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FIRST-PARTY PROPERTY DAMAGE DEMAND LETTER

State of Illinois


[LAW FIRM LETTERHEAD]

PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION - FOR RESOLUTION PURPOSES ONLY
PROTECTED UNDER IL 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 - ILLINOIS 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 Illinois 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 Illinois 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. ILLINOIS PROPERTY INSURANCE LAW

A. Prompt Payment Requirements

Under Illinois law:

215 ILCS 5/154.6 - Unfair claims practices

B. Appraisal Provisions

No mandatory appraisal statute; governed by policy terms. Court compels appraisal when properly invoked.

C. Bad Faith Standard

Illinois provides statutory remedy under 215 ILCS 5/155 for vexatious and unreasonable delay or denial. No common law bad faith recognized. Must show insurer's conduct was vexatious and unreasonable - not mere denial or delay. Cramer v. Insurance Exchange Agency, 675 N.E.2d 897 (Ill. 1996).

D. Available Remedies

25% of claim amount or $60,000 (whichever less) plus attorney fees and costs under 215 ILCS 5/155


III. POLICY INFORMATION AND COVERAGE

A. Policy Details

Item Information
Named Insured [INSURED_NAME]
Policy Number [POLICY_NUMBER]
Policy Type [POLICY_TYPE]
Policy Period [POLICY_PERIOD_START] to [POLICY_PERIOD_END]
Property Address [PROPERTY_ADDRESS]
Property Type [PROPERTY_TYPE]

B. Applicable Coverage and Limits

Coverage Limit Deductible
Dwelling (Coverage A) $[DWELLING_LIMIT] $[DEDUCTIBLE]
Other Structures (Coverage B) $[OTHER_STRUCTURES_LIMIT]
Personal Property (Coverage C) $[PERSONAL_PROPERTY_LIMIT]
Loss of Use (Coverage D) $[LOSS_OF_USE_LIMIT]

C. Coverage Analysis

The loss is clearly covered under Illinois 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 Illinois law:

Date Action Provider Cost
[DATE_1] [ACTION_1] [PROVIDER_1] $[COST_1]
[DATE_2] [ACTION_2] [PROVIDER_2] $[COST_2]

V. CLAIM HISTORY AND INSURER'S RESPONSE

A. Claim Timeline

Date Event
[DATE_OF_LOSS] Date of loss
[CLAIM_REPORT_DATE] Loss reported
[INSPECTION_DATE] Property inspected
[ESTIMATE_DATE] Estimate issued
[PAYMENT_DATE] Payment issued: $[INITIAL_PAYMENT]

B. Insurer's Position and Our Response

[CARRIER_SHORT_NAME] has [DESCRIBE_INSURER_POSITION].

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


VI. DAMAGES AND CLAIMED AMOUNTS

A. Dwelling Damage (Coverage A)

Category Amount
Structural Damage $[STRUCTURAL]
Systems (Electrical/Plumbing/HVAC) $[SYSTEMS]
Interior Finishes $[INTERIOR]
Overhead & Profit $[O_AND_P]
TOTAL DWELLING $[TOTAL_DWELLING]

B. Other Structures (Coverage B)

$[TOTAL_OTHER_STRUCTURES]

C. Personal Property (Coverage C)

Category Replacement Cost
Furniture $[FURNITURE]
Electronics $[ELECTRONICS]
Appliances $[APPLIANCES]
Clothing $[CLOTHING]
Other $[OTHER]
TOTAL $[TOTAL_PP]

D. Loss of Use (Coverage D)

Category Amount
Temporary Housing $[HOUSING]
Increased Expenses $[EXPENSES]
TOTAL $[TOTAL_ALE]

E. Claim Summary

Coverage Claimed Paid Balance Due
Coverage A $[A_CLAIMED] $[A_PAID] $[A_DUE]
Coverage B $[B_CLAIMED] $[B_PAID] $[B_DUE]
Coverage C $[C_CLAIMED] $[C_PAID] $[C_DUE]
Coverage D $[D_CLAIMED] $[D_PAID] $[D_DUE]
Mitigation $[MIT_CLAIMED] $[MIT_PAID] $[MIT_DUE]
SUBTOTAL $[SUBTOTAL_DUE]
Less Deductible ($[DEDUCTIBLE])
TOTAL DUE $[TOTAL_DUE]

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 Illinois 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 Illinois 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. Illinois Prompt Payment Violations

[CARRIER_SHORT_NAME] has violated 215 ILCS 5/154.6 - Unfair claims practices by:

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

B. Unfair Claims Settlement Practices

[CARRIER_SHORT_NAME] has violated 215 ILCS 5/154.6 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 Illinois law:

Illinois provides statutory remedy under 215 ILCS 5/155 for vexatious and unreasonable delay or denial. No common law bad faith recognized. Must show insurer's conduct was vexatious and unreasonable - not mere denial or delay. Cramer v. Insurance Exchange Agency, 675 N.E.2d 897 (Ill. 1996).

Available remedies include: 25% of claim amount or $60,000 (whichever less) plus attorney fees and costs under 215 ILCS 5/155


X. DEMAND

A. Monetary Demand

We demand payment of $[TOTAL_DEMAND]:

Item Amount
Dwelling (Coverage A) $[A_AMOUNT]
Other Structures (Coverage B) $[B_AMOUNT]
Personal Property (Coverage C) $[C_AMOUNT]
Loss of Use (Coverage D) $[D_AMOUNT]
Mitigation $[MIT_AMOUNT]
Statutory Interest/Penalties $[PENALTIES]
SUBTOTAL $[SUBTOTAL]
Less Deductible ($[DEDUCTIBLE])
Less Prior Payments ($[PRIOR_PAYMENTS])
TOTAL DUE $[TOTAL_DUE]

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 Illinois 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:
    - Illinois Department of Insurance, 320 W. Washington Street, Springfield, IL 62767
    - 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], IL [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)
- Illinois Department of Insurance, 320 W. Washington Street, Springfield, IL 62767


ILLINOIS PROPERTY INSURANCE LAW QUICK REFERENCE

Element Illinois Law
Prompt Payment 215 ILCS 5/154.6 - Unfair claims practices
Appraisal No mandatory appraisal statute; governed by policy terms. Court compels appraisal when properly invoked.
Bad Faith Type Statutory (215 ILCS 5/155)
Bad Faith Damages 25% of claim amount or $60,000 (whichever less) plus attorney fees and costs under 215 ILCS 5/155
Unfair Practices Act 215 ILCS 5/154.6
Attorney Fees Recoverable under 215 ILCS 5/155 if vexatious delay found
DOI Address Illinois Department of Insurance, 320 W. Washington Street, Springfield, IL 62767
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First-Party Property Damage Demand Letter - Illinois

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