INSURANCE BAD FAITH DEMAND LETTER
State of Pennsylvania
[LAW FIRM LETTERHEAD]
PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION - FOR RESOLUTION PURPOSES ONLY
PROTECTED UNDER PA 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]
[CLAIMS_DEPARTMENT_ADDRESS]
[CITY], [STATE] [ZIP]
Attention: [ADJUSTER_NAME], [ADJUSTER_TITLE]
Re: FORMAL BAD FAITH DEMAND - PENNSYLVANIA LAW
Insured: [INSURED_NAME]
Claimant: [CLAIMANT_NAME]
Policy Number: [POLICY_NUMBER]
Claim Number: [CLAIM_NUMBER]
Date of Loss: [DATE_OF_LOSS]
Policy Limits: [POLICY_LIMITS]
Response Deadline: [RESPONSE_DEADLINE] (This is a Time-Limited Demand)
Dear [ADJUSTER_NAME]:
I. INTRODUCTION AND NATURE OF DEMAND
This firm represents [CLIENT_NAME] ("our client") in connection with the above-referenced insurance claim arising under the laws of Pennsylvania. This letter constitutes a formal demand for payment of policy benefits wrongfully withheld and serves as notice of [INSURANCE_COMPANY_NAME]'s ("the Company" or "[CARRIER_SHORT_NAME]") bad faith conduct in handling our client's claim under Pennsylvania law.
As a seasoned insurance litigator with decades of experience representing policyholders against major carriers in Pennsylvania, I am well aware of the Company's obligations under 40 Pa. Stat. and Pennsylvania common law. The Company's conduct in this matter constitutes a textbook example of bad faith claims practices that Pennsylvania courts routinely punish with substantial damages.
This is a time-limited demand. The Company has until [RESPONSE_DEADLINE] to tender the full amount owed of $[DEMAND_AMOUNT] and resolve all claims arising from this loss. Failure to do so will result in immediate litigation seeking all available remedies under Pennsylvania law.
II. PENNSYLVANIA BAD FAITH LAW
A. Legal Standard
Pennsylvania provides statutory remedy under 42 Pa.C.S. 8371 for bad faith. Must show by clear and convincing evidence that insurer did not have reasonable basis for denying benefits and knew or recklessly disregarded lack of reasonable basis. Terletsky v. Prudential, 649 A.2d 680 (Pa. Super. 1994).
B. Available Damages Under Pennsylvania Law
Under Pennsylvania law, our client is entitled to recover:
Interest at prime plus 3%, punitive damages, court costs, and attorney fees under 42 Pa.C.S. 8371
C. Punitive Damages Standard
Clear and convincing evidence of bad faith (knowing or reckless disregard)
D. Attorney's Fees
Recoverable under 42 Pa.C.S. 8371
III. POLICY INFORMATION AND COVERAGE
A. Policy Details
| Item | Information |
|---|---|
| Named Insured | [INSURED_NAME] |
| Policy Number | [POLICY_NUMBER] |
| Policy Period | [POLICY_PERIOD_START] to [POLICY_PERIOD_END] |
| Policy Type | [POLICY_TYPE] |
| Applicable Coverage | [COVERAGE_TYPE] |
| Per-Occurrence Limit | [PER_OCCURRENCE_LIMIT] |
| Aggregate Limit | [AGGREGATE_LIMIT] |
| Deductible | [DEDUCTIBLE_AMOUNT] |
B. Coverage Analysis
The policy provides coverage for [DESCRIBE_COVERED_LOSS_TYPE]. The loss clearly falls within the policy's insuring agreement under Pennsylvania law interpretation principles.
[CARRIER_SHORT_NAME] has acknowledged coverage by [DESCRIBE_COVERAGE_ACKNOWLEDGMENT]. Having accepted coverage, the Company is obligated under Pennsylvania law to:
- Conduct a thorough, fair, and objective investigation
- Evaluate the claim in good faith
- Promptly pay all amounts owed under the policy
- Communicate honestly and transparently with the insured
- Avoid unreasonable delays in claim handling
- Refrain from compelling litigation through unreasonable conduct
IV. FACTUAL BACKGROUND AND CLAIM HISTORY
A. The Underlying Loss
On [DATE_OF_LOSS], [DESCRIBE_LOSS_EVENT_IN_DETAIL].
[ADDITIONAL_LOSS_DETAILS]
B. Chronological Timeline of Bad Faith Conduct
| Date | Event | Bad Faith Indicator |
|---|---|---|
| [DATE_1] | [EVENT_1] | [INDICATOR_1] |
| [DATE_2] | [EVENT_2] | [INDICATOR_2] |
| [DATE_3] | [EVENT_3] | [INDICATOR_3] |
| [DATE_4] | [EVENT_4] | [INDICATOR_4] |
| [DATE_5] | [EVENT_5] | [INDICATOR_5] |
| [DATE_6] | [EVENT_6] | [INDICATOR_6] |
V. SPECIFIC BAD FAITH CONDUCT
[CARRIER_SHORT_NAME]'s handling of this claim violates both the express and implied covenants of good faith and fair dealing recognized under Pennsylvania law:
A. Unreasonable Delay
The Company has unreasonably delayed the investigation, evaluation, and payment of this claim in violation of Pennsylvania law:
- [DESCRIBE_SPECIFIC_DELAY_1]
- [DESCRIBE_SPECIFIC_DELAY_2]
- [DESCRIBE_SPECIFIC_DELAY_3]
B. Inadequate Investigation
[CARRIER_SHORT_NAME] failed to conduct the thorough, fair, and objective investigation required under Pennsylvania law:
- [INVESTIGATION_FAILURE_1]
- [INVESTIGATION_FAILURE_2]
- [INVESTIGATION_FAILURE_3]
C. Unreasonable Settlement Offers
The Company's settlement offers have been grossly inadequate:
| Date | Offer Amount | Actual Value | Discrepancy |
|---|---|---|---|
| [DATE_A] | [OFFER_A] | [VALUE_A] | [DISCREPANCY_A] |
| [DATE_B] | [OFFER_B] | [VALUE_B] | [DISCREPANCY_B] |
D. Misrepresentation of Policy Provisions
[DESCRIBE_MISREPRESENTATIONS]
E. Failure to Communicate
[DESCRIBE_COMMUNICATION_FAILURES]
VI. STATUTORY VIOLATIONS
A. Pennsylvania Unfair Claims Settlement Practices Act
[CARRIER_SHORT_NAME]'s conduct violates 40 Pa. Stat. 1171.5, which prohibits:
- Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue
- Failing to acknowledge and act reasonably promptly upon communications with respect to claims
- Failing to adopt and implement reasonable standards for the prompt investigation of claims
- Refusing to pay claims without conducting a reasonable investigation
- Not attempting in good faith to effectuate prompt, fair, and equitable settlements of claims in which liability has become reasonably clear
- Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered
- Attempting to settle a claim for less than the amount to which a reasonable person would have believed he or she was entitled
- Failing to promptly provide a reasonable explanation of the basis in the policy for denial or inadequate offer
B. Pennsylvania Prompt Payment Requirements
[CARRIER_SHORT_NAME] has violated 40 Pa. Stat. 1171.5 - Unfair claims settlement practices by:
- [SPECIFIC_PROMPT_PAYMENT_VIOLATION_1]
- [SPECIFIC_PROMPT_PAYMENT_VIOLATION_2]
- [SPECIFIC_PROMPT_PAYMENT_VIOLATION_3]
VII. DAMAGES
A. Contract Damages
| Category | Amount |
|---|---|
| Policy Benefits Owed | $[AMOUNT] |
| Less Amounts Paid | ($[AMOUNT_PAID]) |
| Net Policy Benefits Due | $[NET_AMOUNT] |
B. Consequential Damages
| Category | Amount |
|---|---|
| [CONSEQUENTIAL_CATEGORY_1] | $[AMOUNT_1] |
| [CONSEQUENTIAL_CATEGORY_2] | $[AMOUNT_2] |
| [CONSEQUENTIAL_CATEGORY_3] | $[AMOUNT_3] |
| Total Consequential Damages | $[TOTAL_CONSEQUENTIAL] |
C. Emotional Distress Damages
[DESCRIBE_EMOTIONAL_DISTRESS_IF_RECOVERABLE_UNDER_PA_LAW]
D. Punitive/Exemplary Damages
Under Pennsylvania law, punitive damages require: Clear and convincing evidence of bad faith (knowing or reckless disregard)
The Company's conduct meets this standard because [DESCRIBE_AGGRAVATING_FACTORS].
E. Statutory Penalties
Under Pennsylvania law, our client is entitled to:
[STATE_SPECIFIC_STATUTORY_PENALTIES]
VIII. DEMAND
Based on the foregoing, we hereby demand that [CARRIER_SHORT_NAME]:
A. Monetary Demand
Pay the total sum of $[TOTAL_DEMAND_AMOUNT] as follows:
| Component | Amount |
|---|---|
| Policy Benefits | $[POLICY_BENEFITS] |
| Statutory Interest/Penalties | $[STATUTORY_INTEREST] |
| Consequential Damages | $[CONSEQUENTIAL_DAMAGES] |
| TOTAL DEMAND | $[TOTAL_DEMAND_AMOUNT] |
B. Settlement Terms
In addition to the monetary payment:
- Full and complete release of all claims by [CARRIER_SHORT_NAME] against our client
- Confidentiality agreement regarding settlement terms (optional)
- Correction of any adverse information reported to industry databases
IX. TIME-LIMITED NATURE OF THIS DEMAND
THIS DEMAND EXPIRES AT 5:00 P.M. [TIME_ZONE] ON [RESPONSE_DEADLINE].
Consequences of Non-Response
If [CARRIER_SHORT_NAME] fails to accept this demand by the deadline:
-
Litigation will be filed immediately in Pennsylvania seeking all available remedies
-
This demand will be withdrawn and our client will seek:
- Full policy benefits plus prejudgment interest
- All consequential and emotional distress damages
- Punitive damages without limitation
- Attorney's fees and costs
- All statutory penalties under Pennsylvania law -
Regulatory complaints will be filed with:
- Pennsylvania Insurance Department, 1326 Strawberry Square, Harrisburg, PA 17120
- National Association of Insurance Commissioners
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 regarding this claim
- All communications with the insured/claimant
- Adjuster notes, diaries, and activity logs
- All documents received from or sent to the insured/claimant
- All photographs, videos, and inspection reports
- All expert reports, estimates, and evaluations
- Claim handling guidelines, manuals, and procedures
- Training materials relevant to this type of claim
- Reserve information and reserve change documentation
- Supervisor notes and approvals
- Quality assurance or audit reports
XI. CONCLUSION
[CARRIER_SHORT_NAME]'s handling of this claim represents precisely the type of conduct that Pennsylvania bad faith laws were enacted to prevent and punish. We strongly encourage the Company to use this opportunity to resolve this matter fairly under Pennsylvania law.
Please direct all communications regarding this matter to the undersigned.
Respectfully submitted,
[LAW_FIRM_NAME]
By: _______________________________
[ATTORNEY_NAME]
[BAR_NUMBER]
[ADDRESS]
[CITY], PA [ZIP]
[PHONE]
[FAX]
[EMAIL]
Counsel for [CLIENT_NAME]
ENCLOSURES:
- Policy declarations page
- Relevant policy provisions
- Claim correspondence chronology
- Damage documentation
- Expert reports (if applicable)
CC:
- [CLIENT_NAME]
- Pennsylvania Insurance Department, 1326 Strawberry Square, Harrisburg, PA 17120 (via complaint filing)
PENNSYLVANIA LAW QUICK REFERENCE
| Element | Pennsylvania Law |
|---|---|
| Bad Faith Type | Statutory (42 Pa.C.S. 8371) |
| Governing Statute | 40 Pa. Stat. |
| Unfair Practices Act | 40 Pa. Stat. 1171.5 |
| Prompt Payment | 40 Pa. Stat. 1171.5 - Unfair claims settlement practices |
| Punitive Standard | Clear and convincing evidence of bad faith (knowing or reckless disregard) |
| Attorney Fees | Recoverable under 42 Pa.C.S. 8371 |
| DOI Address | Pennsylvania Insurance Department, 1326 Strawberry Square, Harrisburg, PA 17120 |