Key Takeaways
- Pennsylvania requires insurers to acknowledge claims within 10 working days
- Insurers must make claim decisions within a reasonable time after receiving proof of loss
- Pennsylvania has specific requirements for prompt payment of undisputed claims
- Policyholders have the right to dispute claim decisions through appraisal or legal action
- Unfair claims practices can result in penalties and licensing action
Last updated: January 2026
Pennsylvania Property Claims Handling
Pennsylvania has specific requirements for handling property insurance claims to protect policyholders.
Claims Timeline Requirements
Pennsylvania regulations establish timeframes for claims handling:
Required Timeframes
| Action | Timeframe |
|---|---|
| Acknowledge claim | 10 working days |
| Begin investigation | Promptly after notice |
| Request information | Within 10 working days |
| Claim decision | Reasonable time after proof of loss |
| Pay undisputed claims | 15 days after settlement |
Acknowledgment Requirements
Upon receiving notice of a claim, insurers must:
- Acknowledge receipt in writing
- Explain the claims process
- Provide contact information for claims adjuster
- Request necessary documentation
Investigation Requirements
Good Faith Investigation
Pennsylvania requires insurers to:
- Investigate claims promptly and thoroughly
- Consider all available evidence
- Not deny claims without proper investigation
- Document investigation activities
Documentation Requests
- Insurers may request reasonable documentation
- Must specify what is needed
- Cannot require unreasonable proof
- Must accept reasonable alternatives
Payment Requirements
Undisputed Claims
| Requirement | Timeline |
|---|---|
| Undisputed portion | Pay within 15 days |
| Partial payment | Pay what is not disputed |
| Final payment | After all disputes resolved |
Interest on Late Payments
Pennsylvania may require interest on late claim payments when insurer delays unreasonably.
Unfair Claims Practices
Pennsylvania prohibits unfair claims settlement practices:
Prohibited Practices
- Misrepresenting policy provisions to claimants
- Failing to acknowledge claims promptly
- Failing to communicate claim decisions timely
- Denying claims without reasonable investigation
- Offering substantially less than reasonable value
- Delaying payment to pressure settlement
- Not attempting good faith settlement when liability clear
- Failing to provide reasonable explanation for denial
Penalties for Violations
| Violation Type | Potential Penalty |
|---|---|
| Individual violation | Fine up to $10,000 |
| Pattern of violations | Enhanced penalties |
| Willful violations | License suspension/revocation |
| Consumer harm | Restitution required |
Dispute Resolution
Appraisal Process
Many property policies include appraisal clauses:
- Either party can demand appraisal
- Each party selects an appraiser
- Appraisers select an umpire
- Decision by two of three is binding
- Covers amount of loss, not coverage issues
Legal Action
Policyholders may pursue legal remedies:
- Breach of contract claims
- Bad faith claims (if applicable)
- Statutory violations
- Must typically sue within policy time limits
Public Adjuster Regulations
Pennsylvania regulates public adjusters:
Requirements
| Requirement | Details |
|---|---|
| Licensing | Must be licensed by Department |
| Contract | Written contract required |
| Disclosure | Fees must be disclosed |
| Prohibited Practices | Cannot solicit during disaster |
Public Adjuster Role
- Represents policyholder in claims
- Negotiates with insurer on behalf of insured
- Prepares claim documentation
- Cannot practice law or adjust for insurers
Test Your Knowledge
Within how many working days must a Pennsylvania insurer acknowledge receipt of a property claim?
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D
Test Your Knowledge
What is prohibited under Pennsylvania unfair claims practices law?
A
B
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D