Templates Demand Letters Insurance Bad Faith Demand Letter - West Virginia

Insurance Bad Faith Demand Letter - West Virginia

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INSURANCE BAD FAITH DEMAND LETTER

State of West Virginia


[LAW FIRM LETTERHEAD]

PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION — FOR RESOLUTION PURPOSES ONLY
PROTECTED UNDER W. VA. R. EVID. 408 AND F.R.E. 408


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 constitutes a formal bad faith demand and notice of the Company's statutory and common law violations in its handling of our client's claim. It is addressed to you, your supervisors, and the Company's legal department simultaneously because the conduct described herein is of a severity that demands immediate attention at the highest levels of your organization.

Context — West Virginia Is a Uniquely Hostile Jurisdiction for Insurer Bad Faith:

West Virginia has among the most policyholder-protective bad faith laws in the United States. I have practiced insurance law in West Virginia for [____] years, and the conduct described in this letter represents some of the most egregious claims-handling I have witnessed. The Company faces exposure under (a) the common-law first-party bad faith claim under Hayseeds, Jenkins, and McCormick — which uniquely awards attorney's fees and consequential damages to insureds who substantially prevail against their insurer regardless of whether the insurer acted in good or bad faith — and (b) the statutory Unfair Trade Practices Act standards codified at W. Va. Code § 33-11-4(9), where violations rise to a general business practice or constitute a single sufficiently serious violation. W. Va. Code § 33-11-4a abolished the third-party private cause of action in 2005 but does not alter the first-party common-law remedies, which remain robust.

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. Dual System: Statutory + Common Law Bad Faith

West Virginia recognizes two overlapping — and cumulative — bad faith frameworks:

1. Statutory Bad Faith — W. Va. Code § 33-11-4 (UTPA)

The West Virginia Unfair Trade Practices Act, W. Va. Code § 33-11-4(9), defines specific unfair claims settlement practices. A violation constitutes bad faith when it is committed with such frequency as to constitute a general business practice, or when a single serious violation inflicts actual injury on the insured.

2. Common Law Bad Faith

Independent of the UTPA, West Virginia common law imposes a duty of good faith and fair dealing on all insurers. The implied covenant of good faith requires insurers to:

  • 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. First-Party Private Cause of Action — Common Law (Hayseeds / Jenkins / McCormick)

A critical and WV-specific distinction: Only first-party insureds — policyholders suing their own insurer — may pursue a private bad-faith cause of action in court. The first-party private COA arises from West Virginia common law as articulated in Hayseeds, Inc. v. State Farm Fire & Cas., 177 W. Va. 323 (1986); Jenkins v. J.C. Penney Cas. Ins. Co., 167 W. Va. 597 (1981); and McCormick v. Allstate Ins. Co., 197 W. Va. 415 (1996). The UTPA standards in W. Va. Code § 33-11-4(9) supply the substantive yardstick for the statutory variant of the claim. W. Va. Code § 33-11-4a abolished the THIRD-party private cause of action in 2005; third-party claimants' sole remedy is an administrative complaint with the WV Insurance Commissioner. § 33-11-4a does not eliminate the first-party common-law right.

Our client is the named insured (first-party claimant) and therefore retains a direct private cause of action against the Company.

[☐ Third-Party Context Note: If this claim also involves an excess verdict against the insured, the insured may assign their first-party bad faith rights against the insurer to a third-party plaintiff as an alternative pathway. See Section II.F below.]

Available damages under the first-party common-law claim and § 33-11-4(9):

  • 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 of actual malice (W. Va. Code § 55-7-29)
  • 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), is the cornerstone of West Virginia bad faith jurisprudence. The Hayseeds court held that whenever a first-party policyholder substantially prevails in any insurance dispute, the insurer must pay:

"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 moment the insurer breaches its policy — regardless of intent — and the insured substantially prevails, the full Hayseeds remedy flows automatically.

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, 196 W. Va. 659, 474 S.E.2d 529 (1996)
  • Duty-to-defend cases
  • Property damage / fire claims
  • All other first-party insurance contexts

D. Punitive Damages — W. Va. Code § 55-7-29

West Virginia imposes actual malice as the standard for punitive damages in bad faith cases: the insurer must have actually known the claim was proper but willfully, maliciously, and intentionally denied or delayed it. The standard is demanding, but when met, the Hayseeds consequential/attorney fee damages stack on top of punitive damages.

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 cap does not apply if the insurer engaged in conduct with the specific intent to cause injury. For egregious misconduct, the cap may be challenged or exceeded.

Bifurcated trial procedure: Under § 55-7-29(c), a defendant may request a bifurcated trial — compensatory damages in Phase 1, punitive damages in Phase 2.

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:

  1. Whether there was appropriate investigation and evaluation based on objective, cogent evidence
  2. Whether there was a genuine and substantial issue as to the insured's liability
  3. Whether there was potential for a substantial excess verdict against the insured

If [________________________________] has exposed our client to personal liability exceeding the policy limits, the Company is also liable for the full excess verdict under Shamblin. See Marshall v. Saseen, 196 W. Va. 659, 474 S.E.2d 529 (1996).

F. Assignment of Bad Faith Rights

Under West Virginia law, an insured may assign their first-party bad faith rights against their own insurer to a judgment creditor (third-party claimant). If such an assignment has occurred or is contemplated in this matter, note that the assignee steps into the shoes of the insured and may pursue all § 33-11-4a remedies, including punitive damages and attorney's fees.

G. Statute of Limitations

Claim Type Limitations Period Statute
Insurance contract (written policy) 10 years from breach W. Va. Code § 55-2-6
UTPA bad faith claim 1 year after underlying appeal period expires W. Va. Code § 55-2-12
Common law bad faith / tort 2 years from discovery W. Va. Code § 55-2-12
Administrative UTPA complaint (third parties) 1 year from discovery W. Va. Code § 33-11-4a

The UTPA limitations period begins after the underlying coverage dispute is finally resolved on appeal, not from the date of the claim denial. This protects insureds who are litigating coverage while the bad faith clock runs.


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 [________________________________].

Under West Virginia's policy interpretation principles, all ambiguities are construed against the insurer and in favor of the insured. The Company cannot now raise coverage defenses that were not timely and clearly communicated, as this would constitute misrepresentation of policy provisions in violation of W. Va. Code § 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

[________________________________] failed to conduct the thorough, fair, and objective investigation required by W. Va. Code § 33-11-4(9)(c) in the following respects:

☐ 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 has been compelled to litigate this claim by offering substantially less than the amounts our client is entitled to recover — a direct violation of W. Va. Code § 33-11-4(9)(f).

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
☐ [________________________________]

This conduct directly violates W. Va. Code § 33-11-4(9)(f), which prohibits compelling insureds to institute litigation to recover amounts due.

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 to which a reasonable person would have believed they were entitled
(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 above violations constitute an unfair claims settlement practice — either as a general business practice or as a single sufficiently serious violation — entitling our client to all available remedies under Hayseeds, Jenkins, McCormick, and the UTPA standards of W. Va. Code § 33-11-4(9).


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 consequential damages flow automatically from [________________________________]'s breach of the insurance contract — regardless of whether the Company acted in good or bad faith — upon our client's substantial prevailment:

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

Under West Virginia common law bad faith (Hayseeds / Jenkins / McCormick) and the UTPA standards of W. Va. Code § 33-11-4(9), our client has suffered the following compensable emotional distress and mental anguish as a direct result of [________________________________]'s bad faith conduct:

[________________________________]
[________________________________]
[________________________________]

Emotional distress damages: $[________]

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 $[________]

Note: The cap does not apply if [________________________________] acted with the specific intent to cause injury, in which case punitive damages may exceed $500,000.

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 [__/__/____].

West Virginia does not have a codified time-limited demand statute (unlike some other states). However, under West Virginia bad faith law, the Company's failure to respond to a reasonable policy-limits demand when liability and damages are clear is itself evidence of bad faith under W. Va. Code § 33-11-4(9)(f) and (g). See Shamblin v. Nationwide Mut. Ins. Co., 183 W. Va. 585, 396 S.E.2d 766 (1990).

If [________________________________] fails to tender the demanded amount by [__/__/____]:

  1. 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)
    - Actual and consequential damages (common-law bad faith; UTPA standards under W. Va. Code § 33-11-4(9))
    - Punitive damages — up to 4× compensatory or $500,000 (W. Va. Code § 55-7-29)
    - Pre- and post-judgment interest
    - All other available relief

  2. Regulatory complaint filed with:
    - West Virginia Offices of the Insurance Commissioner
    P.O. Box 50540, Charleston, WV 25305-0540
    Tel: (304) 558-3354 | Toll-free: (888) 879-9842
    Complaint Form: www.wvinsurance.gov

  • National Association of Insurance Commissioners (NAIC)
  1. All prior settlement discussions are withdrawn. Once this deadline passes, our client will not entertain further settlement discussions below the full value of all damages, including uncapped punitive damages.

  2. 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 without the limitations in W. Va. Code § 55-7-29 if [________________________________]'s conduct is shown to have involved the specific intent to injure
☐ 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 rights under the WV Insurance Guaranty Association Act (W. Va. Code § 33-26A-1 et seq.) if applicable
☐ [________________________________]

Nothing in this letter constitutes a waiver of any right, claim, or remedy available to our client.


XII. CONCLUSION

West Virginia law is unequivocal: an insurer that breaches its contract with a policyholder will pay not only the policy benefits wrongfully withheld, but also the policyholder's attorney's fees, the economic losses caused by the delay, and — when the insurer's conduct rises to actual malice — punitive damages as well. This is the promise of Hayseeds, Jenkins, McCormick, and the Unfair Trade Practices Act standards at W. Va. Code § 33-11-4(9).

[________________________________]'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 bad faith standard W. Va. Code § 33-11-4(9) — Unfair Trade Practices Act (general business practice OR single serious violation)
First-party private action Common law — Hayseeds, Jenkins, McCormick (FIRST-PARTY INSUREDS ONLY)
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 Even a good-faith breach triggers Hayseeds liability
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
UTPA SOL 1 year after underlying appeal period expires
Tort / bad faith SOL 2 years — W. Va. Code § 55-2-12
Punitive bifurcation Defendant may request bifurcated trial — W. Va. Code § 55-7-29(c)
WV Insurance Regulator WV Offices of the Insurance Commissioner, P.O. Box 50540, Charleston, WV 25305

SOURCES AND REFERENCES

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About This Template

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.

Important Notice

This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Last updated: May 2026