Georgia Bad Faith Insurance Complaint (Civil Action)

COMPLAINT FOR BREACH OF INSURANCE CONTRACT AND STATUTORY BAD FAITH — GEORGIA

TABLE OF CONTENTS

1. Caption
2. Parties, Jurisdiction, and Venue
3. General Allegations
4. Statutory Demand and 60-Day Period
5. Count I — Breach of Insurance Contract
6. Count II — Statutory Bad Faith Penalty under O.C.G.A. § 33-4-6
7. Count III — Attorney's Fees under O.C.G.A. § 33-4-6
8. Damages
9. Prayer for Relief
10. Demand for Trial by Jury
11. Notice to Commissioner of Insurance
12. Signature Block
13. Verification
14. Certificate of Service
15. Georgia Practice Notes
16. Sources and References

1. CAPTION

STATE OF GEORGIA

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

CIVIL ACTION FILE NO. [________________________________]

COMPLAINT FOR BREACH OF INSURANCE CONTRACT AND STATUTORY BAD FAITH (O.C.G.A. § 33-4-6)

COMES NOW Plaintiff [PLAINTIFF NAME], by and through undersigned counsel, and files this Complaint against Defendant [INSURER NAME], showing the Court as follows:

2. PARTIES, JURISDICTION, AND VENUE

1. Plaintiff [PLAINTIFF NAME] is a resident of [COUNTY] County, Georgia, and was the named insured (or beneficiary) under the policy of insurance described herein at all relevant times.

2. Defendant [INSURER NAME] is a [STATE] corporation authorized to issue and engaged in the business of insurance in the State of Georgia. Defendant may be served with process through its registered agent for service in Georgia: [REGISTERED AGENT NAME AND ADDRESS].

3. This Court has subject-matter jurisdiction over this action because the amount in controversy exceeds the jurisdictional minimum and the action arises under the laws of the State of Georgia, including O.C.G.A. § 33-4-6.

4. Venue is proper in this Court pursuant to O.C.G.A. § 14-2-510 and Ga. Const. Art. VI, § II, Para. VI, because Defendant is a foreign corporation transacting business in [COUNTY] County and the cause of action originated in this County.

5. All conditions precedent to the filing of this action have been satisfied, performed, or waived, including the statutory pre-suit demand required by O.C.G.A. § 33-4-6.

3. GENERAL ALLEGATIONS

A. The Insurance Policy

6. On or about [__/__/____], Defendant issued Policy No. [POLICY NUMBER] (the "Policy") to Plaintiff, providing [TYPE OF COVERAGE — e.g., homeowners, automobile, commercial property, life, disability, UM/UIM] coverage with limits of $[POLICY LIMITS].

7. The Policy was in full force and effect at all times relevant to this action, and all premiums had been timely paid.

8. The Policy is a simple written contract governed by Georgia law and subject to the six-year statute of limitations of O.C.G.A. § 9-3-24.

B. The Covered Loss

9. On or about [__/__/____], Plaintiff suffered a loss covered by the Policy when [DESCRIBE LOSS EVENT IN DETAIL — date, location, cause, nature, and extent of damage].

10. The loss is a covered peril under the insuring agreement of the Policy and is not subject to any applicable exclusion or limitation.

11. The amount of the covered loss is not less than $[LOSS AMOUNT], exclusive of statutory penalties, attorney's fees, interest, and costs.

C. Compliance with Policy Conditions

12. Plaintiff timely notified Defendant of the loss on or about [__/__/____] and has fully cooperated with Defendant's investigation, including:

• Submitting a sworn Proof of Loss on [__/__/____];
• Providing photographs, repair estimates, receipts, and other documentation;
• Permitting inspection of the [property / vehicle / records];
• Submitting to an Examination Under Oath on [__/__/____] (if applicable);
• Producing all reasonably requested documents and records.

13. Plaintiff has performed every condition precedent to recovery under the Policy.

D. Defendant's Refusal to Pay

14. Despite Plaintiff's complete performance and the absence of any reasonable basis for refusal, Defendant has [denied the claim outright / underpaid the claim / unreasonably delayed payment] by [describe specific conduct, dates, and stated grounds].

15. Defendant's stated reason(s) for denial [summarize grounds asserted in denial letter dated __/__/____] are pretextual, contrary to the Policy language, contrary to Georgia law, and unsupported by any reasonable investigation.

16. The conduct described above was not undertaken in good faith and lacks any reasonable or probable cause within the meaning of O.C.G.A. § 33-4-6 and Cotton States Mut. Ins. Co. v. Brightman, 276 Ga. 683 (2003).

4. STATUTORY DEMAND AND 60-DAY PERIOD

17. On [__/__/____], Plaintiff (through counsel) sent Defendant a written demand for payment of the loss pursuant to O.C.G.A. § 33-4-6 (the "Statutory Demand"), via certified mail, return receipt requested. A true and correct copy of the Statutory Demand is attached as Exhibit A.

18. Defendant received the Statutory Demand on or about [__/__/____], as evidenced by the return receipt attached as Exhibit B.

19. More than sixty (60) days have elapsed between Defendant's receipt of the Statutory Demand and the filing of this Complaint, satisfying the prerequisite to recovery under O.C.G.A. § 33-4-6 and Cagle v. State Farm Fire & Cas. Co., 236 Ga. App. 726 (1999).

20. Defendant has refused, and continues to refuse, to pay the loss notwithstanding the Statutory Demand and the expiration of the 60-day cure period.

5. COUNT I — BREACH OF INSURANCE CONTRACT

21. Plaintiff realleges and incorporates Paragraphs 1 through 20 as if fully set forth herein.

22. The Policy is a valid, enforceable contract between Plaintiff and Defendant.

23. Plaintiff performed all obligations and conditions required of Plaintiff under the Policy.

24. Defendant materially breached the Policy by failing and refusing to pay the covered loss in the amount of not less than $[LOSS AMOUNT].

25. As a direct and proximate result of Defendant's breach, Plaintiff has suffered damages in the amount of the unpaid policy benefits, plus consequential damages, pre-judgment interest under O.C.G.A. § 7-4-2, and costs of suit.

6. COUNT II — STATUTORY BAD FAITH PENALTY UNDER O.C.G.A. § 33-4-6

26. Plaintiff realleges and incorporates Paragraphs 1 through 25 as if fully set forth herein.

27. Defendant's refusal to pay the loss is "frivolous and unfounded" within the meaning of O.C.G.A. § 33-4-6 and United States Fid. & Guar. Co. v. Biddy Lumber Co., 114 Ga. App. 358 (1966).

28. Defendant's bad-faith conduct includes, without limitation:

• Denying coverage without conducting any reasonable or adequate investigation;
• Relying on policy exclusions or defenses that are facially inapplicable;
• Misrepresenting policy provisions and Georgia law;
• Demanding documentation already provided in order to manufacture delay;
• Offering to pay substantially less than the amount clearly owed;
• Failing to communicate or respond to Plaintiff's reasonable inquiries;
• Engaging in conduct that, while not directly actionable under O.C.G.A. § 33-6-34, evidences a frivolous and unfounded refusal under § 33-4-6 (e.g., failure to acknowledge the claim promptly, failure to adopt reasonable claim-handling standards, failure to attempt good-faith settlement when liability is reasonably clear);
• [OTHER SPECIFIC ACTS].

29. Defendant had no reasonable or probable cause to deny or delay payment.

30. Pursuant to O.C.G.A. § 33-4-6(a), Plaintiff is entitled to recover, in addition to the loss, a statutory penalty in the amount of the greater of (a) fifty percent (50%) of Defendant's liability for the loss, or (b) Five Thousand Dollars ($5,000.00).

7. COUNT III — ATTORNEY'S FEES UNDER O.C.G.A. § 33-4-6

31. Plaintiff realleges and incorporates Paragraphs 1 through 30 as if fully set forth herein.

32. Pursuant to O.C.G.A. § 33-4-6(a), Plaintiff is entitled to recover all reasonable attorney's fees incurred in the prosecution of this action against Defendant.

33. The reasonable value of those services will be established at trial through competent expert testimony, based on time spent, factual and legal complexity, and prevailing rates in this locality, as required by the statute.

34. Because Plaintiff's recovery of attorney's fees is provided exclusively by O.C.G.A. § 33-4-6, Plaintiff does not assert an additional claim under O.C.G.A. § 13-6-11 for the same conduct. See United States Auto. Ass'n v. Carroll, 226 Ga. App. 144 (1997) (§ 33-4-6 is the exclusive remedy for bad faith in first-party insurance disputes).

8. DAMAGES

35. Plaintiff has been damaged by Defendant's breach and bad-faith conduct in amounts to be proven at trial, including:

• Contract damages (unpaid policy benefits): $[AMOUNT];
• Consequential damages flowing from the breach (where recoverable): $[AMOUNT];
• Statutory bad-faith penalty under O.C.G.A. § 33-4-6 (greater of 50% of liability or $5,000): $[AMOUNT];
• Reasonable attorney's fees under O.C.G.A. § 33-4-6: in an amount to be proven at trial;
• Pre-judgment interest under O.C.G.A. § 7-4-2 and § 7-4-15;
• Post-judgment interest under O.C.G.A. § 7-4-12;
• Costs of suit.

9. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully prays that this Court:

• A. Enter judgment in favor of Plaintiff and against Defendant on Counts I, II, and III;
• B. Award Plaintiff the unpaid policy benefits in an amount not less than $[AMOUNT];
• C. Award Plaintiff the statutory bad-faith penalty under O.C.G.A. § 33-4-6, equal to the greater of fifty percent (50%) of Defendant's liability or $5,000.00;
• D. Award Plaintiff all reasonable attorney's fees incurred in the prosecution of this action under O.C.G.A. § 33-4-6;
• E. Award Plaintiff pre-judgment and post-judgment interest as allowed by Georgia law;
• F. Award Plaintiff the costs of this action; and
• G. Grant such other and further relief as the Court deems just and proper.

10. DEMAND FOR TRIAL BY JURY

Plaintiff hereby demands a trial by jury on all issues so triable as a matter of right pursuant to O.C.G.A. § 9-11-38 and Ga. Const. Art. I, § I, Para. XI.

11. NOTICE TO COMMISSIONER OF INSURANCE

Pursuant to O.C.G.A. § 33-4-6(b), Plaintiff will serve a copy of this Complaint upon the Georgia Commissioner of Insurance and the Consumers' Insurance Advocate within twenty (20) days of filing, addressed as follows:

12. SIGNATURE BLOCK

Respectfully submitted, this [____] day of [_______________], 20[____].

[LAW FIRM NAME]

By: [________________________________]

[ATTORNEY NAME]

Georgia Bar No. [________]

Counsel for Plaintiff

[STREET ADDRESS]

[CITY, GA ZIP]

Telephone: [NUMBER]

Email: [EMAIL]

13. VERIFICATION

STATE OF GEORGIA

COUNTY OF [________________________________]

I, [PLAINTIFF NAME], having been first duly sworn, depose and state that I am the Plaintiff in the foregoing Complaint, that I have read the same, and that the facts stated therein are true and correct to the best of my knowledge, information, and belief.

[________________________________]

[PLAINTIFF NAME]

Sworn to and subscribed before me this [____] day of [_______________], 20[____].

[________________________________]

Notary Public, State of Georgia

(My Commission Expires: [_______________])

14. CERTIFICATE OF SERVICE

I hereby certify that I have this day served a true and correct copy of the foregoing COMPLAINT upon Defendant by service of process through its registered agent and, within twenty (20) days of filing, upon the Georgia Commissioner of Insurance and the Consumers' Insurance Advocate, in compliance with O.C.G.A. § 33-4-6(b), via United States Mail, postage prepaid, addressed as set forth above.

This [____] day of [_______________], 20[____].

[________________________________]

[ATTORNEY NAME], Georgia Bar No. [________]

15. GEORGIA PRACTICE NOTES

• Statutory remedy is exclusive. Georgia does NOT recognize a common-law tort of bad faith for first-party insurance claims. O.C.G.A. § 33-4-6 is the exclusive remedy. United States Auto. Ass'n v. Carroll, 226 Ga. App. 144 (1997). Do not plead negligent or intentional infliction, fraud (absent independent fraud elements), RICO, or punitive damages under § 51-12-5.1 based solely on bad-faith claim handling. Likewise, do not duplicate fees under O.C.G.A. § 13-6-11 for the same conduct.
• 60-day demand is jurisdictional. A written demand for payment must be made and received MORE THAN 60 days before suit is filed. Filing on day 60 — or before the demand is received — bars the penalty and fees. Always document delivery (certified mail green card, FedEx confirmation, or hand-delivery affidavit). Cagle v. State Farm Fire & Cas. Co., 236 Ga. App. 726 (1999).
• Penalty cap. O.C.G.A. § 33-4-6 caps the penalty at the GREATER of 50% of the insurer's liability for the loss, or $5,000 — plus all reasonable attorney's fees. The penalty is NOT capped at the lesser of those amounts.
• § 33-6-34 has no private right of action. O.C.G.A. § 33-6-37 expressly prohibits a private cause of action under the Unfair Claims Settlement Practices Act. § 33-6-34 conduct may be admitted as evidence of bad faith under § 33-4-6, but cannot stand alone as a claim. The Commissioner of Insurance enforces § 33-6-34 administratively.
• UM/UIM claims. For uninsured/underinsured motorist disputes, plead under O.C.G.A. § 33-7-11, which authorizes a 25% penalty (with a $25,000 floor in some interpretations) plus attorney's fees. § 33-4-6 and § 33-7-11 generally do not stack on the same claim.
• Motor-vehicle liability claims. O.C.G.A. § 33-4-7 imposes affirmative bad-faith duties on liability insurers in certain third-party motor-vehicle claims with separate demand and penalty procedures.
• First-party property regulations. Ga. Comp. R. & Regs. r. 120-2-52 establishes claim-handling timeframes (acknowledgement within 15 days; coverage decision and payment within reasonable timeframes). Violations support, but do not independently create, a § 33-4-6 claim.
• Attorney's-fees proof. Fees must be established by competent expert testimony as to reasonable value, based on time spent, complexity, and prevailing local rates. Maintain contemporaneous time records from inception.
• Statute of limitations. Six years from breach for written insurance contracts under O.C.G.A. § 9-3-24.
• Commissioner notice. Serve the Commissioner of Insurance and Consumers' Insurance Advocate within 20 days of filing per § 33-4-6(b).
• "Frivolous and unfounded" standard. Brightman, Biddy Lumber, and Haezebrouck require that the insurer have no reasonable ground to contest the claim. Any reasonable defense — even one ultimately rejected — defeats the bad-faith penalty.
• Post-suit payment does not abate. Under § 33-4-6, a bad-faith action is not abated by payment after the 60-day period.

16. SOURCES AND REFERENCES

• O.C.G.A. § 33-4-6 — Liability of insurer for damages and attorney's fees — https://law.justia.com/codes/georgia/title-33/chapter-4/section-33-4-6/
• O.C.G.A. § 33-4-7 — Affirmative duty in motor vehicle liability claims — https://law.justia.com/codes/georgia/title-33/chapter-4/section-33-4-7/
• O.C.G.A. § 33-6-34 — Unfair claims settlement practices — https://law.justia.com/codes/georgia/title-33/chapter-6/article-2/section-33-6-34/
• O.C.G.A. § 33-6-37 — No private right of action under Article 2
• O.C.G.A. § 33-7-11 — Uninsured/underinsured motorist coverage — https://law.justia.com/codes/georgia/title-33/chapter-7/section-33-7-11/
• Ga. Comp. R. & Regs. r. 120-2-52 — Fair and Equitable Settlement of First-Party Property Damage Claims — https://rules.sos.ga.gov/gac/120-2-52
• Cagle v. State Farm Fire & Cas. Co., 236 Ga. App. 726 (1999) — 60-day demand prerequisite
• United States Fid. & Guar. Co. v. Biddy Lumber Co., 114 Ga. App. 358 (1966) — "frivolous and unfounded" standard
• Cotton States Mut. Ins. Co. v. Brightman, 276 Ga. 683 (2003) — reasonable and probable cause standard
• Haezebrouck v. State Farm Mut. Auto. Ins. Co., 290 Ga. App. 420 (2008) — reasonable ground defeats bad-faith penalty
• United States Auto. Ass'n v. Carroll, 226 Ga. App. 144 (1997) — § 33-4-6 is exclusive remedy
• Drew Eckl & Farnham, "Georgia Courts Continue to Uphold 'Exclusive Remedy' Rule Under O.C.G.A. § 33-4-6" — https://www.deflaw.com/insights/georgia-courts-continue-to-uphold-exclusive-remedy-rule-under-ocga-33-4-6/
• Georgia Office of Commissioner of Insurance and Safety Fire — https://oci.georgia.gov/

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. A Georgia-licensed attorney must review and customize this document before filing. Laws, citations, and court rules change frequently; verify all authorities before use.