Insurance Bad Faith Demand Letter - West Virginia
INSURANCE BAD FAITH DEMAND LETTER
State of West Virginia
[LAW FIRM LETTERHEAD]
SETTLEMENT COMMUNICATION — FOR RESOLUTION PURPOSES ONLY
W. VA. R. EVID. 408 / FED. R. EVID. 408 MAY LIMIT SPECIFIED USES OF DISPUTED-CLAIM NEGOTIATIONS; THEY DO NOT CREATE A GENERAL PRIVILEGE
VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
Article No.: [________________________________]
AND VIA EMAIL TO: [________________________________]
[IF APPLICABLE: AND HAND DELIVERED ON [__/__/____]]
Date: [__/__/____]
[INSURANCE COMPANY FULL LEGAL NAME]
Attn: [________________________________] Claims Department
[________________________________]
[________________________________], [____] [________]
ALSO SERVED UPON:
[________________________________] (Supervising Claims Manager)
[________________________________] (Regional Claims Director)
[________________________________] (Legal / Coverage Counsel)
Attention: [________________________________], [________________________________]
Re: FORMAL BAD FAITH DEMAND — WEST VIRGINIA LAW
Insured: [________________________________]
Claimant / Our Client: [________________________________]
Policy Number: [________________________________]
Claim Number: [________________________________]
Date of Loss: [__/__/____]
Type of Claim: [________________________________]
Policy Limits: $[________________________________]
Demand Amount: $[________________________________]
Response Deadline: [__/__/____] at 5:00 p.m. Eastern Time
Dear [________________________________]:
I. INTRODUCTION — NATURE AND URGENCY OF THIS DEMAND
This firm represents [________________________________] ("our client") in connection with [________________________________]'s ("[________________________________]" or "the Company") handling of the above-referenced insurance claim under West Virginia law.
This letter demands payment of the covered claim and identifies claims-handling conduct for your review. It is addressed to you, your supervisors, and the Company's legal department.
Context — West Virginia Is a Uniquely Hostile Jurisdiction for Insurer Bad Faith:
I have practiced insurance law in West Virginia for [____] years. The conduct described in this letter may support a coverage claim and, if the required facts are proved, additional relief under Hayseeds. A separate unfair-settlement-practice claim under W. Va. Code § 33-11-4(9) requires a general business practice and resolution of underlying liability and damages. Section 33-11-4a eliminates the third-party private unfair-practice action; it does not create a first-party action.
This demand expires at 5:00 p.m. Eastern Time on [__/__/____]. If the Company fails to tender $[________________________________] and fulfill the additional demands set forth herein, litigation will be filed immediately in [________________________________] County Circuit Court, West Virginia.
II. WEST VIRGINIA BAD FAITH LAW — THE COMPLETE LEGAL FRAMEWORK
A. Coverage Claim and Unfair-Practice Standards
The coverage claim and a separate implied unfair-practice claim have different predicates under McCormick.
1. Unfair settlement practices — W. Va. Code § 33-11-4(9)
Section 33-11-4(9) lists unfair settlement practices performed with such frequency as to indicate a general business practice. A single isolated violation does not satisfy that statutory predicate for an implied claim.
2. Policy benefits and additional contract-based relief
The insurer should address the policy benefits and the claims-handling issues described below. Hayseeds may permit additional relief if the insured substantially prevails on a covered property-damage claim. The practices at issue include:
- Conduct a thorough, fair, and objective investigation
- Evaluate claims based on facts, not financial incentives
- Promptly and fairly settle claims when liability is reasonably clear
- Deal honestly and transparently with their insured at all times
B. Coverage Relief and Separate Unfair-Practice Claim
Hayseeds addresses additional relief upon substantial success on a policy claim. Jenkins recognizes an implied § 33-11-4(9) unfair-practice cause of action, and McCormick explains that it has different predicates from the coverage claim: a general business practice and resolution of underlying liability and damages. Section 33-11-4a channels third-party unfair-practice complaints to the Insurance Commissioner and does not itself create a first-party cause of action.
Our client is the named insured and seeks policy benefits. Any separate § 33-11-4(9) claim requires facts establishing its distinct predicates.
Potential remedies depend on the claim and proof:
- Actual damages — all policy benefits wrongfully withheld
- Consequential damages — economic losses flowing from the breach (Hayseeds)
- Emotional distress damages (where proven)
- Punitive damages — upon clear and convincing evidence that the damages resulted from actual malice toward the plaintiff or conscious, reckless, and outrageous indifference to the health, safety, and welfare of others (W. Va. Code § 55-7-29(a))
- Attorney's fees — recoverable under Hayseeds (presumptively 1/3 of policy face amount)
C. The Hayseeds Doctrine — West Virginia's Most Powerful Policyholder Remedy
Hayseeds, Inc. v. State Farm Fire & Cas., 177 W. Va. 323, 352 S.E.2d 73 (1986), addresses additional relief when a policyholder substantially prevails on a covered property-damage claim. Marshall applies specified relief to UM/UIM coverage litigation. The Hayseeds categories are:
"1. The insured's reasonable attorneys' fees in vindicating its claim; 2. the insured's damages for net economic loss caused by the delay in settlement, and damages for aggravation and inconvenience."
What makes Hayseeds uniquely devastating for insurers:
The insurer's good faith is irrelevant. Hayseeds applies even when the insurer reasonably believed its position was correct. The West Virginia Supreme Court stated plainly: "when an insured purchases a contract of insurance, he buys insurance — not a lot of vexatious, time-consuming, expensive litigation." The insured must substantially prevail; fees must be reasonable and for services necessary to obtain payment, and additional damages must be proved.
Attorney's fees formula: Reasonable fees are presumptively one-third of the face amount of the policy (adjustable only for exceptionally small or large policies). For a $[________________________________] policy, the presumptive Hayseeds fee alone is $[________].
Hayseeds has been extended and applied in:
- UM/UIM claims: Marshall v. Saseen, 192 W. Va. 94, 450 S.E.2d 791 (1994)
- Duty-to-defend cases
- Property damage / fire claims
- Other contexts only after checking claim-specific authority
D. Punitive Damages — W. Va. Code § 55-7-29
Section 55-7-29(a) supplies two statutory routes: actual malice toward the plaintiff or conscious, reckless, and outrageous indifference to the health, safety, and welfare of others, proved by clear and convincing evidence. Apply any claim-specific insurance precedent separately; the statutory text does not reduce every bad-faith punitive claim to knowing that the claim was proper and intentionally denying it.
W. Va. Code § 55-7-29 (enacted 2015) caps punitive damages at the greater of:
- 4× the amount of compensatory damages, or
- $500,000
The section states no specific-intent or generic egregious-conduct exception to subsection (c)'s cap. Do not demand an award above the cap without separate current controlling authority.
Bifurcated trial procedure: Under § 55-7-29(b), a jury action involving punitive damages may, upon any defendant's request, proceed under the subsection's two-stage process. Subsection (c) supplies the cap.
E. Shamblin Duty — Failure to Settle Within Policy Limits
Shamblin v. Nationwide Mut. Ins. Co., 183 W. Va. 585, 396 S.E.2d 766 (1990), imposes on every liability insurer the duty to settle within policy limits when doing so would be in the best interest of the insured. The Shamblin standard requires the insurer to prove by clear and convincing evidence that it attempted good faith settlement negotiations and had substantial, reasonable grounds for refusing to settle.
In evaluating whether the Shamblin duty was met, courts consider:
- Whether there was appropriate investigation and evaluation based on objective, cogent evidence
- Whether there was a genuine and substantial issue as to the insured's liability
- Whether there was potential for a substantial excess verdict against the insured
If the insurer's failure to make a good-faith settlement within policy limits leads to an excess verdict, Marshall v. Saseen, 192 W. Va. 94, 450 S.E.2d 791 (1994), permits a separate suit to establish any liability for that excess under Shamblin.
F. Proposed Assignment Requires Separate Authority
Section 33-11-4a does not authorize assignment, punitive damages, or attorney's fees. It instead makes an administrative complaint the sole remedy of a third-party claimant for the unfair settlement or bad-faith conduct covered by the section. If an assignment of a first-party claim has occurred or is contemplated, West Virginia counsel must identify separate current authority for assignability, the assigned claim, and each requested remedy rather than attributing those rights to § 33-11-4a.
G. Statute of Limitations
| Claim Type | Limitations Period | Statute |
|---|---|---|
| Insurance contract (signed written policy) | § 55-2-6 supplies a ten-year period, but an applicable policy suit clause may require earlier filing; check § 33-6-14 and its standard-fire-policy exception | W. Va. Code §§ 55-2-6, 33-6-14 |
| Separate § 33-11-4(9) claim | One year under § 55-2-12(c); determine claim-specific accrual | Wilt v. State Auto (1998) |
| Separate common-law bad-faith claim | One year under § 55-2-12(c); determine claim-specific accrual | Noland v. Virginia Insurance Reciprocal (2009) |
| Administrative UTPA complaint (third parties) | 1 year from discovery | W. Va. Code § 33-11-4a |
The one-year period does not itself fix the accrual date. Determine when each separate claim accrued under the facts and controlling authority; Noland addresses discovery of a refusal to defend, not every property-payment dispute.
III. POLICY INFORMATION AND COVERAGE
A. Policy Details
| Item | Information |
|---|---|
| Named Insured | [________________________________] |
| Policy Number | [________________________________] |
| Policy Type | ☐ Homeowners ☐ Auto ☐ Commercial GL ☐ UM/UIM ☐ Life ☐ Disability ☐ [____] |
| Policy Carrier | [________________________________] |
| Policy Period | [__/__/____] to [__/__/____] |
| Per-Occurrence Limit | $[________________________________] |
| Aggregate Limit | $[________________________________] |
| Deductible | $[________________________________] |
| Coverage Type | [________________________________] |
B. Coverage Confirmed
The loss at issue clearly falls within the policy's insuring agreement under West Virginia law. [________________________________] has ☐ confirmed / ☐ implicitly acknowledged coverage by [________________________________].
The Company previously identified these coverage grounds: [________________________________]. If it now asserts a different ground, identify the policy term, timing, and any facts supporting waiver or estoppel. Under Potesta v. United States Fidelity & Guaranty Co., No. 24441 (W. Va. May 15, 1998), a late-stated defense is not automatically waived; waiver requires intentional relinquishment of a known right, and estoppel requires qualifying detrimental reliance. A late defense alone does not establish misrepresentation under § 33-11-4(9)(a).
IV. FACTUAL BACKGROUND AND TIMELINE OF BAD FAITH CONDUCT
A. The Underlying Loss or Claim
On [__/__/____], [________________________________].
[Provide a detailed, factual narrative of what happened, including the nature of the claim, what benefits are owed, and what our client has suffered as a result of the claim and the insurer's handling of it.]
[________________________________]
[________________________________]
[________________________________]
B. Chronological Timeline of Bad Faith Conduct
The following timeline documents [________________________________]'s pattern of unreasonable conduct in handling this claim:
| Date | Event | Bad Faith Indicator |
|---|---|---|
| [__/__/____] | Loss occurred — [________________________________] | — |
| [__/__/____] | Claim reported to [________________________________] | — |
| [__/__/____] | [________________________________] | ☐ Failure to promptly acknowledge claim |
| [__/__/____] | [________________________________] | ☐ Failure to conduct timely investigation |
| [__/__/____] | [________________________________] | ☐ Unreasonable delay in inspection / evaluation |
| [__/__/____] | [________________________________] | ☐ Misrepresentation of policy provisions |
| [__/__/____] | [________________________________] | ☐ Denial / inadequate offer without explanation |
| [__/__/____] | [________________________________] | ☐ Compelled litigation by offering far less than owed |
| [__/__/____] | [________________________________] | ☐ [________________________________] |
| [__/__/____] | [________________________________] | ☐ [________________________________] |
V. SPECIFIC BAD FAITH CONDUCT — STATUTORY AND COMMON LAW VIOLATIONS
A. Unreasonable Delay in Claim Handling
[________________________________] has unreasonably delayed the investigation, evaluation, and payment of this claim in violation of W. Va. Code § 33-11-4(9)(b) and (c):
☐ Delay in acknowledging claim: The claim was reported on [__/__/____], but [________________________________] did not acknowledge receipt until [__/__/____] — a delay of [____] days.
☐ Delay in investigation: [____] days / months have elapsed since the claim was reported. No final coverage decision has been made. No reasonable basis for this delay exists.
☐ Delay in inspection: Despite repeated requests, the Company did not inspect the [________________________________] until [__/__/____] — [____] days after the claim was reported.
☐ Delay in payment: [________________________________] issued only $[________________________________] on [__/__/____], leaving $[________________________________] unpaid and unjustified.
☐ Specific delay conduct: [________________________________]
B. Failure to Conduct a Reasonable and Objective Investigation
[________________________________] refused to pay this claim without a reasonable investigation based on the available information, conduct addressed by W. Va. Code § 33-11-4(9)(d), in the following respects. Subsection (9)(c) separately concerns the insurer's adoption and implementation of reasonable standards for prompt claim investigation.
☐ Failed to interview key witnesses: [________________________________]
☐ Failed to obtain and review: [________________________________]
☐ Relied on biased or unqualified expert: [________________________________], whose report [________________________________]
☐ Ignored favorable evidence, including: [________________________________]
☐ Failed to apply the correct legal standard under West Virginia law: [________________________________]
☐ Conducted a one-sided investigation designed to support denial rather than to objectively evaluate the claim
☐ [________________________________]
C. Inadequate and Unreasonable Settlement Offers
The Company's settlement offers have been grossly disproportionate to the true value of this claim, in violation of W. Va. Code § 33-11-4(9)(g):
| Date | Company's Offer | Reasonable Value | Shortfall | Explanation |
|---|---|---|---|---|
| [__/__/____] | $[________] | $[________] | $[________] | [________________________________] |
| [__/__/____] | $[________] | $[________] | $[________] | [________________________________] |
| [__/__/____] | $[________] | $[________] | $[________] | [________________________________] |
The Company's offer may support a claim under W. Va. Code § 33-11-4(9)(g) if it compels our client to litigate and the amount ultimately recovered substantially exceeds the offer, after our client claimed an amount reasonably similar to that recovery.
D. Misrepresentation of Policy Provisions — W. Va. Code § 33-11-4(9)(a)
[________________________________] misrepresented pertinent policy provisions to our client as follows:
☐ Told our client that [________________________________] is excluded when the policy contains no such exclusion
☐ Failed to disclose that [________________________________] is a covered benefit
☐ Represented that the policy limit applicable to this claim is $[________________________________] when in fact it is $[________________________________]
☐ Mischaracterized the cause of loss as [________________________________] to invoke an inapplicable exclusion
☐ [________________________________]
E. Failure to Provide Timely Explanation for Denial
[________________________________] failed to promptly provide a reasonable, policy-based explanation for its denial of / inadequate offer on this claim, in violation of W. Va. Code § 33-11-4(9)(n):
☐ No denial letter has been issued despite [____] days having elapsed since the claim was submitted
☐ The denial letter issued on [__/__/____] cited: [________________________________] — which is not a valid basis under the policy or West Virginia law
☐ The denial failed to identify the specific policy provisions upon which [________________________________] relied
☐ [________________________________]
F. Compelling Litigation Through Unreasonable Conduct
[________________________________] has compelled our client to retain counsel and pursue litigation by:
☐ Offering only $[________________________________] — less than [____]% of the reasonable value of this claim
☐ Ignoring repeated correspondence from our client dated [__/__/____], [__/__/____], and [__/__/____]
☐ Refusing to engage in good-faith negotiations
☐ Stonewalling for [____] months without making any additional payment
☐ [________________________________]
If the Company's offer compels our client to litigate and our client ultimately recovers substantially more than the offer on a claim for a reasonably similar amount, the conduct may fall under W. Va. Code § 33-11-4(9)(g). Other unfair-practice allegations require their own statutory predicates.
G. Additional Bad Faith Conduct
☐ Reserve manipulation: [________________________________] set unreasonably low reserves of $[________________________________] on a claim with a clear value of $[________________________________], indicating a deliberate strategy to underpay
☐ Expert bias: [________________________________] retained [________________________________] — a vendor known for producing insurer-favorable opinions — rather than conducting an independent evaluation
☐ Litigation-threat retaliation: After our client retained counsel, [________________________________] [________________________________]
☐ Repeated UTPA violations: This pattern mirrors [________________________________]'s conduct in [________________________________] other claims pending before the WV Insurance Commissioner as of [__/__/____], evidencing a general business practice
☐ [________________________________]
VI. WEST VIRGINIA UTPA VIOLATIONS — W. Va. Code § 33-11-4(9)
[________________________________]'s conduct violates the following specific subsections of W. Va. Code § 33-11-4(9):
☐ (a) — Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue
☐ (b) — Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies
☐ (c) — Failing to adopt and implement reasonable standards for the prompt investigation of claims arising under insurance policies
☐ (d) — Refusing to pay claims without conducting a reasonable investigation based upon all available information
☐ (e) — Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed
☐ (f) — Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear
☐ (g) — Compelling insureds to institute litigation to recover amounts due under an insurance policy by offering substantially less than the amounts ultimately recovered in actions brought by such insureds
☐ (h) — Attempting to settle a claim for less than the amount a reasonable person would have expected from written or printed advertising material accompanying or included with the application
☐ (n) — Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement
The conduct described above may support an unfair-settlement-practice claim under § 33-11-4(9) if evidence establishes a general business practice and the underlying liability and damages have been resolved.
VII. DAMAGES
A. Contract / Policy Benefits Withheld
| Component | Amount |
|---|---|
| Policy benefits owed | $[________] |
| Less amounts paid to date | ($[________]) |
| Net Policy Benefits Due | $[________] |
B. Hayseeds Consequential Damages (Hayseeds, 177 W. Va. 323 (1986))
The following losses may be recoverable if our client substantially prevails and proves the amount and causal link required by Hayseeds:
| Category | Description | Amount |
|---|---|---|
| Net economic loss from delay | [________________________________] | $[________] |
| Loss of use / displacement costs | [________________________________] | $[________] |
| Carrying costs / mortgage interest | [________________________________] | $[________] |
| Business interruption / lost revenue | [________________________________] | $[________] |
| Storage costs | [________________________________] | $[________] |
| Other direct economic loss | [________________________________] | $[________] |
| Total Net Economic Loss | $[________] | |
| Aggravation and inconvenience | [Describe physical and emotional burden on client] | $[________] |
C. Hayseeds Attorney's Fees (Presumptive Formula)
Under Hayseeds, reasonable attorney's fees are presumptively one-third of the face amount of the policy — subject to upward or downward adjustment only if the policy is "either extremely small or enormously large."
Presumptive Hayseeds Attorney's Fee Calculation:
| Item | Amount |
|---|---|
| Policy face amount | $[________________________________] |
| Presumptive attorney's fee (1/3) | $[________] |
This fee is owed in addition to all other damages — it is not deducted from the client's recovery.
D. Emotional Distress Damages
If supported by the claim and evidence, our client seeks proven damages for aggravation and inconvenience arising from the claims process, as recognized in Hayseeds. Describe the effect and proof:
[________________________________]
[________________________________]
[________________________________]
Proven aggravation and inconvenience: $[________]
E. Punitive Damages — W. Va. Code § 55-7-29
[________________________________]'s conduct rises to the level of actual malice required for punitive damages because [________________________________] actually knew this claim was valid and properly owed but willfully, maliciously, and intentionally [denied / delayed / undervalued] it for the following reasons:
☐ Internal documents (which we anticipate will be revealed in discovery) will show that [________________________________]
☐ [________________________________]'s own adjuster notes reflect [________________________________]
☐ The Company received [________________________________] confirming the claim's validity but nevertheless [________________________________]
☐ The pattern of conduct — [____] months of delay, [____] inadequate offers, and [____] unanswered communications — reflects deliberate indifference, not oversight
☐ [________________________________]
Punitive damages — maximum exposure under W. Va. Code § 55-7-29:
| Compensatory Damages | 4× Cap | Statutory Alternative Cap | Applicable Cap |
|---|---|---|---|
| $[________] | $[________] | $500,000 | $[________] |
Section 55-7-29(c) states no specific-intent exception. The applicable ceiling is the greater of four times compensatory damages or $500,000 unless separate current controlling authority establishes a different result.
F. Total Demand Summary
| Component | Amount |
|---|---|
| Policy Benefits Due (net) | $[________] |
| Net Economic Loss (Hayseeds) | $[________] |
| Aggravation and Inconvenience (Hayseeds) | $[________] |
| Attorney's Fees (Hayseeds — 1/3 of policy) | $[________] |
| Emotional Distress Damages | $[________] |
| Punitive Damages (if applicable / demanded at this time) | $[________] |
| TOTAL DEMANDED | $[________________________________] |
VIII. FORMAL DEMANDS
Based on the foregoing, we hereby demand that [________________________________]:
A. Monetary Payment
Tender the sum of $[________________________________] in immediately available funds, by [__/__/____], representing:
☐ Full policy benefits due: $[________________________________]
☐ Net economic loss and consequential damages: $[________________________________]
☐ Aggravation and inconvenience: $[________________________________]
☐ Attorney's fees (Hayseeds — subject to final calculation upon resolution): $[________________________________]
☐ [________________________________]
B. Non-Monetary Demands
☐ Provide, within [____] days, a complete, unredacted copy of the entire claim file as of this date, including all adjuster notes, diary entries, internal communications, reserve history, supervisor approvals, expert reports, and valuation inputs
☐ Immediately cease and desist from [________________________________]
☐ Provide in writing, within [____] days, a full and specific explanation — citing the exact policy provisions and factual basis — for each item denied, depreciated, or underpaid
☐ Designate, within [____] days, a senior claims officer with authority to settle this claim for the amount demanded
☐ Acknowledge in writing that no further depreciation, offset, or deduction not already communicated will be applied to this claim
☐ Confirm that all documents and ESI relating to this claim are being preserved (see Section X below)
IX. TIME-LIMITED NATURE OF THIS DEMAND AND CONSEQUENCES
THIS DEMAND EXPIRES AT 5:00 P.M. EASTERN TIME ON [__/__/____].
Please respond to this demand by the stated date. Section 33-11-4(9)(f) addresses failure to attempt a prompt, fair settlement when liability is reasonably clear, but a separate implied unfair-practice claim still requires a general business practice and resolution of underlying liability and damages.
If [________________________________] fails to tender the demanded amount by [__/__/____]:
-
Immediate litigation in West Virginia Circuit Court — [________________________________] County — seeking:
- Full policy benefits
- Net economic loss, aggravation, and inconvenience (Hayseeds)
- Attorney's fees — presumptively 1/3 of policy face amount (Hayseeds)
- Relief on a separate § 33-11-4(9) claim only if its distinct predicates are established
- Punitive damages — up to 4× compensatory or $500,000 (W. Va. Code § 55-7-29)
- Pre- and post-judgment interest
- All other available relief
-
Regulatory complaint filed with:
- West Virginia Offices of the Insurance Commissioner
P.O. Box 50540, Charleston, WV 25305-0540
P&C consumer services: (304) 558-3386 | Toll-free: (888) 879-9842
Complaint route: https://www.wvinsurance.gov/Consumer-Services-P-C
- West Virginia Offices of the Insurance Commissioner
-
All prior settlement discussions are withdrawn. Once this deadline passes, our client will not entertain further settlement discussions below the full value of supported damages, including any punitive damages available within W. Va. Code § 55-7-29(c)'s cap.
-
Media / Public interest notification may be provided to the extent appropriate and permissible under West Virginia law.
X. DOCUMENT PRESERVATION DEMAND
This letter constitutes formal legal notice that [________________________________] must immediately preserve all documents and electronically stored information (ESI) relating to this claim, including without limitation:
☐ The complete claim file — all versions, drafts, notes, and prior iterations
☐ All internal communications (email, text, chat, memo) regarding this claim and coverage decisions
☐ Adjuster diary, activity log, and field notes — all entries
☐ Reserve history — initial reserve, all changes, explanations, and approvals
☐ Supervisor / manager instructions, approvals, and overrides
☐ All expert reports, estimates, IME reports, engineering reports, and cause-and-origin analyses
☐ All documents received from or sent to the insured, contractors, public adjusters, or other parties
☐ All photographs, videos, and inspection materials
☐ Claims-handling guidelines, manuals, training materials, and Best Practices documents in effect at the time of adjustment
☐ Any algorithmic, computer-assisted, or automated claim evaluation outputs (e.g., Colossus, Xactimate parameters, pricing overrides, settlement authority matrices)
☐ Quality assurance, audit, and peer-review records for this claim
☐ Litigation hold notices issued by [________________________________] regarding this claim
☐ Reinsurance communications regarding this claim or similar claims
☐ Statistical or actuarial data regarding claims of this type
Failure to preserve these materials after receipt of this notice will result in an application for spoliation sanctions, adverse inference jury instructions, and all other available remedies in subsequent litigation. West Virginia courts take ESI preservation obligations seriously, and we will not hesitate to pursue sanctions for any destruction of evidence.
XI. RESERVATION OF RIGHTS
Our client expressly reserves all rights and remedies available under West Virginia law, including but not limited to:
☐ The right to amend the claimed damages as additional losses are identified or quantified
☐ The right to seek punitive damages, when supported, subject to W. Va. Code § 55-7-29's standard, procedure, and cap and any separately verified controlling authority
☐ The right to pursue individual claims against [________________________________]'s adjusters, supervisors, and officers under West Virginia law
☐ The right to seek class action status if [________________________________]'s conduct proves to be a general business practice affecting multiple West Virginia policyholders
☐ The right to seek attorney's fees in excess of the Hayseeds presumptive formula if the circumstances warrant
☐ All applicable rights under the WV Insurance Guaranty Association Act (W. Va. Code § 33-26-1 et seq.) if an insurer insolvency affects this claim
☐ [________________________________]
Nothing in this letter constitutes a waiver of any right, claim, or remedy available to our client.
XII. CONCLUSION
West Virginia law provides additional relief when the required claim-specific elements are proved. Hayseeds addresses a policyholder who substantially prevails on a property-damage claim; Marshall extends specified relief to UM/UIM coverage suits. A separate § 33-11-4(9) claim requires proof of its general-business-practice predicate, and any punitive request must satisfy the applicable cause of action and W. Va. Code § 55-7-29.
[________________________________]'s conduct in handling our client's claim has been [unreasonable / egregious / in textbook violation of West Virginia law]. We have documented the violations meticulously. We are fully prepared to try this case before a West Virginia jury, which will hear all of the evidence described in this letter.
Use this final opportunity to resolve this matter fairly. Tender $[________________________________] on or before [__/__/____].
Respectfully submitted,
[________________________________]
By: [________________________________]
[________________________________], Esq.
WV Bar No. [________]
[________________________________]
[________________________________], WV [________]
Tel: [________________________________]
Fax: [________________________________]
Email: [________________________________]
Counsel for [________________________________]
ENCLOSURES:
☐ Policy declarations page and relevant coverage provisions
☐ Chronological claim correspondence file
☐ Our client's demand / proof of loss documentation
☐ Photographs, inspection reports, and evidence supporting the claim
☐ Contractor / expert estimates supporting the claimed amount
☐ Written denial letter(s) from [________________________________] — with our annotations
☐ [________________________________]'s own adjuster report (if obtained)
☐ Expert reports supporting our client's position
☐ [________________________________]
CC:
- [________________________________] (Client) — via separate secure transmission
- [________________________________] (Senior Claims Officer / Regional Director)
- [________________________________] (General Counsel / Legal Department)
- West Virginia Offices of the Insurance Commissioner — P.O. Box 50540, Charleston, WV 25305-0540 (if regulatory complaint filed concurrently)
- File
WEST VIRGINIA BAD FAITH LAW — QUICK REFERENCE
| Element | West Virginia Rule |
|---|---|
| Statutory unfair-practice standard | W. Va. Code § 33-11-4(9) requires a general business practice for an implied claim |
| First-party relief | Hayseeds addresses property-damage coverage relief; Marshall extends specified relief to UM/UIM suits; Jenkins and McCormick discuss the distinct implied § 33-11-4(9) claim |
| Third-party private action | ABOLISHED in 2005 by W. Va. Code § 33-11-4a; sole remedy = WV OIC administrative complaint |
| Hayseeds — attorney fees | Presumptively 1/3 of policy face amount when insured substantially prevails |
| Hayseeds — good faith irrelevant | Substantial success on a covered property-damage claim, not insurer bad faith alone, triggers the specified relief |
| Hayseeds — consequential damages | Net economic loss from delay + aggravation and inconvenience |
| Punitive damages standard | Actual malice (insurer KNEW claim was proper but willfully denied) |
| Punitive damages cap | Greater of 4× compensatory or $500,000 — W. Va. Code § 55-7-29 |
| Shamblin duty | Settle within policy limits; insurer bears burden of proof (clear & convincing) |
| Marshall v. Saseen | Shamblin applies to UM/UIM carriers |
| Contract SOL | 10 years — W. Va. Code § 55-2-6 |
| Separate unfair-practice SOL | Determine period and accrual from controlling claim-specific authority; § 55-2-12 alone does not establish an appeal-period trigger |
| Punitive bifurcation | Jury action may be bifurcated upon any defendant's request — W. Va. Code § 55-7-29(b) |
| WV Insurance Regulator | WV Offices of the Insurance Commissioner, P.O. Box 50540, Charleston, WV 25305 |
SOURCES AND REFERENCES
- W. Va. Code § 33-11-4 (UTPA): https://code.wvlegislature.gov/33-11-4/
- W. Va. Code §§ 55-2-6, 55-2-12(c), and 33-6-14 (limitations and policy suit clauses): § 55-2-6, § 55-2-12, § 33-6-14
- Wilt v. State Automobile Mutual Insurance Co., No. 24579 (W. Va. June 24, 1998): official opinion
- Noland v. Virginia Insurance Reciprocal, No. 34702 (W. Va. Sept. 24, 2009): official opinion
- Potesta v. United States Fidelity & Guaranty Co., No. 24441 (W. Va. May 15, 1998): official opinion
- W. Va. Code § 33-11-4a (Abolition of Third-Party Private Action; sole third-party remedy is administrative complaint): https://code.wvlegislature.gov/33-11-4A/
- Jenkins v. J.C. Penney Cas. Ins. Co., 167 W. Va. 597, 280 S.E.2d 252 (1981) (statutory bad faith — general business practice)
- McCormick v. Allstate Ins. Co., 197 W. Va. 415, 475 S.E.2d 507 (1996) (common-law Hayseeds claim distinguished from statutory UTPA claim)
- W. Va. Code § 55-7-29 (Punitive Damages Cap): https://code.wvlegislature.gov/55-7-29/
- Hayseeds, Inc. v. State Farm Fire & Cas., 177 W. Va. 323, 352 S.E.2d 73 (1986): https://law.justia.com/cases/west-virginia/supreme-court/1986/16782-5.html
- Shamblin v. Nationwide Mut. Ins. Co., 183 W. Va. 585, 396 S.E.2d 766 (1990): https://law.justia.com/cases/west-virginia/supreme-court/1990/19035-5.html
- Marshall v. Saseen, 192 W. Va. 94, 450 S.E.2d 791 (1994): https://www.courtswv.gov/sites/default/pubfilesmnt/2023-11/22038.pdf
- Justia — W. Va. Code § 33-11-4a (2012): https://law.justia.com/codes/west-virginia/2012/chapter33/article11/33-11-4a
- Chartwell Law — West Virginia Bad Faith Map: https://www.chartwelllaw.com/bad-faith-claims-map/west-virginia
- WV Young Lawyers Section — Insurance Law Handbook: https://wvyounglawyers.com/practice-handbook/insurance-law/
- Bordas & Bordas — Hayseeds Damages: https://www.bordaslaw.com/blog-posts/the-cost-of-a-wrongly-denied-insurance-claim-hayseeds-damages/
- WV Office of the Insurance Commissioner: https://www.wvinsurance.gov
- Frost Brown Todd — WV Punitive Damages Statute: https://frostbrowntodd.com/wv-supreme-court-clarifies-role-of-punitive-damages-statute/
About this template
- Last updated
- November 6, 2026
- Jurisdiction
- West Virginia
- Category
- Demand Letters
Legal authority
- W. Va. Code § 33-11-4(9) (Unfair Trade Practices Act — specific prohibited claims practices)
- W. Va. Code § 33-11-4a (third-party administrative remedy; does not create a first-party private action)
- Jenkins v. J.C. Penney Cas. Ins. Co., 167 W. Va. 597, 280 S.E.2d 252 (1981) (statutory bad faith based on UTPA violation — general business practice)
- McCormick v. Allstate Ins. Co., 197 W. Va. 415, 475 S.E.2d 507 (1996) (distinguishing common-law Hayseeds claim from statutory UTPA bad faith)
- W. Va. Code § 55-7-29 (punitive damages — clear and convincing evidence of actual malice or conscious, reckless, and outrageous indifference; statutory cap)
- W. Va. Code § 55-2-6 (written-contract limitations period, subject to applicable policy suit clauses)
- W. Va. Code § 33-6-14 (minimum policy suit period for covered non-marine policies; standard fire policy excepted)
- W. Va. Code § 55-2-12(c) (one-year period for separate bad-faith and unfair-settlement claims under Wilt and Noland)
- Wilt v. State Automobile Mutual Insurance Co., No. 24579 (W. Va. June 24, 1998) (unfair-settlement limitation)
- Noland v. Virginia Insurance Reciprocal, No. 34702 (W. Va. Sept. 24, 2009) (common-law bad-faith limitation)
- Potesta v. United States Fidelity & Guaranty Co., No. 24441 (W. Va. May 15, 1998) (late coverage defenses, waiver and estoppel)
- Hayseeds, Inc. v. State Farm Fire & Cas., 177 W. Va. 323, 352 S.E.2d 73 (1986) (attorney fees + net economic loss + aggravation/inconvenience when insured substantially prevails — applies even if insurer acted in GOOD faith)
- Shamblin v. Nationwide Mut. Ins. Co., 183 W. Va. 585, 396 S.E.2d 766 (1990) (insurer's duty to settle within policy limits; excess verdict liability)
- Marshall v. Saseen, 192 W. Va. 94, 450 S.E.2d 791 (1994) (UM/UIM policy limits, fees, proven aggravation/inconvenience; separate excess-verdict action)
- W. Va. Code § 55-7-13A et seq. (modified comparative fault — recovery allowed at 50%, barred above 50%)
A demand letter is a formal written request to fix a problem or pay what is owed, sent before anyone files a lawsuit. It gives the other side a real chance to settle, creates a record of your attempt to resolve things, and in many cases (unpaid debts, insurance claims, broken contracts) starts a legally required response window. A well-written demand letter lays out what happened, what you want, and a deadline to act, which is often enough to get results without ever going to court.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
The statutes this template relies on are listed under Legal authority.
W. Va. Code § 33-26-1 (checked November 6, 2026): "This article may be cited as the "West Virginia Insurance Guaranty Association Act.""
Hayseeds, Inc. v. State Farm Fire & Cas., 177 W. Va. 323, 352 S.E.2d 73 (1986) (checked November 6, 2026): "Whenever a policyholder substantially prevails in a property damage suit against its insurer"
Marshall v. Saseen, 192 W. Va. 94, 450 S.E.2d 791 (1994) (UM/UIM relief) (checked November 6, 2026): "the policyholder's reasonable attorney fees, and damages proven for aggravation and inconvenience."
W. Va. Code § 33-11-4a(a)-(b) (checked September 19, 2026): "A third-party claimant may not bring a private cause of action or any other action against any person for an unfair claims settlement practice. A third-party claimant's sole remedy against a person for an unfair claims settlement practice or the bad faith settlement of a claim is the filing of an administrative complaint with the Commissioner in accordance with subsection (b) of this section. The administrative complaint shall be filed as soon as practicable but in no event later than one year following the actual or implied discovery of the alleged unfair claims settlement practice."
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