FIRST-PARTY PROPERTY DAMAGE DEMAND LETTER

State of California

[LAW FIRM LETTERHEAD]

PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION - FOR RESOLUTION PURPOSES ONLY
PROTECTED UNDER CA RULES OF EVIDENCE AND F.R.E. 408

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND VIA EMAIL TO: [ADJUSTER_EMAIL]

Date: [DATE]

[INSURANCE_COMPANY_NAME]
[PROPERTY_CLAIMS_DEPARTMENT_ADDRESS]
[CITY], [STATE] [ZIP]

Attention: [ADJUSTER_NAME], [ADJUSTER_TITLE]
Re: FORMAL DEMAND FOR PROPERTY DAMAGE CLAIM - CALIFORNIA LAW
Insured: [INSURED_NAME]
Property Address: [PROPERTY_ADDRESS]
Policy Number: [POLICY_NUMBER]
Claim Number: [CLAIM_NUMBER]
Date of Loss: [DATE_OF_LOSS]
Type of Loss: [LOSS_TYPE]
Coverage Limits: [COVERAGE_LIMITS]
Response Deadline: [RESPONSE_DEADLINE]

Dear [ADJUSTER_NAME]:

I. INTRODUCTION AND NATURE OF DEMAND

This firm represents [CLIENT_NAME] ("our client") in connection with the above-referenced property damage insurance claim arising under California law. This letter constitutes a formal demand for payment of all policy benefits owed for covered losses sustained at [PROPERTY_ADDRESS].

Having represented policyholders in California for decades, the pattern in this case is all too familiar: a legitimate claim, a covered loss, and an insurer that has [DELAYED PAYMENT/UNDERVALUED THE LOSS/DENIED COVERAGE WITHOUT JUSTIFICATION].

II. CALIFORNIA PROPERTY INSURANCE LAW

A. Prompt Payment Requirements

Under California law:

Cal. Ins. Code 790.03(h) - Claims must be accepted or denied within 40 days; Cal. Code Regs. 2695.7

B. Appraisal Provisions

Cal. Ins. Code 2071 (standard fire policy includes appraisal); governed by policy for other types

C. Bad Faith Standard

California recognizes both tort and contract theories for bad faith. The implied covenant of good faith and fair dealing requires insurers to not unreasonably withhold policy benefits. Insurer acts in bad faith when it unreasonably withholds benefits. Gruenberg v. Aetna Ins. Co., 9 Cal.3d 566 (1973). Even genuine dispute does not shield insurer if position is unreasonable.

D. Available Remedies

Policy benefits, consequential damages, emotional distress, Brandt fees (attorney fees to obtain benefits), and punitive damages

III. POLICY INFORMATION AND COVERAGE

A. Policy Details

B. Applicable Coverage and Limits

C. Coverage Analysis

The loss is clearly covered under California law interpretation principles because:

1. The cause of loss is a covered peril
2. The damage occurred during the policy period
3. The property is covered property
4. No exclusions apply
5. All policy conditions have been satisfied

IV. THE LOSS EVENT

A. Description of Loss

On [DATE_OF_LOSS], the insured property at [PROPERTY_ADDRESS] sustained significant damage due to [DESCRIBE_LOSS_EVENT].

[DETAILED_NARRATIVE]

B. Cause and Origin

The cause of the loss was:

• Fire (accidental/electrical/HVAC/other)
• Water damage (plumbing/appliance/roof/storm)
• Wind/Windstorm
• Hail
• Hurricane/Named Storm
• Tornado
• Lightning
• Theft/Vandalism
• [OTHER_CAUSE]

C. Mitigation Efforts

Our client took immediate steps to mitigate damage as required under California law:

V. CLAIM HISTORY AND INSURER'S RESPONSE

A. Claim Timeline

B. Insurer's Position and Our Response

[CARRIER_SHORT_NAME] has [DESCRIBE_INSURER_POSITION].

This position is unreasonable under California law because [EXPLAIN_WHY_WRONG].

VI. DAMAGES AND CLAIMED AMOUNTS

A. Dwelling Damage (Coverage A)

B. Other Structures (Coverage B)

$[TOTAL_OTHER_STRUCTURES]

C. Personal Property (Coverage C)

D. Loss of Use (Coverage D)

E. Claim Summary

VII. OVERHEAD AND PROFIT

Our client is entitled to general contractor overhead and profit because:

• The repairs require coordination of multiple trades
• The scope and complexity exceeds simple repairs
• A general contractor is reasonably necessary
• Industry standard is [___]% overhead and [___]% profit

[CARRIER_SHORT_NAME]'s refusal to include O&P is contrary to California law and industry standards.

VIII. APPRAISAL DEMAND (IF APPLICABLE)

A. Invoking Appraisal

Due to [CARRIER_SHORT_NAME]'s failure to fairly evaluate this claim, we hereby invoke the appraisal process under the policy and California law.

We appoint [APPRAISER_NAME] as our client's appraiser.

Please provide [CARRIER_SHORT_NAME]'s appraiser within [NUMBER] days.

B. Scope of Appraisal

The following items are submitted to appraisal:

• Amount of loss to dwelling (Coverage A)
• Amount of loss to other structures (Coverage B)
• Amount of loss to personal property (Coverage C)
• [SPECIFIC_DISPUTED_ITEMS]

Note: Coverage questions are reserved for litigation.

IX. STATUTORY VIOLATIONS AND BAD FAITH

A. California Prompt Payment Violations

[CARRIER_SHORT_NAME] has violated Cal. Ins. Code 790.03(h) - Claims must be accepted or denied within 40 days; Cal. Code Regs. 2695.7 by:

• [VIOLATION_1]
• [VIOLATION_2]
• [VIOLATION_3]

B. Unfair Claims Settlement Practices

[CARRIER_SHORT_NAME] has violated Cal. Ins. Code 790.03 et seq. (no private right of action, but establishes standard of care) by:

• Misrepresenting pertinent facts or policy provisions
• Failing to acknowledge and act promptly on communications
• Failing to adopt reasonable investigation standards
• Not attempting good faith settlement when liability is clear
• Compelling litigation by offering substantially less than owed
• Failing to provide reasonable explanation for denial/delay

C. Bad Faith

Under California law:

California recognizes both tort and contract theories for bad faith. The implied covenant of good faith and fair dealing requires insurers to not unreasonably withhold policy benefits. Insurer acts in bad faith when it unreasonably withholds benefits. Gruenberg v. Aetna Ins. Co., 9 Cal.3d 566 (1973). Even genuine dispute does not shield insurer if position is unreasonable.

Available remedies include: Policy benefits, consequential damages, emotional distress, Brandt fees (attorney fees to obtain benefits), and punitive damages

X. DEMAND

A. Monetary Demand

We demand payment of $[TOTAL_DEMAND]:

XI. RESPONSE DEADLINE AND CONSEQUENCES

This demand must be accepted by 5:00 p.m. [TIME_ZONE] on [RESPONSE_DEADLINE].

Consequences of Non-Response

If [CARRIER_SHORT_NAME] fails to accept this demand:

1. Litigation will be filed in California seeking:
   - All policy benefits
   - Statutory penalties and interest
   - Bad faith damages
   - Punitive damages (where available)
   - Attorney's fees and costs

2. Regulatory complaints will be filed with:
   - California Department of Insurance, 300 Capitol Mall, Suite 1700, Sacramento, CA 95814
   - National Association of Insurance Commissioners

3. Appraisal will be invoked (if not already)

XII. DOCUMENT PRESERVATION NOTICE

This letter serves as notice to preserve all documents and ESI related to this claim.

XIII. CONCLUSION

[CARRIER_SHORT_NAME] sold our client a policy promising protection against property losses. That loss has occurred. The coverage is clear. The only thing missing is payment.

Respectfully submitted,

[LAW_FIRM_NAME]

By: _______________________________
[ATTORNEY_NAME]
[BAR_NUMBER]
[ADDRESS]
[CITY], CA [ZIP]
[PHONE]
[EMAIL]

Counsel for [CLIENT_NAME]

ENCLOSURES:
- Policy declarations page
- Relevant policy provisions
- Contractor estimates
- Photographs of damage
- Personal property inventory
- Supporting documentation

CC:
- [CLIENT_NAME]
- [MORTGAGEE_NAME] (if applicable)
- California Department of Insurance, 300 Capitol Mall, Suite 1700, Sacramento, CA 95814

CALIFORNIA PROPERTY INSURANCE LAW QUICK REFERENCE