Insurance Bad Faith Demand Letter - Maryland

INSURANCE BAD FAITH DEMAND LETTER

State of Maryland

[LAW FIRM LETTERHEAD]

SETTLEMENT COMMUNICATION - FOR RESOLUTION PURPOSES ONLY
EVIDENTIARY USE SUBJECT TO MD. RULE 5-408 AND, WHERE APPLICABLE, FED. R. EVID. 408

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND VIA EMAIL TO: [ADJUSTER_EMAIL]

Date: [__/__/____]

[INSURANCE_COMPANY_NAME]
[CLAIMS_DEPARTMENT_ADDRESS]
[________________________________]

Attention: [ADJUSTER_NAME], [ADJUSTER_TITLE]
Re: FORMAL BAD FAITH DEMAND — MARYLAND LAW — PRE-MIA NOTICE
Insured: [________________________________]
Claimant: [________________________________]
Policy Number: [________________________________]
Claim Number: [________________________________]
Date of Loss: [__/__/____]
Policy Limits: $[________________________________]
Response Deadline: [__/__/____] (THIS IS A TIME-LIMITED DEMAND)

Dear [ADJUSTER_NAME]:

I. INTRODUCTION AND NATURE OF DEMAND

This firm represents [________________________________] ("our client") in connection with the above-referenced insurance claim. This letter serves as formal notice that, absent prompt and full resolution of this claim, we will file a statutory complaint with the Maryland Insurance Administration ("MIA") under Md. Code Ann., Ins. § 27-1001 seeking a finding that [INSURANCE_COMPANY_NAME] ("the Company" or "[CARRIER_SHORT_NAME]") has failed to act in good faith, followed by a civil action for bad faith under Md. Code Ann., Cts. & Jud. Proc. § 3-1701.

This is not a generic bad-faith letter from a jurisdiction with no statutory teeth. Maryland's first-party bad faith regime was enacted in 2007 by the General Assembly (Chapter 150, Laws of Maryland 2007) after two decades of legislative effort. It is codified in a carefully interlocking set of provisions in the Insurance Article and the Courts Article. The Company's conduct in handling this claim triggers the full apparatus of that statute.

This is a time-limited demand. The Company has until [__/__/____] to tender the full amount owed of $[________________________________] and resolve all claims arising from this loss. Failure to do so will result in the immediate filing of an MIA complaint followed by litigation.

II. MARYLAND'S FIRST-PARTY BAD FAITH FRAMEWORK

A. Statutory Background — 2007 Reform

Until October 1, 2007, Maryland did not recognize a first-party tort remedy for bad-faith denial under Mesmer v. Md. Auto. Ins. Fund, 353 Md. 241, 725 A.2d 1053 (1999). The General Assembly then enacted Chapter 150 of the 2007 Laws of Maryland, creating a statutory cause of action and a mandatory administrative prelude.

The resulting framework is now codified at:

• Md. Code Ann., Cts. & Jud. Proc. § 3-1701 — the cause of action;
• Md. Code Ann., Ins. § 27-1001 — the MIA procedure.

B. "Good Faith" Definition — § 3-1701(a)(5)

Maryland has a statutory definition of good faith that every claim handler must understand:

"Good faith" means an informed judgment based on honesty and diligence supported by evidence the insurer knew or should have known at the time the insurer made a decision on a claim.

Note the three elements: (1) informed judgment, (2) honesty and diligence, (3) supported by evidence. Conclusions based on incomplete investigation, desk reviews that ignore field conditions, or reliance on pretextual interpretations fail this standard as a matter of law.

C. Scope — § 3-1701(b)

The statute applies to first-party claims under:

• Property and casualty insurance policies issued, sold, or delivered in Maryland; and
• Individual disability insurance policies issued, sold, or delivered in Maryland.

A liability insurer’s failure to settle a defended third-party claim within policy limits is a distinct tort discussed in State Farm Mutual Automobile Insurance Co. v. White, 248 Md. 324 (1967). Mesmer distinguishes that situation from an insurer’s refusal to undertake a contractual defense.

D. Mandatory MIA Complaint Process — § 27-1001

Unless one of the narrow exceptions applies, a § 3-1701 claim cannot be filed directly in court. The insured must first file a written complaint with the MIA.

Exceptions to the MIA pre-suit requirement (§ 27-1001(c)(2)):
☐ Action is within the District Court's small-claim jurisdiction;
☐ Commercial insurance policy with applicable coverage limits exceeding $1,000,000;
☐ Insured and insurer agree to waive the MIA prerequisite.

MIA Procedure (§ 27-1001):

1. Complaint Filing — Insured files written complaint with MIA attaching: (a) all proof-of-loss documentation; (b) applicable coverage and amount claimed; (c) claimed actual damages; (d) claimed expenses and litigation costs.
2. Insurer Response — Insurer must file a written response within thirty (30) days after MIA forwards the filing (§ 27-1001(d)(4)).
3. MIA Decision — MIA must render a written decision within ninety (90) days of complaint receipt (§ 27-1001(e)(1)).

4. MIA Findings — The MIA will determine:

   • Whether the insurer is obligated to provide coverage;
   • The amount the insured was entitled to receive;
   • Whether the insurer breached that obligation;
   • Whether any breach was in bad faith;
   • The amount of actual damages, expenses, litigation costs, and interest.

5. Hearing and Judicial Review — An adversely affected party has 30 days after service of the MIA decision to request a de novo administrative hearing under § 27-1001(f). A final decision may be appealed to circuit court under § 27-1001(g), where judicial review ordinarily uses the agency record under § 2-215 and State Government § 10-222. If no hearing is requested during the 30-day window, the MIA decision becomes final under § 27-1001(f)(3). Section 3-1701(c) generally requires that final decision before a civil action, subject to its listed exceptions. The 30-day period is for requesting a hearing, not a separate deadline to file the § 3-1701 action.

E. Damages Under § 3-1701(e)

If the insured prevails and the trier of fact finds that the insurer failed to act in good faith under § 3-1701(e):

1. Actual damages — capped at the applicable policy limits;
2. Statutory interest — on actual damages, expenses, and litigation costs under § 3-1701(e)(3), at the § 11-107(a) rate from the date the claim would have been paid if the insurer had acted in good faith;
3. Expenses and litigation costs, including reasonable attorney's fees capped at one-third (1/3) of the actual damages recovered.

F. Breach of Contract — Preserved in Parallel

Section 3-1701(i) does not limit a civil action for damages or other remedies otherwise available under another law. Our client reserves any separate claim for benefits due under the policy; the availability and measure of other contract remedies must be established under the governing policy and law.

G. Delay Provision — § 3-1701(f)

The statute provides a narrow safe harbor: an insurer cannot be found to have acted in bad faith solely based on delay in determining coverage or payment, if the insurer acted within the time period specified by statute or regulation for claim investigation. The safe harbor is narrow and does not apply where, as here, the delay is accompanied by other indicia of bad faith.

H. Separate Tort Claims

No punitive amount is demanded under § 3-1701. Any separate tort theory requires its own factual and legal analysis.

III. POLICY INFORMATION AND COVERAGE

A. Policy Details

B. Coverage Analysis

The policy provides coverage for [DESCRIBE_COVERED_LOSS_TYPE]. The loss falls squarely within the policy's insuring agreement.

Under Maryland contract-interpretation principles, the burden to establish the applicability of an exclusion falls on the insurer. Clendenin Bros. v. U.S. Fire Ins. Co., 390 Md. 449, 889 A.2d 387 (2006). If policy language is ambiguous, consider relevant extrinsic evidence of the parties' intent; construe unresolved ambiguity against the insurer as drafter. Sullins v. Allstate Ins. Co., 340 Md. 503, 667 A.2d 617 (1995); Cole v. State Farm Mut. Ins. Co., 359 Md. 298, 753 A.2d 533 (2000).

[CARRIER_SHORT_NAME] has [acknowledged/partially acknowledged/denied] coverage by [DESCRIBE]. Having [reached that position], [CARRIER_SHORT_NAME] was obligated under Maryland law to:

• Conduct a thorough, fair, and objective investigation reflecting "honesty and diligence";
• Evaluate the claim based on evidence the insurer knew or should have known;
• Promptly pay amounts for which liability was reasonably clear;
• Provide promptly on request a reasonable explanation of a denial (§ 27-303(6));
• Where the evidence shows a general business practice, refrain from compelling litigation through substantially inadequate offers (§ 27-304(7)).

IV. FACTUAL BACKGROUND AND CLAIM HISTORY

A. The Underlying Loss

On [__/__/____], [DESCRIBE_LOSS_EVENT_IN_DETAIL].

[ADDITIONAL_LOSS_DETAILS]

B. Chronology of Bad Faith Conduct

V. SPECIFIC BAD FAITH CONDUCT

A. Lack of "Informed Judgment" — § 3-1701(a)(5) Violation

[CARRIER_SHORT_NAME]'s decision on this claim was not an "informed judgment" because:

• [DESCRIBE_INFORMATION_IGNORED_OR_NOT_GATHERED]
• [DESCRIBE_FAILURE_TO_INSPECT_OR_INVESTIGATE]
• [DESCRIBE_RELIANCE_ON_UNQUALIFIED_ADJUSTER_OR_CONSULTANT]

B. Unreasonable Delay

• [DESCRIBE_SPECIFIC_DELAY_1]
• [DESCRIBE_SPECIFIC_DELAY_2]
• [DESCRIBE_SPECIFIC_DELAY_3]

Section 3-1701(f) provides that timely delay alone does not establish lack of good faith. The asserted violation here therefore must rest on supported conduct beyond delay alone, including [SPECIFY].

C. Inadequate Investigation (§ 27-304(3) and (4), if a General Business Practice)

• [INVESTIGATION_FAILURE_1]
• [INVESTIGATION_FAILURE_2]
• [INVESTIGATION_FAILURE_3]

D. Unreasonable Settlement Offers (§ 27-304(7) and (8), if a General Business Practice)

If supported by pattern evidence and the ultimate recovery, the gap between the offer and documented value may support a § 27-304(7) allegation.

E. Misrepresentation of Policy Provisions (§ 27-303(1))

[CARRIER_SHORT_NAME] misrepresented coverage by stating [DESCRIBE_MISREPRESENTATION]. The actual policy language [DESCRIBE_ACTUAL_LANGUAGE].

F. Failure to Provide a Reasonable Explanation (§ 27-303(6))

On [__/__/____], our client requested an explanation of the denial. [CARRIER_SHORT_NAME] has not promptly provided a reasonable explanation of its basis as required by § 27-303(6): [DESCRIBE].

G. Failure to Communicate (§ 27-304(2), if a General Business Practice)

• [FAILURE_1]
• [FAILURE_2]

VI. STATUTORY VIOLATIONS — MD. CODE ANN., INS. §§ 27-303 AND 27-304

A. § 27-303 Violations Catalog

[CARRIER_SHORT_NAME]'s conduct violates at least the following subsections of § 27-303:

☐ § 27-303(1) — Misrepresenting facts or policy provisions
☐ § 27-303(2) — Refusing payment for an arbitrary or capricious reason based on all available information
☐ § 27-303(5) — Failing to settle under one policy part to influence settlement under another
☐ § 27-303(6) — Failing to provide promptly on request a reasonable explanation for denial
☐ § 27-303(9) — Failing to act in good faith on a first-party property/casualty claim

B. § 27-304 — General Business Practice

Section 27-304 is a separate list of prohibited conduct that requires frequency indicating a general business practice. If supported by evidence, identify the exact § 27-304 subsection and the pattern facts; do not import § 27-304's numbering into § 27-303.

VII. DAMAGES

A. Contract Damages (Available in Both Breach-of-Contract and § 3-1701 Actions)

B. Consequential Damages (Breach of Contract Track)

Under Maryland contract law, consequential damages reasonably foreseeable at the time of contracting are recoverable:

C. § 3-1701 Recoverable Items

D. Separate Claims

No separate tort damages are included in the § 3-1701 calculation above. Any separate claim must be evaluated on its own elements and evidence.

E. Emotional Distress

No emotional distress damages are included in this contract or § 3-1701 demand. Counsel must evaluate any separate tort claim and its remedies on its own facts and legal basis before asserting it.

VIII. DEMAND

A. Monetary Demand

Based on the foregoing, [CARRIER_SHORT_NAME] must pay the total sum of $[TOTAL_DEMAND_AMOUNT]:

B. Settlement Terms

• Payment delivered within ten (10) business days of acceptance;
• Limited release, covering only claims arising from this specific loss;
• Correction of any adverse reporting to CLUE, ISO, or NAIC databases;
• No confidentiality requirement that would prohibit reporting to the MIA or regulatory authorities.

IX. TIME-LIMITED NATURE OF THIS DEMAND

THIS DEMAND EXPIRES AT 5:00 P.M. EASTERN TIME ON [__/__/____].

Consequences of Non-Response

If [CARRIER_SHORT_NAME] fails to resolve this claim by the deadline:

1. MIA Complaint under § 27-1001 — We will immediately file a formal complaint with the Maryland Insurance Administration at 200 St. Paul Place, Suite 2700, Baltimore, MD 21202. [CARRIER_SHORT_NAME] will have thirty (30) days to respond, and the MIA will issue a decision within ninety (90) days.

2. Civil Action under § 3-1701 — Following the MIA process, we will file suit in the Circuit Court for [________] County, Maryland (or, where diversity exists, in the U.S. District Court for the District of Maryland), seeking:

   • Full policy benefits;
   • Pre- and post-judgment interest at the legal rate;
   • Attorney's fees up to one-third of actual damages under § 3-1701(g);
   • Litigation costs and expenses.

3. Breach of Contract Claim — We will assert a parallel breach of contract claim seeking consequential damages not available under § 3-1701.

4. Common-Law Claims — Any separate tort claim requires its own duty, elements, and proof; no punitive amount is included in this first-party statutory demand.

5. MIA Consumer Complaint — If warranted, our client may also use the Maryland Insurance Administration's property-insurance complaint route; counsel must determine how any consumer complaint relates to the § 27-1001 filing above.

6. Demand Will Be Withdrawn — Any later settlement position may account for additional documented costs and expenses as permitted by applicable law.

X. DOCUMENT PRESERVATION NOTICE

This letter constitutes formal notice to preserve all documents and electronically stored information related to this claim, including but not limited to:

• The complete claim file, including all versions and drafts;
• All internal communications (email, chat, phone recordings, voicemail);
• All communications with the insured/claimant;
• Adjuster notes, diaries, and activity logs;
• Reserve history and reserve-change documentation;
• Supervisor notes, approvals, and referral memos;
• Coverage-opinion memoranda and outside coverage-counsel communications;
• All expert reports, estimates, and evaluations;
• Claim-handling guidelines, manuals, and procedures;
• Training materials relevant to this type of claim;
• Quality-assurance and audit reports touching this claim or claim handler;
• Performance metrics, incentive compensation documentation, and claim-closure quotas for the handler and supervisor;
• Underwriting file.

Spoliation will be pursued vigorously, and we will seek adverse-inference instructions and sanctions at trial.

XI. DISCOVERY PRESERVATION

No current Md. Code Ann., Ins. § 27-1005 exists. The preservation demand above is made under otherwise applicable procedural law. Discovery scope, privilege, and work-product issues must be resolved under the governing court rules and current authority; this letter does not override them.

XII. STATUTE OF LIMITATIONS

Section 5-101 generally requires a civil action at law within three years after accrual unless another Code provision supplies a different period. Calendar any contract claim and § 3-1701 action separately, including the MIA final-decision prerequisite and administrative hearing or appeal route. Under Ins. § 12-104, a policy term shortening the statutory time to sue is illegal and void. Confirm the claim-specific accrual and filing dates.

XIII. CONCLUSION

Maryland's General Assembly enacted § 3-1701 and § 27-1001 to provide the statutory process described above. Attorney's fees are not automatic: § 3-1701(e)(2) permits reasonable fees only when the insured prevails and the trier of fact finds a failure to act in good faith, subject to § 3-1701(g)'s cap.

[CARRIER_SHORT_NAME] has the opportunity to resolve this matter now, on reasonable terms, without subjecting itself to the MIA process, civil litigation, discovery into its claim-handling practices, and reputational consequences. We urge it to take that opportunity.

Please direct all communications regarding this matter to the undersigned.

Respectfully submitted,

[LAW_FIRM_NAME]

By: _______________________________
[ATTORNEY_NAME]
Maryland Attorney Number (AIS): [____________]
[ADDRESS]
[CITY], MD [ZIP]
[PHONE]
[FAX]
[EMAIL]

Counsel for [CLIENT_NAME]

ENCLOSURES:
☐ Policy declarations page
☐ Complete policy
☐ Sworn proof of loss and supporting documentation
☐ Claim correspondence chronology
☐ Damage documentation and estimates
☐ Expert reports (where applicable)
☐ Draft MIA complaint form

CC:

• [CLIENT_NAME]
• File
• Maryland Insurance Administration (upon filing of complaint)

MARYLAND FIRST-PARTY BAD FAITH QUICK REFERENCE

SOURCES AND REFERENCES

• Md. Code Ann., Cts. & Jud. Proc. § 3-1701 — https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gcj&section=3-1701&enactments=false
• Md. Code Ann., Ins. § 27-1001 — https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gin&section=27-1001
• Md. Code Ann., Ins. § 27-303 (Unfair Claim Practices) — https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gin&section=27-303
• Md. Code Ann., Ins. § 27-304 — https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gin&section=27-304
• Md. Code, Ins. § 12-104 — https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gin&section=12-104&enactments=false
• Md. Code, Cts. & Jud. Proc. § 5-101 — https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gcj&section=5-101&enactments=false
• MIA "Insurer Good Faith Requirements" — https://insurance.maryland.gov/Pages/insurer-good-faith-requirements.aspx
• MIA "File a Complaint" — https://insurance.maryland.gov/Consumer/pages/fileacomplaint.aspx
• MIA § 27-1001 Complaint Information Sheet — https://insurance.maryland.gov/consumer/documents/27-1001-complaint-information-sheet-form.pdf
• Mesmer v. Md. Auto. Ins. Fund, 353 Md. 241, 725 A.2d 1053 (1999) — https://www.mdcourts.gov/data/opinions/coa/1999/50a96.pdf
• Sullins v. Allstate Ins. Co., 340 Md. 503, 667 A.2d 617 (1995) — https://www.mdcourts.gov/data/opinions/coa/1995/7a95m.pdf
• Cole v. State Farm Mut. Ins. Co., 359 Md. 298, 753 A.2d 533 (2000) — https://www.mdcourts.gov/data/opinions/coa/2000/92a99.pdf
• Clendenin Bros. v. U.S. Fire Ins. Co., 390 Md. 449, 889 A.2d 387 (2006)
• Maryland Insurance Administration — https://insurance.maryland.gov/