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:
- The cause of loss is a covered peril
- The damage occurred during the policy period
- The property is covered property
- No exclusions apply
- 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:
-
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 -
Regulatory complaints will be filed with:
- Kentucky Department of Insurance, 500 Mero Street, Frankfort, KY 40601
- National Association of Insurance Commissioners -
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 |