One Bad Claim, or a Pattern? What Each State Actually Requires

Short answer: in some states one badly handled claim can be a violation on its own. In most it cannot, and it takes a pattern of them. The rule only bites once the insurer has done it often enough to look like a business practice, so which of those you are in decides what your complaint can achieve. The answer is not national.

By Anthony Braswell for Quorum Industries LLC, The Autobody Directory · Updated 2026-08-22 · How this was written, and what the machine may not do

How this page was produced: Researched, drafted and checked with AI assistance under human direction and signed off by the named author, with the tables on this page built from a register by a script. How this site is written

Nearly every account of this area of law, including most legal marketing and a fair amount of journalism, describes unfair claims settlement practices as a list of things insurers may not do. The list is real and it is remarkably similar from state to state, because most states adopted a version of the same NAIC model. But the list is not the rule. Sitting above it, usually in a single lead-in clause, is a threshold: the sentence that decides whether doing one of those things once is a violation, or whether it takes a pattern. That clause is where the states diverge, and it is the clause almost nobody quotes.

What this page is

We read the threshold clause in every US jurisdiction we could reach, on that jurisdiction's own government host, and recorded the words verbatim. This page is the result. It is organised around one question, and it answers it per jurisdiction, because a national summary of this particular question would destroy the thing worth knowing.

It does not tell you what the prohibited practices are. That list is in deny and delay, what state law actually names, which quotes the conduct provisions themselves.

The nine answers

Forty-seven jurisdictions are read in full and verified first-party, and every one of them is named in this table. Grouped by what the law actually requires before one badly handled claim becomes a violation, they fall into nine answers rather than one rule with local variations. Inside those nine there are thirty-four distinct formulations, because states that land in the same family still get there in different words, and the words are what a regulator applies.

Every jurisdiction, and what we read to say so

All 51 US jurisdictions are named below and all 51 carry a citation. What differs is the evidence behind the row: 47 were read end to end and adjudicated first-party, and four could not be read at all. The four short rows say which kind of short they are, and the section after the table names what stopped us in each case.

Seven states run two tests on the same conduct

This is the finding we did not expect, and it is the one with the most practical bite.

In seven jurisdictions the threshold depends on who is asking. The insurance department applies one test and a private claimant in court applies another, to the same conduct under the same statute. In every one of the seven the private test is the easier one, which inverts the usual assumption that the regulator is the stronger route.

Florida gates the department's route on frequency at Fla. Stat. § 626.9541(1)(i)3, "Committing or performing with such frequency as to indicate a general business practice any of the following", and then removes the gate for a private claimant in terms: § 624.155 ends "Notwithstanding the provisions of the above to the contrary, a person pursuing a remedy under this section need not prove that such act was committed or performed with such frequency as to indicate a general business practice."

Montana writes the removal out even more cleanly. Mont. Code Ann. 33-18-201 opens "A person may not, with such frequency as to indicate a general business practice, do any of the following", and 33-18-242(2) answers it: "In an action under this section, a plaintiff is not required to prove that the violations were of such frequency as to indicate a general business practice." The private route is then narrowed to six of the paragraphs and defeated by a safe harbour where the insurer "had a reasonable basis in law or in fact for contesting the claim".

New Jersey does the same thing through the 2021 Insurance Fair Conduct Act: N.J.S.A. 17:29BB-3.b, "The claimant shall not be required to prove that the insurer's actions were of such a frequency as to indicate a general business practice."

Louisiana splits by instrument as well as by forum. The commissioner's route at La. R.S. 22:1964(14) carries the frequency lead-in; the private route at 22:1892(I)(2) reads "Any one of the following acts, if knowingly committed or performed by an insurer or representative of the insurer, constitutes a breach", with no frequency element anywhere.

Minnesota is Florida inverted, and it is the reason this family is not just "private claimants get an easier test". Minn. Stat. § 72A.201 subd. 1 removes the gate for the regulator: "The commissioner need not show a general business practice in taking an administrative action for these violations." The same subdivision then closes the private statutory route: "No individual violation constitutes an unfair, discriminatory, or unlawful practice in business, commerce, or trade for purposes of section 8.31."

North Carolina puts the gate and the bar in one sentence, which is why both halves have to be quoted together. N.C. Gen. Stat. § 58-63-15(11): "Committing or performing with such frequency as to indicate a general business practice of any of the following: Provided, however, that no violation of this subsection shall of itself create any cause of action in favor of any person other than the Commissioner". The words "of itself" are doing real work: they bar an action on the subdivision, not an action on the underlying conduct under some other statute, and North Carolina claimants generally travel by Chapter 75 instead.

West Virginia splits by forum and again by instrument, which is the sharpest version of the pattern we found. The statute at W. Va. Code § 33-11-4(9) carries the frequency lead-in, and W. Va. C.S.R. 114-14, the legislative rule issued under it, contains no frequency qualifier anywhere and states its penalty section in the singular.

Two consequences follow. First, "my state requires a pattern" may be true of the department and false of a court, or the reverse. Second, a survey that records one threshold per state, which is what every secondary source we found does, is recording the wrong number in seven jurisdictions.

Same family, different words, and the words are what get applied

Grouping into nine families makes the shape visible. It also flattens something real, so the table above prints the count of distinct formulations alongside the families: states that land in the same column still get there in different words, and a regulator applies the words.

The clearest example is the two-stage family. Illinois looks like a plain fault test if you read 215 ILCS 5/154.6, whose opener counts an act only "if committed without just cause and in violation of Section 154.5". Follow the cross-reference and § 154.5 adds a second gate underneath: an act is an improper claims practice if "(a) it is committed knowingly in violation of this Act or any rules promulgated hereunder; or (b) It has been committed with such frequency to indicate a persistent tendency to engage in that type of conduct." The full Illinois test is fault, and then knowing or frequency. We recorded Illinois as a fault state once, off § 154.6 alone, and it was wrong. Reading one section of a statute can put a state in the wrong column exactly as reliably as reading none of it.

Vermont drops a word every other state carries. Its lead-in reads "Committing or performing with such frequency as to indicate a business practice any of the following", without "general", confirmed on two separate government URLs. And the qualifier governs only subdivision (9): 8 V.S.A. § 4724(21)(B), which forbids misinforming an insured to steer them to a particular auto glass provider, is freestanding, so a single act under (21) needs no frequency showing at all.

Ohio puts the pattern inside the definition itself. Ohio Adm. Code 3901-1-54(C)(14): "'Practice' means a type of activity or conduct engaged in by an insurer with such frequency as to constitute a customary procedure or policy routinely followed in the settlement of insurance claims. A single act is not a business practice. However, an act that is malicious, deliberate, conscious and knowing may be the basis for corrective action ordered only by the superintendent without a showing that the conduct is a practice." The escape hatch is conjunctive, all four words at once, and it opens only for the superintendent.

New Hampshire is the only state in the set that forbids the inference most people assume the law invites. RSA 417:4, XV(a) conditions its list on acts "committed without just cause and not merely inadvertently or accidentally", and the words frequency and general business practice appear nowhere in the section. XV(b) then makes complaint volume admissible but expressly insufficient on its own.

Massachusetts deleted the gate outright. M.G.L. c. 176D § 3(9) reads "An unfair claim settlement practice shall consist of any of the following acts or omissions", and we searched the whole section to confirm: general business practice, frequency, knowingly and willful appear nowhere in it.

Can you sue on it, and on what

The threshold above decides whether the conduct is a violation. This decides whether you can do anything about it yourself, and the two do not track each other: a state can make one bad claim a violation and still give you no way to sue on it.

Read the two kinds of no as two different answers, because they are. Of the 47 jurisdictions read, sixteen give a private claimant an action of some kind, thirteen foreclose one in the instrument's own words, and sixteen simply create none and bar none, which leaves the question open rather than closed. West Virginia answers differently depending on who is claiming. A further one we did not decide, and those rows say what we read and what we did not. Those numbers add to 47, which is every jurisdiction read.

A yes in this table does not always mean you. Who may sue is a separate question from where the remedy lives, and we have read it on only eight of the 47 rows. On Colorado, Maryland, Nevada, Texas and Washington the action belongs to the policyholder making a claim on their own policy, so a person claiming against somebody else's insurer gets nothing from it. On West Virginia the instrument bars a third-party claimant in its own words. Every other row is silent on the question because nobody has read it, and silence here must not be read as open to anyone.

Nothing in this table says you have no remedy. It is an answer about suing on this claims-conduct regime and nothing else. Contract, common-law bad faith where the state recognises it, a consumer protection statute, a prompt-payment provision with its own interest clock: all of those sit outside this regime, most of them were not read for this page, and several of the rows below say so in terms while preserving them.

What this changes about a claim you are in right now

If your state is in the flat, fault, fault OR frequency or split-by-forum column, a single mishandled claim is capable of being a violation, and a complaint that recites the specific conduct and the specific provision is asking the department to find something it can find.

If your state is in the frequency or definition-of-practice column, your one file is evidence rather than a violation. That is the reason to file it. A pattern is built out of filed complaints, and in most of these states nobody is counting the ones nobody files. Find your state's regulator and its complaint page.

In either case, whether you can personally sue is a separate question from whether the insurer broke the rule, and the table above answers it per jurisdiction. Read it with the caveat it carries: a "no" there is about suing on this regime, not about whether you have a remedy.

What we are not saying

We are not saying that an insurer in a frequency state can mishandle your claim without consequence. Other law reaches the same conduct: contract, common-law bad faith where the state recognises it, consumer protection statutes, and in several states a separate prompt-payment provision with its own interest clock. This page is about one clause in one regime.

We are not saying a state in the flat column is a better place to have a claim. A flat threshold with a regulator that brings no actions is worth less than a frequency threshold in front of an active market conduct division, and this page measures neither.

We do not claim that any insurer has violated any of these provisions. Nothing on this page is a finding about any company, and nothing here is legal advice.

We are not claiming completeness. Not every row on this page is finished, and rather than counting the short ones here, where the number would go stale, the section below names each one, says what stopped us, and states the exact question still open. The counts live in the generated tables above, which are built from the register.

What we could not verify, and why

This page is 47 of 51. The other four are set out here rather than left as a number, because "the other four" is four untested assertions wearing one word. Each entry names the citation we believe is operative, what stopped us, and the exact question still open. A wall is a verdict about a host, never about a state: none of these jurisdictions is being characterised, and nothing below is evidence that its law is weak, strong or absent.

Not read (4)

In these four we have not read the operative text on a government host. The citation in the table above is a lead we identified, not a provision we opened, and the rows carry no test because we do not know it.

Alabama, Ala. Admin. Code ch. 482-1-125. No refusal. Two non-wall failures: alisondb.legislature.state.al.us no longer resolves in DNS, and alison.legislature.state.al.us returns a JavaScript shell. Its JSON backend honours only a page parameter at about 97 records per page and the Title 27 window is longer than the reader returns, so s 27-12-24 sits past the readable portion.

Still open: What is the verbatim lead-in of Ala. Code 1975 s 27-12-24, and does it carry the frequency clause? Is there any government host or API parameter that returns a single Code of Alabama section?

Georgia, O.C.G.A. Title 33 Ch. 6 Art. 2. ANSWERED, AND THE ANSWER IS THAT GEORGIA PUBLISHES NO GOVERNMENT-HOSTED CODE TEXT. The open question was whether ANY Georgia government host serves ss 33-6-33, 33-6-34 and 33-6-37. On 2026-08-22 https://www.legis.ga.gov/laws/official-code redirected to the General Assembly's own 404 page, and the only Official Code link anywhere on that page points to http://www.lexisnexis.com/hottopics/gacode, a commercial host. That is not a refusal and not a fetcher problem: it is the state's own site telling you where its Code lives, and it is not on a government server. The Secretary of State's RULES host is a different matter and works fine in a browser.

Still open: UNCHANGED IN SUBSTANCE AND NARROWER IN SCOPE. What is the verbatim lead-in of O.C.G.A. s 33-6-33 or s 33-6-34, and does it carry the NAIC frequency clause? Georgia publishes no government-hosted Code text, so the routes left are a Georgia appellate opinion, an Office of State Administrative Hearings decision, or a market conduct examination report that quotes the lead-in. Rule 120-2-52 does not answer it: the rule is auto claims handling and carries no threshold of its own.

Mississippi, Miss. Code Ann. §§ 83-5-29 to 83-5-51. billstatus.ls.state.ms.us refused twice with ROBOTS_DISALLOWED on an SSL certificate verification failure, on two distinct bill paths, so the refusal is host-wide rather than a bad URL. legislature.ms.gov refused on the legislation path; its root loaded but served no code or bill-text links. Separately COULD NOT READ rather than walled: MID bulletins 2013-4, 2006-1 and 2025-7 all return 200 with no machine-readable text, which is a format failure.

Still open: Does Miss. Code Ann. 83-5-35 contain an unfair claim settlement practices paragraph, and does it carry the NAIC frequency lead-in? Two routes: fix or tolerate the billstatus SSL chain so a bill reprinting 83-5-35 can be read, or run an OCR pass on MID bulletin 2013-4, the on-point auto-repair bulletin. NOTE the D-561 precedent: rendering a scanned MID bulletin and LOOKING at it recovered the whole of s 83-11-501 on the first attempt.

Tennessee, Tenn. Comp. R. and Regs. ch. 0780-01-05. REFINED ON 2026-08-22, AND THE REFINEMENT CHANGES THE VERDICT'S SCOPE. The Tennessee CODE remains Lexis-walled. The Secretary of State RULES host does NOT refuse a person: https://publications.tnsosfiles.com/rules/0780/0780-01/0780-01-05.pdf opened in a browser on 2026-08-22 and served the PDF. It returned HTTP 403 to a scripted request on the same URL in the same session, so the 403 is CLIENT-CONDITIONAL rather than a refusal of the document. We did not escalate past one ordinary request: no rotation, no second client, no header games. The consequence is recorded rather than worked around: the chapter is readable by a person and is not readable by our tooling, so it is not read here.

Still open: THREE, AND ONE HAS MOVED. (1) Does Tenn. Code Ann. s 56-8-105 carry the frequency phrase, and does it gate the whole catalogue or only some paragraphs? The Code is Lexis-only. (2) Chapter 0780-01-05 was noticed in 2016 as a NEW chapter and the certified in-force text has still not been read; the file is reachable in a browser and not by our reader, so the block is ours and not the state's. (3) Is there a Tennessee government host serving the Code text at all, the same question Georgia was just asked and answered no to?

Corrections

This page is new. These are corrections to the register it is built from, made while building it, and they are here because a page that only shows its wins is not evidence of anything.

2026-08-22, Minnesota: a finding of ours withdrawn. The sweep that read Minnesota transcribed its lead-in as "with such frequency to indicate a general business practice", noticed the missing "as", and escalated it as a possible codification quirk worth a law librarian's attention. Re-fetched from the same revisor.mn.gov URL: the word is present. Minnesota reads like everyone else. The error was ours and it had already been promoted from a transcription slip into a publishable observation about a statute, which is exactly the failure this project's re-read pass exists to catch. One transcription error in twenty-eight rows re-checked.

2026-08-22, Wyoming: "no regime" was a truncated read. We had recorded a working hypothesis that Wyoming has no unfair claims settlement practices provision at all. It has one, Wyo. Stat. Ann. § 26-13-124, with a single uniform frequency lead-in governing all seventeen paragraphs. The hypothesis came from a PDF our reader silently truncated. A truncated read is not an absence, and the row now says so.

2026-08-22, New Hampshire: upgraded from our weakest line to a first-party read. This register previously treated New Hampshire as the least supported entry in the set. Read in full, it turned out to be the one jurisdiction that expressly forbids inferring a violation from complaint volume alone, which is the opposite of a weak row.

2026-08-22, the count of formulations. Two earlier pages of ours put the number of distinct thresholds at seven, then twelve. Both were honest counts of the states read at the time and both are superseded by this page, whose family count and formulation count are printed in the table above and generated from the register rather than typed here, so this paragraph cannot go stale the way those two did. The earlier numbers are left in place on those pages where they describe what that page examined, and they now point here.

2026-08-22, five rows promoted the same day this page shipped, and the page moved under itself. The page went live in the morning with five jurisdictions held one tier below verified, including California, on the rule that a read by a subagent is not a read by the adjudicator. All five were then re-read first-party the same day: California and Michigan in a browser on each legislature's own site, Indiana out of the shadow DOM of the 2026 Indiana Code, Texas across both chapters, and Wyoming out of the Legislature's own Title 26 compilation downloaded whole. The tables above rebuilt themselves from the register and the held section disappeared because it had nothing left in it. The Texas result is the one worth naming: chapter 542 subchapter A, which descends from a statute that historically carried the frequency clause, does not carry it now, and neither does chapter 541. The words "frequency" and "general business practice" appear zero times in either. Texas is flat.

2026-08-22, the second axis, published a day after the register was ready and deliberately not sooner. The table above answering "can you sue on it" existed as complete data on this register before it existed as a page. It was held back for one pass because the prose it summarises does not collapse cleanly: Maryland is "no under this subtitle, yes elsewhere", West Virginia differs by who is claiming, New Hampshire is yes but only after the commissioner has found a violation. Collapsing that badly would be the worst error this site could make, because a reader takes it as an answer to whether they can do anything. The six values it landed on keep the two kinds of no apart, and the sentence saying a "no" is not "no remedy" is generated rather than typed, so it cannot be edited out of the page by accident. Two separate gates assert it is still there.

2026-08-22, three of the walls were ours. The page shipped naming seven jurisdictions we said publish no reachable text. Three of the seven were re-tried in a browser the same day and none of them was a state refusing us. Wisconsin's three recorded refusals were our own fetcher failing closed because it could not read robots.txt; the host serves a browser normally. Arizona was serving a JavaScript challenge to a plain client. Alaska's 403 does not fire for a browser at all. All three are now read in full and the register says so on each row: no Wisconsin, Arizona or Alaska government host ever refused us. A wall is a verdict about a host, and three of these were verdicts about our own reader wearing a host's clothes.

2026-08-22, Georgia: we said the department had no claims chapter, and it has an auto one. This row recorded that Georgia's Insurance Department publishes no unfair claims settlement practices chapter. True of the name, false of the substance. Ga. Comp. R. and Regs. Subject 120-2-52, "Fair and Equitable Settlement of First Party Property Damage Claims", is on the Secretary of State's own rules host, is about personal private passenger motor vehicle claims on its face, and was read in full. It caps betterment and depreciation deductions at 20 percent of pre-loss market value with wear and tear capped at $1,000, forbids requiring the insured to supply parts, and carries the pay-the-difference-or-name-a-shop rule that our other pages attributed to Kentucky and Ohio alone until the same day. It carries no frequency clause, so Georgia's threshold is still unanswered and the row stays short. The lesson is one this project has learned before: searching where a rule belongs misses the state that files it somewhere else.

2026-08-22, Tennessee: the refusal is conditional on who is asking. We recorded that the Secretary of State's rules host now 403s the chapter files. More precisely: the same URL serves the PDF to a browser and returns 403 to a scripted request. We did not escalate past one ordinary attempt, so the chapter is readable by a person and is not read here, and the row says exactly that instead of implying Tennessee refuses the public.

2026-08-22, the families are a layer we added. The nine-family grouping is ours, not any state's. It is assigned explicitly per jurisdiction from a fixed vocabulary recorded in the register, never derived by matching words in a note, and the table is generated from those assignments rather than typed. If you disagree with a placement, the verbatim clause it was placed from is in the register and you can put it somewhere else.

Related

• Deny and delay: the states that name it in law, quoted
• When insurance will not pay for a proper repair
• Where to file an insurance complaint in every state
• Almost no state bans steering: most of them put a price on it

Sources

Every row on this page renders from our unfair claims register, data/compliance/ucspa.json. Each row records the provision, the URL on the issuing jurisdiction's own government host, the date it was read, the verbatim threshold clause, and the tier of the evidence behind it. The two tables above and the section naming what we could not verify are generated from that register, not typed, by tools/build-threshold-tables.js, and our pre-deploy gate fails if the page and the register disagree. The citation column therefore cannot drift from the rows.

Three rules govern what appears here. Only a row we read and adjudicated ourselves renders as verified: a read carried out by a subagent is recorded a tier lower, because the reader who found the text is not the reader who adjudicated it. Only a government host counts as a source; commercial mirrors are recorded as leads and never quoted. And a jurisdiction we could not read is named with its wall, because a page that quietly holds forty rows and calls itself a survey of fifty-one is the failure mode this whole register was built to avoid.

The read dates in the Evidence column are the dates those instruments were opened. The bulk of the sweep ran 2026-08-19 through 2026-08-21, with the earliest rows read on 2026-08-13 and the promotion pass that re-read and adjudicated twenty-eight of them completed on 2026-08-22.

This page is not legal advice. Every provision quoted has exceptions, definitions and cross-references that the full instrument states and a table cannot.

General consumer information: not legal, insurance, or financial advice. Requirements, coverage, and practices vary by state, policy, and manufacturer.

Where this fits

Each link says what it is for. We add one only when a reader on this page has a real reason to need that page next.

• Deny and Delay: The States That Name It in Law, Quoted (the prohibited conduct itself, quoted, once you know what your state requires before it counts)
• Claims help by state (the regulator that applies whichever test your state uses)
• Our Evidence Standard: Rule, Record, Assessment (why a row here says ASSESSED rather than verified, and what that costs)
• Montana Bans Paying DRP and Non-DRP Shops Differently. Whether You Can Sue Over It Is a Separate Question. (one state where the act names the conduct but the private cause of action reaches only six of its subsections)
• Why Claims Against Insurers Almost Never Succeed (why a rule on the books so rarely turns into a decided case)