For Consumers

Understanding the Insurance Fair Conduct Act

What is the Insurance Fair Conduct Act (IFCA)?

This law protects policyholders whose insurance company denied their claim for coverage or payment of benefits without good reason (

Before suing your insurer, you can send an IFCA notice to the insurer and to the Office of the Insurance Commissioner (OIC). A superior court judge can make a decision on your claim 20 days after you submit it. You can receive three times the actual damages if your insurer denied your claim without good reason. "Actual damages" are the amount of money that the insurer would have owed you if they had not denied your claim in the first place.

Who does the law apply to?

It applies only to claims that you make with your own insurance company. It doesn't apply to claims that you have with someone else's insurance company.

Does the Insurance Fair Conduct Act apply to my health insurance company?

No. The Insurance Fair Conduct Act does not apply to health insurance companies. The Patient Bill of Rights protects health insurance policyholders.

However, IFCA applies to insurance policy claims that may include medical costs. Auto and homeowner policies, for example, typically cover medical costs up to a certain amount.