IN THE [SUPERIOR/STATE] COURT OF [______] COUNTY

STATE OF GEORGIA

[PLAINTIFF FULL LEGAL NAME],

Plaintiff,

v.

[DEFENDANT INSURANCE COMPANY LEGAL NAME],

Defendant.

COMPLAINT FOR BREACH OF CONTRACT, STATUTORY BAD-FAITH, PUNITIVE DAMAGES, ATTORNEY’S FEES, AND INJUNCTIVE RELIEF

[// GUIDANCE: Replace bracketed items with matter-specific information. Paragraph numbering auto-updates in most word processors when using a multi-level list.]

TABLE OF CONTENTS

1. Preliminary Statement
2. Parties
3. Jurisdiction and Venue
4. Factual Allegations
5. Causes of Action
   - Count I – Breach of Contract
   - Count II – Statutory Bad Faith (O.C.G.A. § 33-4-6)
   - Count III – Punitive Damages (O.C.G.A. § 51-12-5.1)
   - Count IV – Attorney’s Fees (O.C.G.A. § 13-6-11)
   - Count V – Injunctive Relief
6. Prayer for Relief
7. Demand for Jury Trial
8. Verification
9. Certificate of Service

1. PRELIMINARY STATEMENT

1. This is an action arising from Defendant’s wrongful refusal to timely and fully indemnify Plaintiff under Policy No. [__] for a covered loss occurring on [DATE OF LOSS].
2. Defendant’s conduct constitutes breach of contract and statutory bad faith under O.C.G.A. § 33-4-6, entitling Plaintiff to the policy benefit, 50% penalty, interest, reasonable attorney’s fees, and punitive damages.
3. Plaintiff also seeks injunctive relief compelling immediate payment of the undisputed claim amount to prevent continuing irreparable harm.

2. PARTIES

1. Plaintiff [PLAINTIFF LEGAL NAME] is a citizen of Georgia residing at [ADDRESS] and is the named insured under the Policy.
2. Defendant [DEFENDANT LEGAL NAME] (“Insurer”) is a [STATE OF INC.] insurance company authorized to transact insurance business in Georgia, with its principal office at [ADDRESS] and a registered agent for service of process at [ADDRESS].

3. JURISDICTION AND VENUE

1. This Court has subject-matter jurisdiction pursuant to O.C.G.A. § 15-7-4 / § 15-6-8 (depending on court selected) because the amount in controversy exceeds its jurisdictional minimum and involves claims arising under Georgia law.
2. Venue is proper in this County under O.C.G.A. § 33-4-1 and § 14-2-510(b)(4) because Defendant maintains an agent or place of business here and the cause of action accrued here.

4. FACTUAL ALLEGATIONS

1. On or about [DATE], Plaintiff purchased Homeowners/Commercial/Auto Policy No. [__] (“Policy”) from Defendant in consideration of premium paid.
2. The Policy provided coverage for [TYPE OF LOSS] with limits of $[__].
3. On [DATE OF LOSS], Plaintiff sustained a covered loss when [DESCRIPTION OF INCIDENT].
4. Plaintiff timely notified Defendant and complied with all Policy conditions precedent, including but not limited to prompt notice, documentation, and cooperation with Defendant’s investigation.
5. On [DATE], Plaintiff submitted a sworn proof of loss in the amount of $[__].
6. Despite clear liability and coverage, Defendant:
   a. Failed to acknowledge coverage within 15 days of receiving notice, contrary to Ga. Comp. R. & Regs. r. 120-2-52-03;
   b. Failed to tender any payment within 60 days of written demand dated [DATE], triggering O.C.G.A. § 33-4-6; and
   c. Asserted unfounded coverage defenses without reasonable cause.
7. Defendant’s refusal to pay is in bad faith and without substantial justification.
8. Plaintiff has suffered monetary damages, consequential damages, and continues to incur attorney’s fees and costs.

5. CAUSES OF ACTION

COUNT I – Breach of Contract

1. Plaintiff incorporates by reference ¶¶ 1-[__] above.
2. The Policy is a valid, enforceable contract.
3. Defendant materially breached the Policy by refusing to pay covered benefits.
4. As a direct and proximate result, Plaintiff has been damaged in an amount not less than $[POLICY BENEFIT] plus interest.

COUNT II – Statutory Bad Faith (O.C.G.A. § 33-4-6)

1. Plaintiff incorporates by reference ¶¶ 1-[__] above.
2. Plaintiff made written demand for payment on [DATE], more than 60 days prior to filing suit.
3. Defendant’s failure to pay was in bad faith, entitling Plaintiff to:
   a. The greater of (i) 50% of the liability for the loss or (ii) $5,000; and
   b. All reasonable attorney’s fees.

COUNT III – Punitive Damages (O.C.G.A. § 51-12-5.1)

1. Plaintiff incorporates by reference ¶¶ 1-[__] above.
2. Defendant’s conduct demonstrates willful misconduct, malice, wantonness, and an entire want of care raising the presumption of conscious indifference to consequences.
3. Plaintiff seeks punitive damages in an amount to be determined by the enlightened conscience of a fair and impartial jury.

COUNT IV – Attorney’s Fees (O.C.G.A. § 13-6-11)

1. Plaintiff incorporates by reference ¶¶ 1-[__] above.
2. Defendant has acted in bad faith, has been stubbornly litigious, and has caused Plaintiff unnecessary trouble and expense, entitling Plaintiff to recover the expenses of litigation, including reasonable attorney’s fees.

COUNT V – Injunctive Relief (Order to Pay Claim)

1. Plaintiff incorporates by reference ¶¶ 1-[__] above.
2. Defendant’s ongoing refusal to pay threatens immediate and irreparable harm not fully compensable by money damages, including [e.g., foreclosure risk, loss of business goodwill].
3. Plaintiff requests a mandatory injunction compelling Defendant to pay the undisputed portion of the claim forthwith.

6. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests:
a. Judgment against Defendant for the full policy benefit of $[__];
b. Statutory bad-faith penalty pursuant to O.C.G.A. § 33-4-6;
c. Pre- and post-judgment interest as allowed by law;
d. Reasonable attorney’s fees under O.C.G.A. §§ 33-4-6 & 13-6-11;
e. Punitive damages under O.C.G.A. § 51-12-5.1;
f. Mandatory injunctive relief requiring immediate payment;
g. All costs of this action; and
h. Such other and further relief as the Court deems just and proper.

7. DEMAND FOR JURY TRIAL

Pursuant to Article I, Section I, Paragraph XI of the Georgia Constitution and O.C.G.A. § 9-11-38, Plaintiff demands a trial by jury on all issues so triable.

8. VERIFICATION

STATE OF GEORGIA )
COUNTY OF [__] )

BEFORE ME, the undersigned authority, personally appeared [PLAINTIFF NAME], who, being duly sworn, deposes and states that the facts contained in the foregoing Complaint are true and correct to the best of [his/her/its] knowledge, information, and belief.

[PLAINTIFF NAME]
(Date)

Sworn to and subscribed before me this ___ day of ____, 20__.

Notary Public
My Commission Expires: _____

[// GUIDANCE: Verification is required in some insurance matters; confirm necessity under local practice.]

9. CERTIFICATE OF SERVICE

I certify that I have this day served a true and correct copy of the foregoing Complaint upon all counsel of record by [STATUTORILY-APPROVED METHOD, e.g., e-service, hand delivery, or U.S. Mail] addressed as follows:

[DEFENSE COUNSEL NAME & ADDRESS]

This ___ day of ____, 20__.

[PLAINTIFF’S COUNSEL NAME]
Georgia Bar No. [__]
[LAW FIRM NAME]
[ADDRESS]
[PHONE] | [EMAIL]

[// GUIDANCE:
1. Review local court rules for font, margin, and pleading paper requirements.
2. File a Georgia Civil Case Initiation Form contemporaneously with the Complaint.
3. If the policy contains an appraisal or arbitration clause, consider alleging satisfaction or waiver, or alternatively plead a demand for arbitration in the alternative.
4. Re-verify statutory citations before filing to account for any legislative amendments.
]