FIRST-PARTY PROPERTY DAMAGE DEMAND LETTER
State of Massachusetts
[LAW FIRM LETTERHEAD]
PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION - FOR RESOLUTION PURPOSES ONLY
PROTECTED UNDER MA 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 - MASSACHUSETTS 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 Massachusetts 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 Massachusetts 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. MASSACHUSETTS PROPERTY INSURANCE LAW
A. Prompt Payment Requirements
Under Massachusetts law:
Mass. Gen. Laws Ch. 176D - Unfair claims settlement practices
B. Appraisal Provisions
No mandatory appraisal statute; governed by policy terms
C. Bad Faith Standard
Massachusetts provides statutory remedy under Chapter 93A and 176D. Unfair claims practices under 176D violations actionable under 93A. Must show unfair or deceptive act. Van Dyke v. St. Paul Fire & Marine Ins. Co., 388 Mass. 671 (1983). Private right of action available.
D. Available Remedies
Actual damages, double or treble damages (for knowing/willful violations), and attorney fees under Chapter 93A
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 Massachusetts 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 Massachusetts 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 Massachusetts 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 Massachusetts 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 Massachusetts 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. Massachusetts Prompt Payment Violations
[CARRIER_SHORT_NAME] has violated Mass. Gen. Laws Ch. 176D - Unfair claims settlement practices by:
- [VIOLATION_1]
- [VIOLATION_2]
- [VIOLATION_3]
B. Unfair Claims Settlement Practices
[CARRIER_SHORT_NAME] has violated Mass. Gen. Laws Ch. 176D 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 Massachusetts law:
Massachusetts provides statutory remedy under Chapter 93A and 176D. Unfair claims practices under 176D violations actionable under 93A. Must show unfair or deceptive act. Van Dyke v. St. Paul Fire & Marine Ins. Co., 388 Mass. 671 (1983). Private right of action available.
Available remedies include: Actual damages, double or treble damages (for knowing/willful violations), and attorney fees under Chapter 93A
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 Massachusetts 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:
- Massachusetts Division of Insurance, 1000 Washington Street, Suite 810, Boston, MA 02118
- 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], MA [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)
- Massachusetts Division of Insurance, 1000 Washington Street, Suite 810, Boston, MA 02118
MASSACHUSETTS PROPERTY INSURANCE LAW QUICK REFERENCE
| Element | Massachusetts Law |
|---|---|
| Prompt Payment | Mass. Gen. Laws Ch. 176D - Unfair claims settlement practices |
| Appraisal | No mandatory appraisal statute; governed by policy terms |
| Bad Faith Type | Statutory (Chapter 93A/176D) |
| Bad Faith Damages | Actual damages, double or treble damages (for knowing/willful violations), and attorney fees under Chapter 93A |
| Unfair Practices Act | Mass. Gen. Laws Ch. 176D |
| Attorney Fees | Recoverable under Chapter 93A |
| DOI Address | Massachusetts Division of Insurance, 1000 Washington Street, Suite 810, Boston, MA 02118 |