First-Party Property Damage Demand Letter - Georgia

FIRST-PARTY PROPERTY DAMAGE DEMAND LETTER

State of Georgia

[LAW FIRM LETTERHEAD]

PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION — FOR RESOLUTION PURPOSES ONLY
INADMISSIBLE UNDER O.C.G.A. § 24-4-408 AND FED. R. EVID. 408

VIA STATUTORY OVERNIGHT DELIVERY AND CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND VIA EMAIL TO: [________________________________]

Date: [__/__/____]

[INSURANCE_COMPANY_NAME]
[________________________________]
[________________________________]
[CITY], [STATE] [ZIP]

Attention: [________________________________], Property Claims Adjuster
Re: FIRST-PARTY PROPERTY DAMAGE DEMAND — O.C.G.A. § 33-4-6 60-DAY DEMAND
Insured: [________________________________]
Property Address: [________________________________], [________________________________] County, Georgia [____]
Policy Number: [________________________________]
Claim Number: [________________________________]
Date of Loss: [__/__/____]
Cause of Loss: [________________________________]
Coverage Limits: $[________________________________]
Response Deadline: [__/__/____] (60 days from receipt)

Dear [________________________________]:

I. INTRODUCTION — THIS IS THE STATUTORY 60-DAY DEMAND UNDER O.C.G.A. § 33-4-6

This firm represents [________________________________] ("our client" or "the Insured") in connection with the above-referenced first-party property-insurance claim arising under Georgia law.

This letter constitutes the formal statutory demand for payment required by O.C.G.A. § 33-4-6 as a condition precedent to a bad-faith action. The sixty (60)-day clock begins upon receipt of this letter. If [INSURANCE_COMPANY_NAME] (the "Carrier") refuses to tender the full amount owed within sixty (60) days, and such refusal is found to be in bad faith, the Carrier will be liable for:

1. The full loss (policy benefits wrongfully withheld);
2. A statutory penalty of not more than fifty percent (50%) of the liability for the loss, or $5,000, whichever is greater;
3. All reasonable attorney's fees incurred in the prosecution of the action.

See O.C.G.A. § 33-4-6(a). Within twenty (20) days of filing suit, our office will mail a copy of this demand and the complaint to the Commissioner of Insurance as required by O.C.G.A. § 33-4-6(b) and to the Consumers' Insurance Advocate under O.C.G.A. § 33-4-6(c).

II. GOVERNING GEORGIA LAW

A. The Standard Fire Policy — O.C.G.A. § 33-24-44

Georgia has adopted the Standard Fire Policy codified at O.C.G.A. § 33-24-44. Any policy issued in Georgia must contain provisions not less favorable than the statutory standard form. The policy issued to our client is presumed to contain such protections, including the twelve (12)-month contractual limitations period, requirements for proof of loss, and appraisal provisions. Policy language is construed under Georgia rules favoring the insured where ambiguous: BayRock Mortgage Corp. v. Chicago Title Ins. Co., 286 Ga. App. 18, 20 (2007); Richards v. Hanover Ins. Co., 250 Ga. 613 (1983).

B. Bad Faith — O.C.G.A. § 33-4-6

The Georgia bad-faith statute provides a private cause of action against a first-party property insurer that "refuses to pay" a covered loss in bad faith after a 60-day statutory demand. The standard articulated in McCall v. Allstate Ins. Co., 251 Ga. 869, 871 (1984), is whether the refusal is "frivolous and unfounded." Statutory penalties are unavailable only where the Carrier has "any reasonable ground to contest the claim" on a disputed material fact. BayRock Mortgage, supra.

C. Unfair Claims Settlement Practices — O.C.G.A. §§ 33-6-30 to 33-6-37

While Georgia's Unfair Claims Settlement Practices Act (O.C.G.A. §§ 33-6-30 through 33-6-37) does not create a private cause of action (Moradi v. Cincinnati Ins. Co., 170 Ga. App. 628 (1984)), violations of the enumerated practices in O.C.G.A. § 33-6-34 constitute evidentiary support for a bad-faith claim under § 33-4-6 and may be reported to the Commissioner of Insurance for administrative sanctions.

D. Statute of Limitations

• Written Contract (Policy Suit): Six (6) years — O.C.G.A. § 9-3-24
• Standard Fire Policy Contractual Limitation: Twelve (12) months — O.C.G.A. § 33-24-44 (subject to tolling principles)
• Tort-Based Property Damage Claims: Four (4) years — O.C.G.A. § 9-3-30

E. Appraisal

Georgia does not have a mandatory appraisal statute; appraisal is governed exclusively by the policy contract. Under Turner v. Atlanta Girls' School, Inc., 288 Ga. App. 115 (2007), a properly invoked appraisal clause is binding as to the amount of loss but not as to coverage issues, which remain for judicial determination.

III. POLICY INFORMATION AND COVERAGE

A. Policy Details

B. Coverage Limits

C. Coverage Trigger

The loss at [________________________________] is covered under the policy's insuring agreement because:

1. The cause of loss — [________________________________] — is a covered peril under the policy.
2. The loss occurred within the policy period (on [__/__/____]).
3. The damaged property is scheduled/covered under the declarations page.
4. No applicable exclusion bars coverage under Georgia contract-construction principles.
5. All policy conditions (notice, mitigation, cooperation, proof of loss) have been timely satisfied.

IV. THE LOSS

A. Description of Loss

On [__/__/____] at approximately [__:__] [AM/PM], the insured property at [________________________________] in [________________________________] County, Georgia, sustained significant damage caused by [________________________________].

Notable Georgia events and perils relevant to this claim:

• ☐ Hurricane / tropical storm (coastal Georgia — Chatham, Bryan, Liberty, McIntosh, Glynn, Camden counties)
• ☐ Tornado / severe thunderstorm (North Georgia / Metro Atlanta)
• ☐ Ice storm or winter weather event
• ☐ Wildfire (South Georgia / Okefenokee region)
• ☐ Hail storm (I-75 / I-85 corridor)
• ☐ Water damage (plumbing, roof leak, HVAC, appliance)
• ☐ Fire / lightning
• ☐ Theft / vandalism
• ☐ Tree fall / fallen object
• ☐ Other: [________________________________]

B. Mitigation

Pursuant to the policy's "Duties After Loss" provision and Georgia common law, our client took prompt action to mitigate further damage:

C. Notice and Proof of Loss

Notice of loss was provided to [INSURANCE_COMPANY_NAME] on [__/__/____]. A sworn proof of loss was submitted on [__/__/____] (or will be submitted upon request). All requested recorded statements, examinations under oath, and document productions have been timely completed.

V. CLAIM HISTORY

The Carrier's Position

[INSURANCE_COMPANY_NAME] has [denied / underpaid / delayed / improperly reserved rights on] the claim on the following grounds: [________________________________].

This position is unreasonable under Georgia law and violates the Carrier's duty of good faith because:

• [________________________________]
• [________________________________]
• [________________________________]

VI. DAMAGES

A. Dwelling (Coverage A) — Full Scope of Repair

The scope of covered damage to the dwelling is documented in the contractor estimate prepared by [________________________________], a Georgia-licensed general contractor (License No. [________________________________] issued by the Georgia State Licensing Board for Residential and General Contractors under O.C.G.A. § 43-41-1 et seq.).

B. Other Structures (Coverage B)

C. Personal Property (Coverage C)

Personal property inventory prepared using room-by-room replacement-cost valuation per policy terms:

D. Additional Living Expense / Loss of Use (Coverage D)

Our client has been displaced from the property since [__/__/____]:

E. Claim Summary and Balance Due

VII. OVERHEAD AND PROFIT — GEORGIA STANDARD

Under Georgia law and industry custom, general contractor overhead and profit ("GCOP") at twenty percent (20% = 10% O + 10% P) is properly included in a replacement-cost estimate whenever the scope reasonably requires a general contractor's coordination of three or more trades. See Mabry v. State Farm Mut. Auto. Ins. Co., 279 Ga. 462 (2005) (insurer cannot depreciate components that would not be depreciated by a reasonable contractor). The Carrier's exclusion or partial withholding of GCOP here is contrary to Georgia law and industry practice.

VIII. APPRAISAL DEMAND (CONDITIONAL)

To the extent the parties disagree as to the amount of loss only, we hereby invoke the policy's appraisal provision. Coverage, causation, and policy interpretation questions are not subject to appraisal and are reserved for the court. Turner v. Atlanta Girls' School, 288 Ga. App. 115 (2007).

Insured's Appointed Appraiser: [________________________________]
Qualifications: [________________________________]

The Carrier shall appoint its appraiser within twenty (20) days as provided in the policy. If the appraisers cannot agree on an umpire, either party may petition a court of competent jurisdiction in [________________________________] County, Georgia.

IX. STATUTORY VIOLATIONS

A. Violations of O.C.G.A. § 33-6-34 — Unfair Claims Settlement Practices

[INSURANCE_COMPANY_NAME]'s claim handling violates the enumerated practices of O.C.G.A. § 33-6-34, including:

• ☐ § 33-6-34(1) — Knowingly misrepresenting pertinent facts or policy provisions
• ☐ § 33-6-34(2) — Failing to acknowledge and act reasonably promptly upon claim communications
• ☐ § 33-6-34(3) — Failing to adopt reasonable standards for prompt investigation
• ☐ § 33-6-34(4) — Not attempting in good faith to effectuate prompt, fair, and equitable settlements once liability is reasonably clear
• ☐ § 33-6-34(6) — Compelling the insured to institute litigation to recover amounts due by offering substantially less than ultimately recovered
• ☐ § 33-6-34(8) — Attempting to settle for less than the amount to which a reasonable person would believe entitled
• ☐ § 33-6-34(11) — Failing to provide a prompt, reasonable written explanation of the basis for denial or compromise

B. Bad Faith Under O.C.G.A. § 33-4-6

The Carrier's refusal to pay satisfies the "frivolous and unfounded" standard of McCall v. Allstate because [________________________________].

X. FORMAL DEMAND

We hereby demand payment of $[____] in full and final satisfaction of this first-party property claim, payable to "[________________________________] and [CLIENT_NAME]," and delivered to the undersigned within sixty (60) days of receipt of this letter.

If not paid within sixty (60) days and bad faith is found, the Carrier will additionally be liable for a penalty of up to 50% of the loss (or $5,000, whichever is greater) and all reasonable attorney's fees under O.C.G.A. § 33-4-6.

XI. DOCUMENT PRESERVATION NOTICE

This letter serves as formal notice to preserve all claim-related documents and electronically stored information, including:

• The complete claim file, including drafts and superseded versions
• All reserves and reserve-change history
• Adjuster activity logs, diary entries, and supervisor notes
• All internal and external communications (email, text, recorded calls)
• Photographs, drone footage, inspection videos
• Engineer and contractor reports
• Xactimate/Symbility estimates and scope comparisons
• Training materials and claim handling guidelines
• Quality-assurance audits and "round tables" / supervisor sign-offs

XII. CONSEQUENCES OF NON-PAYMENT

If [INSURANCE_COMPANY_NAME] fails to tender the full amount owed within sixty (60) days:

1. Suit will be filed in the State or Superior Court of [________________________________] County, Georgia, asserting breach of contract, bad faith under O.C.G.A. § 33-4-6, and attorney's fees.
2. A copy of the complaint and this demand will be mailed to the Commissioner of Insurance within twenty (20) days of filing as required by O.C.G.A. § 33-4-6(b) and to the Consumers' Insurance Advocate under § 33-4-6(c).
3. A regulatory complaint will be filed with the Georgia Office of Commissioner of Insurance and Safety Fire (Commissioner John F. King), 2 Martin Luther King Jr. Drive SE, Suite 704, West Tower, Atlanta, GA 30334, citing violations of O.C.G.A. § 33-6-34.
4. Appraisal will be invoked if not already.

XIII. CONCLUSION

The Carrier sold our client a policy promising indemnity for covered losses. That loss has occurred. Coverage is clear, scope is documented, and Georgia law requires payment. The Carrier has sixty (60) days to do the right thing.

Respectfully submitted,

[LAW_FIRM_NAME]

By: _______________________________
[ATTORNEY_NAME]
Georgia Bar No. [________________________________]
[________________________________]
[CITY], GA [____]
Telephone: [________________________________]
Email: [________________________________]

Counsel for [CLIENT_NAME]

ENCLOSURES:
☐ Policy declarations page and relevant endorsements
☐ Contractor scope and Xactimate / Symbility estimate
☐ Photographs and videos of damage
☐ Room-by-room personal property inventory
☐ Receipts for ALE and mitigation expenses
☐ Sworn proof of loss
☐ Public adjuster or engineer report (if applicable)
☐ Certificate of insurance / mortgagee information

CC:

• [CLIENT_NAME]
• [MORTGAGEE_NAME]
• Georgia Office of Commissioner of Insurance and Safety Fire (upon filing suit)
• Consumers' Insurance Advocate (upon filing suit)

GEORGIA PROPERTY INSURANCE QUICK REFERENCE

SOURCES AND REFERENCES

• O.C.G.A. § 33-4-6 (Bad Faith): https://law.justia.com/codes/georgia/title-33/chapter-4/section-33-4-6/
• O.C.G.A. § 33-4-7 (Third-Party MV Property Damage Bad Faith): https://law.justia.com/codes/georgia/title-33/chapter-4/section-33-4-7/
• O.C.G.A. § 33-6-34 (Unfair Claims Practices): https://law.justia.com/codes/georgia/title-33/chapter-6/article-2/section-33-6-34/
• O.C.G.A. § 33-24-44 (Standard Fire Policy): https://law.justia.com/codes/georgia/title-33/chapter-24/article-2/
• O.C.G.A. § 9-3-24 (Six-Year Written Contract SOL): https://law.justia.com/codes/georgia/title-9/chapter-3/article-2/section-9-3-24/
• Georgia Office of Commissioner of Insurance and Safety Fire: https://oci.georgia.gov/
• Georgia Claims Handling Practices Overview: https://www.robinskaplan.com/newsroom/insights/claims-handling-practices-georgia