage a covered home repair or rebuild, it is your responsibility to oversee the project with your contractor, and when applicable, your lender.


However, if you using an insurer’s recommended (sometimes called “preferred”) contractor, then you should expect assistance from the insurer in answering your questions about the contractor’s actions and performance.

Read more about homeowner insurance.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Important change may affect business owners’ insurance

Business owners carry commercial insurance policies to protect their financial interests in their property and to cover their liability arising out their business operations. One of the important liabilities that is covered is in the event that a business is sued. The typical commercial insurance policy includes a clause called “duty to defend,” which means the insurance company is required to defend the business if it is sued and it will pay the associated legal costs. However, some commercial policies are being changed to require businesses to repay legal defense costs if the insurer later determines a claim is not covered.

How will you know if your insurance company will require you to repay legal costs? Read your policy or talk to your agent , broker, or with the insurer. Insurers may be adding the clause to new policies or to renewing policies, so it’s important to know what your policy says.

It’s also important that you promptly report lawsuits to your insurance company. Reporting this information to the insurer too late can impede the insurer’s ability to defend your business against the lawsuit. 

More information:

• Read more about the duty to defend and repaying legal costs.
• Who needs business insurance?  
• Things to consider before buying business insurance.

Questions? Contact our consumer advocates online or at 1-800-562-6900.

Consumers who had trouble with Washington Healthplanfinder have a second chance to enroll

The Washington State Health Benefits Exchange has announced a special enrollment through Feb. 23, 2015 for people who have experienced trouble enrolling in a health plan for 2015 through the state’s exchange, Washington Healthplanfinder.

“I am pleased that Washington consumers who have had trouble with Washington Healthplanfinder have an option for getting coverage effective Jan. 1,” said Insurance Commissioner Mike Kreidler. “I encourage affected consumers to act sooner rather than later.”

The special enrollment applies to people who made an effort to receive health coverage through http://www.wahealthplanfinder.org/ before the Dec. 23 deadline, but who were unable to complete their applications due to a technical error associated with the Washington Healthplanfinder system.

Starting at noon today, affected consumers should fill out an online request form for coverage retroactive to Jan. 1 at: https://petition.wahealthplanfinder.org/. If customers need assistance or do not have Internet access, they can call the Exchange’s Customer Support Center at 1-855-923-4633. Each request will be reviewed and customers will receive a notification of their special enrollment through email or mail.

The Exchange also posted a list of frequently asked questions about the special enrollment period.

Does insurance have to replace my entire roof?

Here's a consumer question related to winter weather: My insurer will repair a portion of my roof that was damaged, but won’t replace the entire roof to match. Can they do this?

This is a common question and it's a frustrating issue for consumers. The short answer is yes, insurers can do that. Home insurance policies cover direct physical damage to the roof, like a tree branch falling in a wind storm and poking a hole in the roof, or blowing a section of your shingles off and allowing water to enter. The insurer will repair the damaged portion of the roof and any resulting water damage. The insurer would not pay to repair any sections of your roof that are not damaged. 

If you decide you want the entire roof replaced, you would have to pay for replacing all non-damaged areas of the roof.

Read more about homeowner insurance on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Oregon Insurance Commissioner extends comment period on Mutual of Enumclaw holding company conversion

The Oregon Insurance Commissioner has extended the open comment period following the Dec. 15 public hearing of the proposed mutual holding company conversion of Mutual of Enumclaw Insurance Co. Comments must be delivered to the Oregon Insurance Commissioner by 5 p.m. on Dec. 29. Comments should be sent to Russell Latham, Financial Regulation Section, Oregon Insurance Division, P. O. Box 14480, Salem, OR 97309-0405.

Mutual of Enumclaw Insurance Co. and its subsidiary, Enumclaw Property and Casualty Insurance Co., have requested permission from the Oregon Insurance Commissioner to reorganize into a holding company structure. Holding companies are corporations that own and control other companies. The new holding company would be the direct owner of Mutual of Enumclaw and the indirect owner of Enumclaw Property and Casualty Insurance Co. Read more about the request in our Dec. 9 blog post.

To find information about viewing the plan of reorganization, view the Dec. 15 public hearing notice from the Oregon Insurance Division.

Insurance Commissioner fines health insurer $50,000

LifeWise Health Plan of Washington has agreed to pay a $50,000 fine for overcharging 5,700 consumers $6 to $38 per month for the first six months of 2014. 

The health plans were WiseEssentials 25 and WiseSavings 20, which are catastrophic plans that trade a high deductible for a lower monthly premium. They are usually purchased by young, healthy people who want coverage in case of an injury, accident or serious illness. Each year, health insurers are required to file with the OIC their health plans--called "forms" in insurance vernacular--and the rates they will charge for each plan. The OIC then reviews and ultimately approves the plans and rates, working with the insurers when they need to. 

In this case, the 2014 rates that LifeWise filed for those catastrophic plans had decreased slightly, depending on the enrollee’s age, because the deductible increased. From January through June 2014, LifeWise charged those consumers rates that were based on the 2013 plans, which had higher deductibles.

As part of the agreement, called a consent order, LifeWise will repay the affected consumers the amounts they overpaid plus 8 percent annual interest. View the consent order here. 

You can search our disciplinary orders or file a complaint against an insurance company, agent or broker on our website.

Edmonds man no longer able to sell insurance

The Office of the Insurance Commissioner has revoked the license of insurance producer Earl C. Dennis of Edmonds.

In 2012, Dennis borrowed $210,000 from a 79-year-old insurance client, which was a significant portion of the client’s net worth. Dennis promised to secure the loan with the deed to his house, which he never did. He arranged to repay the client at a 2 percent interest rate; an unsecured personal loan from a bank ranges from 7 percent to 15 percent or higher. Dennis stopped making loan payments and still owes the client $90,000. State insurance law allows the Insurance Commissioner to revoke an insurance producer’s license if they borrow money from an insurance client who is not a family member or financial institution.

In 2011 and 2012, Dennis sold the same client three annuities, which the client paid for by surrendering two annuities that had higher guaranteed interest rates. In addition to having lower guaranteed interest rates, the three new annuities had limitations and penalties that the old annuities did not have. Insurance producers who sell annuities are required to make an effort to verify that annuities are suitable for their clients’ financial needs and they are required to adequately explain the products to their clients. Dennis did not meet those requirements in this case.

The OIC sought to revoke Dennis’ license in August 2014, but Dennis invoked his right to a hearing. The hearings officer upheld the OIC’s revocation, which means Dennis is no longer legally able to sell insurance in Washington state. You can read the findings from the hearing on the OIC’s website.

Tacoma woman pleads guilty to felony insurance fraud

Christine Marie Larsen, 30, of Tacoma pled guilty in Pierce County Superior Court to insurance fraud for purchasing insurance on her vehicle after it was totaled. 

In November 2013, Larsen’s 2004 Lexus IS300 was totaled in a collision on the freeway while being driven by someone else. The next day, Larsen took out a policy on the car, which was uninsured. She filed a claim for the damages on Dec.1, 2013, stating she had been in a collision that day. The insurance company deemed the car a total loss and paid her $11,250.


The insurer, citing red flags, later investigated the claim and found a Washington State Patrol report for the Nov. 25 collision involving Larsen’s car. The driver was cited for the collision and for not having insurance. The insurer referred the case to the Office of the Insurance Commissioner’s Special Investigations Unit (SIU). SIU investigates insurance fraud and works with the Attorney General’s Office and local prosecutors to prosecute criminal cases.  

Larsen was ordered to repay the insurance settlement and court costs. Read the news release about the case.

Mutual of Enumclaw seeks to convert to holding company

Mutual of Enumclaw Insurance Co. and its subsidiary, Enumclaw Property and Casualty Insurance Co., have requested permission from the Oregon Insurance Commissioner to reorganize into a holding company structure. Holding companies are corporations that own and control other companies. The new holding company would be the direct owner of Mutual of Enumclaw and the indirect owner of Enumclaw Property and Casualty Insurance Co.

While the Washington Office of the Insurance Commissioner (OIC) is not overseeing this conversion, Mutual of Enumclaw has a large customer base in Washington state. The OIC wants Washington consumers to have an opportunity to attend this hearing or provide comment, if they wish to.

The hearing is at 6 p.m. on Dec. 15 in Seattle. View the notice for the hearing location and instructions on how to participate by telephone. Comments may be submitted in writing to this address before Dec. 22:

Russell Latham, Financial Regulation Section, Oregon Insurance Division
P.O. Box 14480
Salem, OR 97309-0405

OIC's online applications not available

Some of the Office of the Insurance Commissioner's online applications are down or do not have full functionality. We are working on resolving these issues and hope to restore all online services as soon as possible. Thank you for your patience.

Contractors Bonding and Insurance Co. seeks OK to redomesticate

Contractors Bonding and Insurance Co. has requested approval from the Office of the Insurance Commissioner (OIC) to redomesticate from Washington state to Illinois. View all related documents.

The OIC has scheduled a public hearing on this request for 11:30 a.m. on Dec. 16 in the Tumwater office. All interested parties may submit letters of support or objections to hearings@oic.wa.gov. Any member of the public may attend the hearing.

Commonwealth Insurance Co. of America requests approval to change its state of domicile

Commonwealth Insurance Co. of America has requested approval from the Washington State Insurance Commissioner to redomesticate from Washington state to Delaware. In plain talk, that means it wants to move its corporate operations from Washington to Delaware. View the documents the company submitted.

The Office of the Insurance Commissioner has scheduled a public hearing on this request for 10:30 a.m. on Dec. 16 in the Tumwater office. Interested parties may submit letters of support or objections to hearings@oic.wa.gov. Any member of the public may attend the hearing.