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FIRST-PARTY PROPERTY DAMAGE DEMAND LETTER

State of Kentucky


[LAW FIRM LETTERHEAD]

PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION - FOR RESOLUTION PURPOSES ONLY
PROTECTED UNDER KY 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 - KENTUCKY 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 Kentucky 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 Kentucky 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. KENTUCKY PROPERTY INSURANCE LAW

A. Prompt Payment Requirements

Under Kentucky law:

KRS 304.12-230 - Unfair claims settlement practices

B. Appraisal Provisions

No mandatory appraisal statute; governed by policy terms

C. Bad Faith Standard

Kentucky provides statutory remedy under Unfair Claims Settlement Practices Act (KRS 304.12-230). Insured may recover for violations of KUCSPA. Must show insurer not acting in good faith. Wittmer v. Jones, 864 S.W.2d 885 (Ky. 1993). Private right of action exists.

D. Available Remedies

Actual damages, attorney fees, and punitive damages for egregious conduct


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 Kentucky 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 Kentucky 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 Kentucky 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 Kentucky 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 Kentucky 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. Kentucky Prompt Payment Violations

[CARRIER_SHORT_NAME] has violated KRS 304.12-230 - Unfair claims settlement practices by:

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

B. Unfair Claims Settlement Practices

[CARRIER_SHORT_NAME] has violated KRS 304.12-230 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 Kentucky law:

Kentucky provides statutory remedy under Unfair Claims Settlement Practices Act (KRS 304.12-230). Insured may recover for violations of KUCSPA. Must show insurer not acting in good faith. Wittmer v. Jones, 864 S.W.2d 885 (Ky. 1993). Private right of action exists.

Available remedies include: Actual damages, attorney fees, and punitive damages for egregious conduct


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 Kentucky 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:
    - Kentucky Department of Insurance, 500 Mero Street, Frankfort, KY 40601
    - 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], KY [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)
- Kentucky Department of Insurance, 500 Mero Street, Frankfort, KY 40601


KENTUCKY PROPERTY INSURANCE LAW QUICK REFERENCE

Element Kentucky Law
Prompt Payment KRS 304.12-230 - Unfair claims settlement practices
Appraisal No mandatory appraisal statute; governed by policy terms
Bad Faith Type Statutory (KUCSPA)
Bad Faith Damages Actual damages, attorney fees, and punitive damages for egregious conduct
Unfair Practices Act KRS 304.12-230
Attorney Fees Recoverable under KRS 304.12-235
DOI Address Kentucky Department of Insurance, 500 Mero Street, Frankfort, KY 40601
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First-Party Property Damage Demand Letter - Kentucky

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