Insurance DOI Complaint and Bad-Faith Demand — Maryland

Insurance DOI Complaint and Bad-Faith Demand (MARYLAND)

Quick-Reference Summary

PART A — MIA COMPLAINT COVER LETTER AND MANDATORY § 27-1001 FILING

Sender Information

[CLAIMANT/INSURED FULL LEGAL NAME]
[Street Address]
[City, MD ZIP]
Telephone: [(___) ___-____]
Email: [____________________]

Date: [__/__/____]

VIA ONLINE PORTAL AND U.S. MAIL

Maryland Insurance Administration
Attn: Consumer Complaint Investigation
[☐ Property and Casualty / ☐ Life and Health / ☐ Appeals and Grievance]
200 St. Paul Place, Suite 2700
Baltimore, MD 21202

Re: Consumer Complaint AND Administrative Filing Under Md. Code Ann., Ins. § 27-1001 — Failure to Act in Good Faith Under Cts. & Jud. Proc. § 3-1701; Unfair Claim Settlement Practices Under Ins. §§ 27-303, 27-304

To the Maryland Insurance Administration:

Pursuant to Md. Code Ann., Ins. § 27-1001, the undersigned files this administrative complaint as a prerequisite to a civil action under Md. Code Ann., Cts. & Jud. Proc. § 3-1701, and as a consumer complaint under Ins. §§ 27-303 and 27-304.

I. Insured–Insurer Relationship

1. [INSURER] issued Policy No. [_______] to Claimant, effective [__/__/____]. The policy was in full force on the date of loss with all premiums paid.

2. The applicable coverage is [coverage type]; the applicable limit is $[________]. Exhibit A is the declarations page.

II. The Claim

3. On [__/__/____], a covered loss occurred: [DETAILED DESCRIPTION].

4. On [__/__/____], Claimant submitted proof of loss to the carrier. Exhibits B-1 through B-[#] are EVERY DOCUMENT SUBMITTED AS PROOF OF LOSS (required by § 27-1001(d)(2)(i)).

5. Claim handling chronology: [DATED CHRONOLOGY of adjuster communications, inspections, partial payments, and the date and basis of denial or under-payment].

III. The Insurer Breached Its Coverage Obligation

6. The policy plainly covers the loss because [policy citation and analysis]. The carrier's denial / under-payment is contrary to the plain policy language and to controlling Maryland authority.

IV. The Insurer Failed to Act in Good Faith (Ins. § 27-1001(a))

7. "Good faith" requires "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." Ins. § 27-1001(a). The carrier did not act in good faith because:

a. No reasonable investigation. [Specifics: failure to inspect, failure to interview, failure to retain qualified experts.]

b. Unsupported coverage position. [Carrier's stated basis for denial and why it is not supported by evidence the carrier knew or should have known.]

c. Material misrepresentation. [If applicable: carrier mis-stated policy language or facts.]

d. Departures from regulatory standards under COMAR 31.15.07.

e. Pattern of similar conduct. [Specifics evidencing general business practice — relevant to § 27-304.]

V. Unfair Claim Settlement Practices Under Ins. § 27-303

The carrier's conduct constitutes one or more of the following unfair claim settlement practices:

☐ § 27-303(1) — Misrepresenting pertinent facts or policy provisions.
☐ § 27-303(2) — Refusing to pay without conducting a reasonable investigation.
☐ § 27-303(3) — Failing to include applicable benefits/coverages.
☐ § 27-303(4) — Failing to act with reasonable promptness in response to claim communications.
☐ § 27-303(5) — Failing to settle promptly under one coverage to influence settlement under another.
☐ § 27-303(6) — Failing to provide a reasonable explanation of the basis for denial or compromise.

[Add specific facts under each subsection.]

VI. Damages Claimed Under § 3-1701 / § 27-1001

VII. Requested MIA Action

Claimant respectfully requests that the Administration:

1. Forward this filing to the insurer (Ins. § 27-1001(d)(3));
2. Require the insurer's written response within 30 days, accompanied by all claim-file documents enabling reconstruction of claim activities (§ 27-1001(d)(4));
3. Issue a written decision within 90 days addressing:
   - Whether the carrier is obligated to cover the underlying first-party claim;
   - The amount the insured was entitled to receive under the policy;
   - Whether the carrier breached its obligation;
   - Whether the carrier failed to act in good faith; and
   - The amount of actual damages, expenses, litigation costs, and interest.

VIII. Documents Submitted

• Exhibit A — Policy declarations page
• Exhibits B-1 through B-[#] — Every document submitted to insurer as proof of loss (§ 27-1001(d)(2)(i))
• Exhibit C — Complete chronology of claim communications
• Exhibit D — Denial / low-ball offer letter and any reservation-of-rights letter
• Exhibit E — Expert reports, appraisals, repair estimates, medical summaries, photographs
• Exhibit F — Documentation of expenses and litigation costs to date
• Exhibit G — Signed MIA Complaint Form

Respectfully submitted,

___________________________________
[CLAIMANT FULL NAME / COUNSEL]
[Title, if counsel]
MD AIS / Bar No. [_____]
Date: [__/__/____]

PART B — BAD-FAITH DEMAND LETTER TO CARRIER

Sender Letterhead

[CLAIMANT / COUNSEL NAME]
[Address]
[City, MD ZIP]
[Telephone] | [Email]

Date: [__/__/____]

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
Tracking No.: [____________________]
AND VIA FIRST-CLASS MAIL
AND VIA EMAIL TO [[email protected]]

[INSURER LEGAL NAME]
Attn: General Counsel and Senior Claims Officer
[Registered Agent Address — verify via https://egov.maryland.gov/BusinessExpress/EntitySearch]
[City, State ZIP]

Cc: Maryland Insurance Administration; [Handling Adjuster]

Re: Demand for Payment and Notice of Bad-Faith Claim Under Md. Code Ann., Cts. & Jud. Proc. § 3-1701; § 27-1001 Administrative Filing Concurrently Submitted to MIA

I. Notice and Purpose

This letter is formal demand for payment of the above-identified Maryland first-party insurance claim and notice of a first-party bad-faith claim under Cts. & Jud. Proc. § 3-1701. A concurrent administrative complaint has been filed with the Maryland Insurance Administration pursuant to the mandatory exhaustion requirement of Md. Code Ann., Ins. § 27-1001.

II. Coverage and Breach

[Concise statement: policy in force, coverage applicable, proof of loss submitted, carrier's denial/under-payment, why the carrier's coverage position is wrong as a matter of policy language and Maryland law.]

III. Failure to Act in Good Faith

The carrier failed to act in good faith — that is, did not exercise an informed judgment based on honesty and diligence supported by evidence the carrier knew or should have known at the time of decision — because:

1. [Specific failures of investigation];
2. [Specific facts the carrier knew or should have known that compel coverage];
3. [Specific COMAR 31.15.07 / Ins. § 27-303 violations];
4. [Pattern evidence under Ins. § 27-304 — frequency indicating general business practice];
5. [Failure to comply with § 27-1001(d) production obligations, if applicable].

IV. Damages Under § 3-1701

Maryland § 3-1701 does not authorize punitive damages, but Claimant reserves the right to pursue common-law claims (e.g., breach of contract, breach of the implied covenant, and — where actual malice is supported — tort claims with potential punitive exposure).

V. Demand for Relief — Thirty (30) Day Window

Within thirty (30) days of the carrier's receipt of this letter (which coincides with the carrier's § 27-1001(d)(4) response deadline), Claimant demands:

1. Payment of $[________] in actual damages and policy benefits;
2. Payment of $[________] in interest;
3. Payment of $[________] in expenses, costs, and reasonable attorneys' fees;
4. Production to the MIA of all required claim-file documents (§ 27-1001(d)(4)(i));
5. Preservation of all internal claim notes, vendor reports, and reserve analyses (litigation hold demanded);
6. Signed release in mutually agreeable form upon payment.

Failure to make a reasonable written tender will result in (a) Claimant pressing the MIA process to a written decision under § 27-1001(e), and (b) upon exhaustion, filing a civil action under § 3-1701 in the appropriate circuit court seeking actual damages, interest, expenses, litigation costs, and reasonable attorneys' fees.

Respectfully,

___________________________________
[CLAIMANT / COUNSEL NAME]
[Title, if counsel]
MD AIS / Bar No. [_____] (if counsel)

Enclosures: [Exhibits A–G as listed]

PART C — PRE-FILING CHECKLIST

Threshold Exhaustion Analysis (CRITICAL)

☐ Confirmed the claim is a first-party property or casualty claim under § 3-1701.
☐ Determined whether MIA exhaustion is REQUIRED (§ 27-1001) or whether one of the three exceptions applies:
☐ District Court small-claim jurisdiction (currently up to $5,000)?
☐ Insurer and insured agreed in writing to waive § 27-1001?
☐ Commercial policy with applicable limit > $1,000,000?
☐ If none of the exceptions applies — DO NOT file in court before completing the MIA process; doing so is fatal to the § 3-1701 claim.

Before Filing the MIA Complaint

☐ Confirmed policy is a Maryland-issued or Maryland-applicable property/casualty/life/health policy.
☐ Gathered EVERY document submitted to the insurer as proof of loss (§ 27-1001(d)(2)(i)).
☐ Identified specific coverage and policy limits.
☐ Quantified actual damages, expenses, and litigation costs.
☐ Identified specific § 27-303 / § 27-304 / COMAR 31.15.07 violations.
☐ Identified specific facts establishing failure to act in good faith under § 27-1001(a) "knew or should have known" standard.
☐ Completed and signed MIA Complaint Form (P&C or L&H as applicable).
☐ Decided submission method: online portal (preferred) / email / U.S. mail / fax.
☐ Calendared 30-day insurer response deadline and 90-day MIA decision deadline.
☐ Calendared § 5-101 3-year statute of limitations and § 27-1001 tolling.
☐ Confirmed limitations is being tolled during MIA pendency.

Before Sending the Carrier Demand

☐ Verified registered agent at https://egov.maryland.gov/BusinessExpress/EntitySearch.
☐ Letter cc's MIA so the carrier knows both tracks are active.
☐ Letter sent certified mail RRR + first-class + email.
☐ Letter quantifies all four § 3-1701 damages categories.
☐ Litigation-hold language included.
☐ Released expressly include § 3-1701 claim AND any common-law claims.

During the MIA Process

☐ Diary all MIA communications and carrier responses.
☐ Submit promptly any documents requested by MIA.
☐ Evaluate carrier's 30-day response and supplement complaint if needed.
☐ Track 90-day MIA decision deadline; silence = "no breach" determination under § 27-1001(e)(1)(ii).

After the MIA Decision

☐ Review MIA written decision.
☐ If unfavorable (or silence = "no breach"): file de novo appeal in circuit court within 30 days under § 27-1001.
☐ If favorable but inadequate damages: appeal de novo for full § 3-1701 damages.
☐ Plead § 3-1701 count separately from common-law claims.
☐ Attach MIA filing, carrier response, and MIA decision as exhibits.
☐ Demand actual damages + interest + expenses + costs + reasonable attorneys' fees in the prayer for relief.
☐ Preserve common-law claims with punitive exposure separately.

SOURCES AND REFERENCES

Maryland Statutes

• Md. Code Ann., Ins. § 27-303 — Unfair Claim Settlement Practices: https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gin&section=27-303
• Md. Code Ann., Ins. § 27-304 — UCSP General Business Practice
• Md. Code Ann., Ins. § 27-1001 — Mandatory Administrative Filing: https://law.justia.com/codes/maryland/insurance/title-27/subtitle-10/section-27-1001/
• Md. Code Ann., Cts. & Jud. Proc. § 3-1701 — First-Party Bad-Faith Action: https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gcj&section=3-1701
• Md. Code Ann., Cts. & Jud. Proc. § 11-107(a) — Pre-judgment Interest Rate
• Md. Code Ann., Cts. & Jud. Proc. § 5-101 — 3-Year Limitations
• Md. Code Ann., Cts. & Jud. Proc. § 4-405 — District Court Small-Claim Jurisdiction

Maryland Regulations (COMAR)

• COMAR 31.15.07 — Unfair Claim Settlement Practices

Key Cases / Authority

• Maryland Senate Bill 389 (2007) — origin of § 3-1701 / § 27-1001 framework

Maryland Insurance Administration

• File a Complaint landing page: https://insurance.maryland.gov/Consumer/pages/fileacomplaint.aspx
• Online Complaint Portal: https://enterprise.insurance.maryland.gov/consumer/ConsumerPortalWelcomePage.aspx
• P&C Complaint Form (PDF): https://insurance.maryland.gov/Consumer/Documents/pccomplaintform.pdf
• Life/Health Complaint Form (PDF): https://insurance.maryland.gov/Consumer/Documents/lh-agcomplaintform08-17rev.pdf
• Mailing: 200 St. Paul Place, Suite 2700, Baltimore, MD 21202
• Phone: 410-468-2000 / 1-800-492-6116
• P&C Email: [email protected]
• L&H Email: [email protected]

Maryland Business Entity Search

• https://egov.maryland.gov/BusinessExpress/EntitySearch

Related Templates in This Repository

• /insurance_law/universal/time_limited_demand_bad_faith.md
• /insurance_law/universal/coverage_position_denial_response.md
• /insurance_law/jurisdictional/md/bad_faith_demand_md.md
• /insurance_law/jurisdictional/md/insurance_claim_denial_appeal.md