60 DAYS: Prove Your Loss
In Georgia, you typically must submit a proof of loss to your insurance company within 60 days of the date of loss. Check the specific terms of your policy to confirm.
The Georgia Guide to Property Insurance Claims: Deadlines, Laws, and FAQs
Fact checked by Brelly Legal TeamLast updated on September 25, 2023
Like most states, Georgia has an expansive list of laws, rules, and deadlines that are applicable to homeowner’s and commercial property insurance claims. To make it easier to understand how these laws apply to property owners and the professionals who support them, we break down what you need to know to get your Georgia claim filed right, moving fast, and paid fully.
60 DAYS: Get Your Check
An insurance company must pay any portion of a claim that's not reasonably disputed within 60 days of receiving a written demand for payment.
Georgia Property Claim FAQs
Homeowners, businesses, and professionals will encounter all kinds of paperwork, process, and claims-related questions when confronted with the possibility of filing an insurance claim in Georgia. Here are some of the common questions you may encounter, with answers written by experts, like experienced attorneys, adjusters, and other insurance professionals.
Making Your Claim -- Frequently Asked Questions
The first step in your property insurance claim is to notify your insurer about your losses. Not only is doing this the only way to get your claim moving, it’s one of your duties of a loss under your insurance policy.
Is there a statutory deadline in Georgia to file a property insurance claim?
No, but you should still notify your insurance company about a loss promptly or immediately after it occurs.
Some states, like Florida, have laws that set specific deadlines for filing property insurance claims (for example, one year from the date of loss). Georgia is not one of those states, so the deadline in Georgia to notify your insurer about a loss is determined by your insurance policy, not state law. This first notice of loss typically starts the claim process, so very often notifying your insurance company about a loss is the same thing as “filing a claim.”
For fire claims in Georgia, your insurance policy probably requires you to give your insurance company “immediate written notice” of the loss. See Georgia’s standard fire policy. For types of losses other than fire, your policy may require “immediate” or “prompt” written notice of the loss. What counts as “immediate” or “prompt” depends on the specific circumstances of your claim.
Regardless of these requirements, it’s in your best interest to file a claim as soon as possible (more on that below).
When should I file a property insurance claim in Georgia?
As soon as possible.
Regardless of when your policy requires you to notify your insurer about a loss, it’s in your best interest to give that notice and file a claim as soon as you can.
More specifically, unless you’re confident that the cost of your losses will be less than your deductible, you should immediately notify your insurance company about your loss. The longer you wait to file your claim, the longer it will take to resolve your claim. Waiting too long to file your claim could also degrade or compromise important evidence about your claim.
Besides giving notice, what else do I have to do for my insurance claim in Georgia?
You have specific duties after a loss, and in Georgia (like elsewhere) you can find the list of those duties in your insurance policy. It’s essential that you comply with these duties, so follow each of them to a T. The exact language used to describe these duties varies from policy to policy.
For an *example* of what you might see in your policy, here are the duties after a loss stated in a State Farm homeowner’s insurance policy for a Georgia property:
“Your Duties After Loss. After a loss to which this insurance may apply, you must cooperate with us in the investigation of the claim and also see that the following duties are performed:
a. give immediate notice to us or our agent …
b. protect the property from further damage or loss …
c. prepare an inventory of damaged or stolen personal property:
(1) showing in detail the quantity, description, age, replacement cost, and amount of loss; and
(2) attaching all bills, receipts, and related documents that substantiate the figures in the inventory ;
d. as often as we reasonably require:
(1) exhibit the damaged property;
(2) provide us with any requested records and documents and allow us to make copies;
(3) while not in the presence of any other insured:
(a) give statements; and
(b) submit to examinations under oath ; and
(4) produce employees, members of the insured’s household, or others for examination under oath to the extent it is within the insured’s power to do so; and
e. submit to us, within 60 days after the loss, your signed, sworn proof of loss that forth, to the best of your knowledge and belief:
(1) the time and cause of loss;
(2) interest of the insured and all others in the property involved and all encumbrances on the property;
(3) other insurance that may cover the loss;
(4) changes in title or occupancy of the property during the term of this policy;
(5) specifications of any damaged structure and detailed estimate for repair of the damage;
(6) an inventory of damaged or stolen personal property, described in 2.c;
(7) receipts for additional living expenses incurred and records supporting the fair rental value loss; and
(8) evidence or affidavit supporting a claim under SECTION I – ADDITIONAL COVERAGES, Credit Card, Bank Fund Transfer Card, Forgery, and Counterfeit Money coverage, stating the amount and cause of loss.”
From Raymond v. State Farm Fire & Cas. Co., 614 F. Supp. 3d 1303, 1308 (N.D. Ga. 2022).
Proving Your Loss - Frequently Asked Questions
After you’ve notified your insurance company and started your claim, you need to prove your losses to your insurance company. Proving that your property suffered losses and that those losses are covered under your insurance policy is at the heart of an insurance claim. As a result, it’s also the most difficult stage in the claims process and where policyholders most often make mistakes. Fortunately, Georgia laws do provide you with basic protections at this stage under the Georgia Insurance Code. Read more to understand how.
When is the deadline in Georgia to file a Proof of Loss?
It depends on the terms of your policy, but usually within sixty (60) days of the loss. For fire losses, Georgia usually law requires you to send your insurer a proof of loss within sixty (60) days of the loss, unless your insurance company extends this deadline in writing.
For types of loss other than fire, Georgia law doesn’t impose any specific deadline on policyholders to file a proof of loss. But your policy probably does. When reviewing your policy to determine your deadline for submitting a proof of loss, consider these four questions:
Does the policy set a deadline to submit my proof of loss? (It usually does.)
If my policy does set a deadline, does the deadline automatically apply for all claims, or does it apply only if my insurance company specifically requests that I submit a proof of loss?
If my policy does set a deadline, how long is the deadline? (It’s usually 60 days, but sometimes it is 30 or 90 days)
If my policy does set a deadline, when is the start date for the deadline — the date of loss or the date when my insurance company requests me to submit a proof of loss?
Once you’ve answered these questions, you should have a much better understanding of your deadline to submit a proof of loss.
Rules and Regulations of the State of Georgia 120-2-19 (for fire losses only)
What is a “Proof of Loss?”
You will hear the term “Proof of Loss” a lot, and see it in your insurance policy. Do not be intimidated! This simply means that you must satisfactorily demonstrate to the insurance company that you sustained the loss you sustained, and the value of that loss.
There are some best practices for this — which includes filling out a “proof of loss form” and getting it notarized. This form and the act of notarizing it enables you to explain your losses “under oath,” which elevates your proof to the insurance company.
A proof of loss is a powerful tool for moving claims forward, but it’s not always necessary in Georgia. In other words, while you should prepare a robust Proof of Loss document, the requirement can be quite thin in the long run. In some instances, that is as simple as allowing a claims adjuster or other agent from the insurance company on your property.
Does Georgia permit an assignment of benefits (AOB) for my claim?
Yes.
If you were to look just at Georgia statutes, you would find Georgia Code § 33-24-17, which states, “A policy may be assignable or not assignable, as provided by its terms.” In other words, under this statute, if your policy allows assignment, you can do it, and if it doesn’t allow assignment, you can’t do it.
But more than a hundred years ago, the Georgia supreme court held that an insurance policy cannot prevent a policyholder from assigning post-loss benefits, and any terms in a policy attempting to do so are null and void. See Santiago v. Safeway Ins. Co.,
196 Ga. App. 480 (1990) (citing Georgia Co-Op. Fire Assn. v. Borchardt & Co., 123 Ga. 181, 183-184 (1905)). (For a very long time, Florida had the same rule, but recently the Florida legislature overturned it, and effectively banned AOBs for policies issued after 2022.) So for now, you’re free to enter an AOB in Georgia if that’s what you want to do.
New to AOBs? No problem. Check out our handy primer on assignments of benefits. It explains what they are, what they do, and offers pros and cons depending on your situation.
If I need help proving my losses in Georgia, can I hire a public adjuster?
Certainly.
Public adjusters are licensed insurance adjusters who work for policyholders instead of insurance companies. Not all claims need a public adjuster. But if your loss is complex or your claim has gone sideways, you might want to consider whether a public adjuster — or PA– would help. PAs do cost money, usually a percentage of the insurance payments they recover for you. And as you would for any other professional, it’s *essential* to do your homework before hiring a PA. You should start by confirming with the Georgia Insurance Commission’s website that the PA is properly licensed. But don’t stop there — read reviews and talk with references before signing a contract.
For a closer look at public adjusting in Georgia, check out our Georgia Guide to Public Adjusting.
Getting Your Check -- Frequently Asked Questions
Getting reimbursed for your losses — it’s the reason you pay premiums. Here are answer to frequently asked questions as this last, critical stage in your insurance claim.
How long will it take to get paid after filing a claim?
Typically 60 days after you’ve submitted a satisfactory proof of loss to your insurer and reached an agreement on payment with your insurer.
For instance, under the form fire policy in Georgia, insurers can take up to sixty (60) days after receiving both (1) your proof of loss and (2) the value of the loss is either agreed upon between you and the insurance company or an appraisal award has been finalized.
The requirement that you reach agreement on payment or have an appraisal finalized can be frustrating. But it’s worth noting that if you’ve submitted a rock-solid proof of loss, and the insurer denies it for more than sixty days without any good reason, the insurer’s denial might constitute bad faith under Georgia insurance law. So 60 days is a reasonable expectation for uncontroversial claims.
What happens if insurance offers me an amount I disagree with? How does arbitration work?
Here’s how it works in the standard fire policy:
In case you and your insurance company fail to agree as to the actual value or the amount of loss, then, on the written demand of either, each shall select a competent and disinterested appraiser and notify the other of the appraiser selected within twenty days of such demand.
The appraisers shall select a competent and disinterested umpire; and failing for fifteen days to agree upon such umpire, then, on request of you or your insurance, such umpire shall be selected by a judge of a court of record in the state in which the property covered is located.
The appraisers shall then appraise the loss, stating separately actual cash value and loss to each item; and, failing to agree, shall submit their differences, only, to the umpire. An award in writing, so itemized, of any two when filed with this Company shall determine the amount of actual cash value and loss. Each appraiser shall be paid by the party selecting him and the expenses of appraisal and umpire shall be paid by the parties equally.
Rules and Regulations of the State of Georgia 120-2-19.01 (Appraisal)
What are the requirements for proving insurance bad faith in Georgia?
To prevail on a claim for insurance bad faith in Georgia, an insured must prove three basic elements:
(1) Coverage: The policy actually covers the claim at issue.
(2) 60-day Demand Notice: The insurer must fail to pay on the claim within 60 days of the insured making a final demand for payment.
(3) Bad faith: The insurer’s failure to pay was motivated by bad faith. Bad faith means a “frivolous and unfounded refusal to pay a claim.” Bad faith is not easy to prove; an insurer will usually not be found to have acted in bad faith if it has any reasonable ground to contest the claim.
Georgia Statute § 33-4-6; Taylor v. Gov’t Emps. Ins. Co., 830 S.E.2d 235, 237 (2019). Under Georgia law, each of these requirements is “strictly construed,” Am. Reliable Ins. Co. v. Lancaster, 849 S.E.2d 697, 702 (2020), meaning that failing to fully and clearly meet any of these requirements will likely defeat a claim of bad faith.
What is the statute of limitations in Georgia to sue on an insurance claim?
In most claims, the deadline to sue for breach of an insurance contract is spelled out in the terms of your insurance policy. Often these policies set the limitation period as low as 1 year or 2 years from when you knew or should have know about the loss.
Although the general limitation period in Georgia for breach of contract (including insurance contracts) is six years, Georgia Code § 9-3-24, Georgia courts have held that insurance policies can shorten that period. Through these decisions, the courts have enforced limitations periods in insurance policies that are as short as one year. See White v. State Farm, 728 S.E.2d 685 (Ga. 2012).
There are exceptions, but they’re narrow. For instance, a court might not enforce a limitation period if it would “work a forfeiture of the policy benefit.” This exception, however, is very fact-specific. Another exception is fire claims, where by statute the limitation period cannot be less than two years from the date of loss. Georgia Code § 33-32-1 (a); White v. State Farm. But most property claims aren’t fire claims. So the best bet for calculating the statute of limitations is to take the limitation period in your policy at face value.
Georgia Statutes and Regulations that Impact Your Insurance Claim
Georgia has a large collection of laws applicable to the insurance claims process for homeowners. Here is a selection of relevant statutes that will help you with the process, all housed within either the Georgia Insurance Code (Title XXXIII (33) of Georgia Statutes) or the Rules & Regulations of the State of Georgia (Rule 120-2 (Rules of Commissioner of Insurance) ).
Georgia Code § 33-32-1 — Standard fire policy.
(a) No policy of fire insurance covering property located in this state shall be made, issued, or delivered unless it conforms as to all provisions and the sequence of the standard or uniform form prescribed by the Commissioner, except that, with regard to multiple line coverage providing other kinds of insurance combined with fire insurance, this Code section shall not apply if the policy contains, with respect to the fire portion of the policy, language at least as favorable to the insured as the applicable portions of the standard fire policy and such multiple line policy has been approved by the Commissioner.
(b) The Commissioner shall file and maintain on file in his office a true copy of the standard fire policy designated as such and bearing the Commissioner’s authenticating certificate and signature and the date of filing. The standard fire insurance policy shall not be required for casualty insurance, marine and transportation insurance, or insurance on growing crops. Insurers issuing the standard fire insurance policy are authorized to affix to or include in such policy a written statement that the policy does not cover loss or damage caused by nuclear reaction or nuclear radiation or radioactive contamination, whether directly or indirectly resulting from an insured peril under the policy; provided, however, that nothing contained in this Code section shall be construed to prohibit the attachment to any such policy of an endorsement or endorsements specifically assuming loss or damage caused by nuclear reaction or nuclear radiation or radioactive contamination.
Georgia Rules & Regulations 120-2-19-.01 — Standard Fire Policy
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Concealment, fraud. |
This entire policy shall be void if, whether before or after a loss, the insured has wilfully concealed or misrepresented any material fact or circumstance concerning this insurance or the subject thereof, or the interest of the insured therein, or in case of any fraud or false swearing by the insured relating thereto. |
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Uninsurable and excepted property. |
This policy shall not cover accounts, bills, currency, deeds, evidences of debt, money or securities; nor, unless specifically named hereon in writing, bullion or manuscripts. |
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Perils not included. |
This Company shall not be liable for loss by fire or other perils insured against in this policy caused, directly or indirectly, by: (a) enemy attack by armed forces, including action taken by military, naval or air forces in resisting an actual or an immediately impending enemy attack; (b) invasion; (c) insurrection; (d) rebellion; (e) revolution; (f) civil war; (g) usurped power; (h) order of any civil authority except acts of destruction at the time of and for the purpose of preventing the spread of fire, provided that such fire did not originate from any of the perils excluded by this policy; (i) neglect of the insured to use all reasonable means to save and preserve the property at and after a loss, or when the property is endangered by fire in neighboring premises; (j) nor shall this Company be liable for loss by theft. |
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Other Insurance. |
Other insurance may be prohibited or the amount of insurance may be limited by endorsement attached hereto. |
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Conditions suspending or restricting insurance. Unless otherwise provided in writing added hereto this Company shall not be liable for loss occurring |
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(a) while the hazard is increased by any means within the control or knowledge of the insured; or
(b) while a described building, whether intended for occupancy by owner or tenant, is vacant or unoccupied beyond a period of sixty consecutive days; or
(c) as a result of explosion or riot, unless fire ensue, and in that event for loss by fire only.
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Other perils or subjects. |
Any other peril to be insured against or subject of insurance to be covered in this policy shall be by endorsement in writing hereon or added hereto. |
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Added provisions. |
The extent of the application of insurance under this policy and of the contribution to be made by this Company in case of loss, and any other provision or agreement not inconsistent with the provisions of this policy, may be provided for in writing added hereto, but no provision may be waived except such as by the terms of this policy is subject to change. |
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Waiver provisions. |
No permission affecting this insurance shall exist, or waiver of any provision be valid, unless granted herein or expressed in writing added hereto. No provision, stipulation or forfeiture shall be held to be waived by any requirement or proceeding on the part of this Company relating to appraisal or to any examination provided for herein. |
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Cancellation of policy. |
This policy shall be cancelled at any time at the request of the insured, in which case this Company shall, upon demand and surrender of this policy, refund the excess of paid premium above the customary short rates for the expired time. This policy may be cancelled at any time by this Company by giving to the insured a five days’ written notice of cancellation with or without tender of the excess of paid premium above the pro rata premium for the expired time, which excess, if not tendered, shall be refunded on demand. Notice of cancellation shall state that said excess premium (if not tendered) will be refunded on demand. |
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Mortgagee interest and obligations. |
If loss hereunder is made payable, in whole or in part, to a designated mortgagee not named herein as the insured, such interest in this policy may be cancelled by giving to such mortgagee a ten days’ written notice of cancellation. |
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If the insured fails to render proof of loss such mortgagee, upon notice, shall render proof of loss in the form herein specified within sixty (60) days thereafter and shall be subject to the provisions hereof relating to appraisal and time of payment and of bringing suit. If this Company shall claim that no liability existed as to the mortgagor or owner, it shall, to the extent of payment of loss to the mortgagee, be subrogated to all the mortgagee’s rights of recovery, but without impairing mortgagee’s right to sue; or it may pay off the mortgage debt and require an assignment thereof and of the mortgage. Other provisions relating to the interests and obligations of such mortgagee may be added hereto by agreement in writing. |
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Pro rata liability. |
This Company shall not be liable for a greater proportion of any loss than the amount hereby insured shall bear to the whole insurance covering the property against the peril involved, whether collectible or not. |
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Requirements in case loss occurs. |
The insured shall give immediate written notice to this Company of any loss, protect the property from further damage, forthwith separate the damaged and undamaged personal property, put it in the best possible order, furnish a complete inventory of the destroyed, damaged and undamaged property, showing in detail quantities, costs, actual cash value and amount of loss claimed; and within sixty days after the loss, unless such time is extended in writing by this Company, the insured shall render to this Company a proof of loss, signed and sworn to by the insured, stating the knowledge and belief of the insured as to the following: the time and origin of the loss, the interest of the insured and of all others in the property, the actual cash value of each item thereof and the amount of loss thereto, all encumbrances thereof, all other contracts of insurance, whether valid or not, covering any of said property, any changes in the title, use, occupation, location, possession, or exposures of said property since the issuing of this policy, by whom and for what purpose any building herein described and the several parts thereof were occupied at the time of loss and whether or not it then stood on leased ground, and shall furnish a copy of all the descriptions and schedules in all policies and, if required, verified plans and specifications of any building, fixtures or machinery destroyed or damaged. The insured, as often as may be reasonably required, shall exhibit to any person designated by this Company all that remains of any property herein described, and submit to examinations under oath by any person named by this Company, and subscribe the same; and, often as may be reasonably required, shall produce for examination all books of accounts, bills, invoices and other vouchers, or certified copies thereof if originals be lost, at such reasonable time and place as may be designated by this Company or its representative, and shall permit extracts and copies thereof to be made. |
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Appraisal. |
In case the insured and this Company shall fail to agree as to the actual value or the amount of loss, then, on the written demand of either, each shall select a competent and disinterested appraiser and notify the other of the appraiser selected within twenty days of such demand. The appraisers shall select a competent and disinterested umpire; and failing for fifteen days to agree upon such umpire, then, on request of the insured or this Company, such umpire shall be selected by a judge of a court of record in the state in which the property covered is located. The appraisers shall then appraise the loss, stating separately actual cash value and loss to each item; and, failing to agree, shall submit their differences, only, to the umpire. An award in writing, so itemized, of any two when filed with this Company shall determine the amount of actual cash value and loss. Each appraiser shall be paid by the party selecting him and the expenses of appraisal and umpire shall be paid by the parties equally. |
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Company’s options. |
It shall be optional with this Company to take all, or any part, of the property at the agreed or appraised value, and also to repair, rebuild or replace the property destroyed or damaged with other of like kind and quality within a reasonable time, on giving notice of its intention so to do within thirty days after the receipt of the proof of loss herein required. |
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Abandonment. |
There can be no abandonment to this Company of any property. |
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When loss payable. |
The amount of loss for which this Company may be liable shall be payable sixty days after proof of loss, as herein provided, is received by this Company and ascertainment of the loss is made either by agreement between the insured and this Company expressed in writing or by the filing with this Company of an award as herein provided. |
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Suit. |
No suit or action on this policy for the recovery of any claim shall be sustainable in any court of law or equity unless all the requirements of this policy shall have been complied with, and unless commenced within two (2) years next after inception of the loss. |
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Subrogation. |
This Company may require from the insured an assignment of all right of recovery against any party for loss to the extent that payment therefor is made by this Company. |
Georgia Code § 33-24-46 — Cancellation or nonrenewal of certain property insurance policies.
(a) This Code section shall apply only to policies of insurance against direct loss to residential real property and the contents thereof, as defined and limited in standard fire policies insuring natural persons as the named insured.
(b) As used in this Code section, the term:
(1) “Claim against a policy” means a contact with an insurer by the insured under the policy or an affected third party for the express purpose of seeking payment of proceeds under the terms of the policy in question. A report of loss or a question relating to coverage shall not independently establish a claim against a policy nor be considered as a claim under Article 2 of Chapter 6 of this title.
(2) “Nonrenewal” or “nonrenewed” means a refusal by an insurer or an affiliate of an insurer to renew. Failure of an insured to pay the premium as required of the insured for renewal, a change in policy terms, or a reduction in coverage after the insurer has manifested a willingness to renew by delivering a renewal policy, renewal certificate, or other evidence of renewal to the named insured or his or her representative or has offered to issue a renewal policy, certificate, or other evidence of renewal or has manifested such intention by any other means shall not be construed to be a nonrenewal.
(3) “Policies” means a policy insuring a natural person as named insured against direct loss to residential real property and the contents thereof, as defined and limited in standard fire policies as approved by the Commissioner.
(4) “Reduction in coverage” means a change made by the insurer which results in a removal of coverage, diminution in scope or less coverage, or the addition of an exclusion. Reduction in coverage shall not include any change, reduction, or elimination of coverage made at the request of the insured. The correction of typographical or scrivener’s errors or the application of mandated legislative changes shall not be considered a reduction in coverage.
(5) “Renewal” means issuance and delivery by an insurer or an affiliate of such insurer of a policy superseding at the end of the policy period a policy previously issued and delivered by the same insurer or issuance and delivery of a certificate or notice extending the term of a policy beyond its policy period or term or the extension of the term of a policy beyond its policy period or term pursuant to a provision for extending the policy by payment of a continuation premium. Any policy with a policy period or term of less than six months shall, for the purposes of this Code section, be considered to have successive policy periods ending each six months following its original date of issue and, regardless of its wording, any interim termination by its terms or by refusal to accept premiums shall be a cancellation subject to this Code section. Any policy written for a term longer than one year or any policy with no fixed expiration date shall be considered as if written for successive policy periods or terms of one year and any termination by an insurer effective on an anniversary date of such policy shall be deemed a refusal to renew.
(c)
(1) No notice of cancellation of a policy as to which this Code section applies shall be effective unless mailed or delivered as prescribed in Code Section 33-24-44. The insurer shall provide the reason or reasons for such cancellation as required by Chapter 39 of this title.
(2) After coverage under a policy to which this Code section applies has been in effect more than 60 days or after the effective date of a renewal policy to which this Code section applies, a notice of cancellation may be issued only for one or more of the following reasons:
(A) Nonpayment of premium;
(B) Discovery of fraud, concealment of material fact, or material misrepresentation made by or with the knowledge of the insured in obtaining the policy, continuing the policy, or presenting a claim under the policy;
(C) The occurrence of a change in the risk which substantially increases any hazard the policy insures against; or
(D) The insured violates any of the material terms or conditions of the policy.
(d)
(1) No insurer shall refuse to renew a policy to which this Code section applies unless a written notice of nonrenewal is mailed or delivered in person to the named insured. Such notice stating the time when nonrenewal will be effective, which shall not be less than 30 days from the date of mailing or delivery of such notice of nonrenewal or such longer period as may be provided in the contract or by statute, shall be delivered as provided in subsection (d) of Code Section 33-24-14, in person, or by depositing the notice in the United States mail to be dispatched by at least first-class mail to the last address of record of the insured and of the lienholder, where applicable, and receiving the receipt provided by the United States Postal Service or such other evidence of mailing as prescribed or accepted by the United States Postal Service. The insurer shall provide the reason or reasons for nonrenewal as required by Chapter 39 of this title.
(2) An insurer shall provide a written notice of a reduction in coverage to the named insured no less than 30 days prior to the effective date of the proposed reduction in coverage; provided that such notice shall be in a separate document with the words “NOTICE OF REDUCTION IN COVERAGE” written in all capital letters in at least 12 point type. Such notice shall be delivered as provided in subsection (d) of Code Section 33-24-14, in person, or by depositing the notice in the United States mail to be dispatched by at least first-class mail to the last address of record of the insured and receiving the receipt provided by the United States Postal Service or such other evidence of mailing as prescribed or accepted by the United States Postal Service.
(e) When a policy is canceled other than for nonpayment of premium or in the event of a refusal to renew or continue a policy, the insurer shall notify the named insured of his possible eligibility for insurance through the Georgia Fair Access to Insurance Requirements Plan. The notice shall accompany or be included in the notice of cancellation or the notice of intent not to renew or not to continue the policy and shall state that such notice availability of the Georgia Fair Access to Insurance Requirements Plan is given pursuant to this Code section. Included in the notice shall be the address by which the Georgia Fair Access to Insurance Requirements Plan might be contacted in order to determine eligibility.
(f) There shall be no liability on the part of and no cause of action of any nature shall arise against the Commissioner or his employees or against any insurer, its authorized representatives, its agents, its employees, or any firm, person, or corporation furnishing to the insurer information as to reasons for cancellation or nonrenewal for any statement made by any of them and in written notice of cancellation or nonrenewal or in any other communication, oral or written, specifying the reasons for cancellation or nonrenewal or providing information pertaining thereto or for statements made or evidence submitted at any formal or informal hearing conducted in connection therewith.
(g) Return of unearned premium, if any, due to cancellations as to which this Code section applies shall be processed in accordance with Code Section 33-24-44.
(h) Notice to the insured shall not be required by this Code section when a policy is canceled by an insurance premium finance company under a power of attorney contained in an insurance premium finance agreement if notification of the existence of the premium finance agreement has been given to the insurer in accordance with the provisions of Chapter 22 of this title. However, the insurer shall comply with the provisions of subsection (d) of Code Section 33-22-13 pertaining to notice to a governmental agency, mortgagee, or other third party. Such notice shall be delivered as provided in subsection (d) of Code Section 33-24-14, in person, or by depositing the notice in the United States mail to be dispatched by at least first-class mail to the last address of record of such governmental agency, mortgagee, or other third party and receiving the receipt provided by the United States Postal Service or such other evidence of mailing as prescribed or accepted by the United States Postal Service.
(i) Cancellation by the insured shall be accomplished as provided in Code Section 33-24-44.1.
(j) No notice refusing the renewal of a policy issued for delivery in this state shall be mailed or delivered by an insurer or its agent duly authorized to effect such notice of nonrenewal for the following reasons:
(1) Lack of, lack of potential for, or failure to agree to a writing of supporting insurance business;
(2) A change in the insurer’s eligibility rules or underwriting rules, provided that this paragraph shall not apply to a change in such rules if the change applies uniformly within a specific class or territory and such change has been approved by the Commissioner under subsection (k) of this Code section; and
(3) Two or fewer claims against the policy within the preceding 36 month period if such claims are not attributable to the negligent or intentional acts of the insured or of persons residing at the insured premises.
(k) If the insurer demonstrates to the satisfaction of the Commissioner that renewal would violate the provisions of this title or would be hazardous to its policyholders or the public, paragraph (2) of subsection (j) shall not apply.
(l)
(1) If the insurer complies with subsection (d) of this Code section, no claim or action may be maintained with respect to a policy which is not renewed unless the named insured files a written notice with the insurer before the time at which nonrenewal becomes effective. The notice shall specify the manner in which the failure to renew is alleged to be unlawful under this subsection. In any subsequent action asserting a violation of subsection (c), (j), or (k) of this Code section, no violation may be alleged other than the specific allegations contained in the notice filed by the named insured.
(2) In addition to other requirements, a notice of nonrenewal shall contain the provisions of paragraph (1) of this subsection in substantially the form which follows:
“NOTICE
Code Section 33-24-46 of the Official Code of Georgia Annotated provides that this insurer must, upon request, furnish you with the reasons for the failure to renew this policy. If you wish to assert that the nonrenewal is unlawful, you must file a written notice with this insurer before the time at which the nonrenewal becomes effective. The notice must specify the manner in which the failure to renew is alleged to be unlawful.
If you do not file the written notice, you may not later assert a claim or action against this insurer based upon an unlawful nonrenewal.”
(m)
(1) Notwithstanding subsection (j) of this Code section, the termination of an agency relationship shall be valid as a reason for a failure to renew a policy. In such case, if the named insured wishes to retain the policy with the particular insurer, the insured shall locate another agent of the insurer and apply for the policy with another agent of the insurer before the time at which the nonrenewal becomes effective. Upon receipt of the application, the insurer shall treat the application as a renewal and not as an original writing. Nothing in this paragraph shall abridge or supersede contractual rights of the terminated agency or the insurer, provided that these contractual rights do not adversely affect the privilege of the named insured to apply for renewal through another agent of the insurer.
(2) A notice of nonrenewal based upon the termination of an agency relationship shall contain the provisions of paragraph (1) of this subsection, in substantially the form which follows:
“NOTICE
Your policy has not been renewed because your present agent no longer represents this insurer. You have the option of procuring coverage through your present agent or retaining this policy by applying through another agent of this insurer. Code Section 33-24-46 of the Official Code of Georgia Annotated provides that if you will locate another agent of the insurer and apply for this policy before the time at which the nonrenewal becomes effective, this insurer will treat the application as a renewal and not as an application for a new policy.”
Georgia Code § 33-24-17 — Assignment of policies.
A policy may be assignable or not assignable, as provided by its terms. . . . Any assignment shall entitle the insurer to deal with the assignee as the owner or pledgee of the policy in accordance with the terms of the assignment until the insurer has received at its home office written notice of termination of the assignment or pledge or written notice by or on behalf of some other person claiming some interest in the policy in conflict with the assignment.
Georgia Code § 33-32-3 — Privilege of rebuilding or reinstating property sustaining loss or damage.
The privilege of rebuilding or reinstating property sustaining loss or damage shall not exist unless it is reserved in the policy.
Georgia Code § 33-32-5 — Amount of insurance in certain fire policies deemed conclusive as to value of property covered.
(a) Whenever any policy of insurance is issued to a natural person or persons or to any legal entity wholly owned by a natural person or persons insuring a specifically described one or two family residential building or structure located in this state against loss by fire and the building or structure is wholly destroyed by fire without fraudulent or criminal fault on the part of the insured or one acting in his or her behalf, the amount of insurance set forth in the policy relative to the building or structure shall be taken conclusively to be the value of the property, except to the extent of any depreciation in value occurring between the date of the policy or its renewal and the loss, provided that, if loss occurs within 30 days of the original effective date of the policy, the insured shall be entitled to the actual loss sustained not exceeding the sum insured. Nothing in this Code section shall be construed as prohibiting the use of coinsurance or as preventing the insurer from repairing or replacing damaged property at its own expense without contribution on the part of the insured.
(b) Subsection (a) of this Code section shall not apply where:
(1) The building or structure is not wholly destroyed by fire;
(2) Insurance policies are issued or renewed by more than one company insuring the same building or structure against fire and the existence of the additional insurance is not disclosed by the insured to all insurers issuing policies;
(3) Two or more buildings or structures are insured under a blanket form for a single amount of insurance; or
(4) The completed value of a building or structure is insured under a builders’ risk policy.
Georgia Code § 33-6-3 — Unfair methods of competition or unfair and deceptive acts or practices prohibited.
No person shall engage in this state in any trade practice which is defined in this article as or determined pursuant to this article to be an unfair method of competition or an unfair or deceptive act or practice in the business of insurance.
Georgia Code § 33-6-4 — Enumeration of unfair methods of competition and unfair or deceptive acts or practices; penalty.
(b) The following acts or practices are deemed unfair methods of competition and unfair and deceptive acts or practices in the business of insurance:
(1) Making, publishing, disseminating, circulating, or placing before the public or causing directly or indirectly to be made, published, disseminated, circulated, or placed before the public in a newspaper, magazine, or other publication or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio station or in any other way an advertisement, announcement, or statement containing any assertion, representation, or statement with respect to the business of insurance or with respect to any person in the conduct of his insurance business, which statement, assertion, or representation is untrue, deceptive, or misleading;
(2) Making, issuing, circulating, or causing to be made, issued, or circulated any estimate, illustration, circular, or statement misrepresenting the terms of any policy issued or to be issued, the benefits or advantages promised thereby, or the dividends or share of the surplus to be received thereon; making any false or misleading statement as to the dividends or share of surplus previously paid on similar policies; making any misleading representation or any misrepresentation as to the financial condition of any insurer, as to the legal reserve system upon which any life insurer operates; using any name or title of any policy or class of policies misrepresenting the true nature thereof; or making any misrepresentation to any policyholder insured in any company for the purpose of inducing or tending to induce the policyholder to lapse, forfeit, or surrender his insurance.
. . . .
(8)(A)
(iii) Making or permitting any unfair discrimination in the issuance, renewal, or cancellation of any policy or contract of insurance against direct loss to residential property and the contents thereof, in the amount of premium, policy fees, or rates charged for the policies or contracts when the discrimination is based solely upon the age or geographical location of the property within a rated fire district without regard to objective loss experience relating thereto.
(iv) (I)Unfair discrimination prohibited by the provisions of this subparagraph includes discrimination based on race, color, and national or ethnic origin. In addition, in connection with any kind of insurance, it shall be an unfair and deceptive act or practice to refuse to insure or to refuse to continue to insure an individual; to limit the amount, extent, or kind of coverage available to an individual; or to charge an individual a different rate for the same coverage because of the race, color, or national or ethnic origin of that individual. The prohibitions of this division are in addition to and supplement any and all other provisions of Georgia law prohibiting such discrimination which were previously enacted and currently exist, or which may be enacted subsequently, and shall not be a limitation on such other provisions of law.
. . . .
Georgia Code § 33-6-5 — Other unfair methods of competition and unfair and deceptive acts or practices.
In addition to Code Section 33-6-4, violations of the following provisions also are defined as unfair methods of competition and unfair and deceptive acts or practices in the business of insurance:
. . . .
(8) No insurance company shall cancel, modify coverage, refuse to issue, or refuse to renew any property or casualty insurance policy solely because the applicant or insured or any employee of either is mentally or physically impaired . . . ; provided, further, that this paragraph shall not be interpreted to modify any other provision of this title relating to the cancellation, modification, issuance, or renewal of any insurance policy or contract;
. . . .
Georgia Code § 33-6-6 — Power of Commissioner as to investigation of unfair or deceptive acts or practices generally.
(a) The Commissioner shall have the power to examine and investigate into the affairs of every person engaged in the business of insurance in this state in order to determine whether the person has been or is engaged in any unfair method of competition or in any unfair or deceptive act or practice prohibited by this chapter.
(b) In addition to any other authority granted to the Commissioner by this title and in addition to those reports required by Code Section 33-3-21, the Commissioner may require persons engaged in the business of insurance in this state to file reports by postal ZIP Code, where appropriate, or in any other format to enable the Commissioner to determine readily if such person has been or is engaged in any unfair method of competition or in any unfair or deceptive act or practice prohibited by this article.
Georgia Code § 33-6-7 — Conduct of hearings by Commissioner; rights of person being investigated; powers of Commissioner; service of process.
(a) Whenever the Commissioner shall have reason to believe that any person has been engaged or is engaging in this state in any unfair method of competition or any unfair or deceptive act or practice, whether or not defined in Code Sections 33-6-4 and 33-6-5, and have reason to believe that a proceeding by the Commissioner in respect to such unfair method of competition or such unfair or deceptive act or practice would be in the public interest, he shall issue and serve upon the person a statement of the charges in that respect and a notice of a hearing on the charges to be held at a time and place fixed in the notice, which time shall not be less than 15 days after the date of the service of the notice.
(b) At the time and place fixed for the hearing, the person shall have an opportunity to be heard and to show cause why an order requiring the person to cease and to desist from the acts, methods, or practices so complained of should not be made by the Commissioner. Upon good cause shown, the Commissioner shall permit any person to intervene, appear, and be heard at the hearing by counsel or in person.
(c) Nothing contained in this article shall require the observance at the hearing of formal rules of pleading or evidence.
(d) The Commissioner at the hearing may administer oaths, examine and cross-examine witnesses, receive oral and documentary evidence, subpoena and compel the attendance of witnesses, and require the production of books, papers, records, correspondence, or other documents which he deems relevant to the inquiry. The Commissioner at the hearing may and, upon request of any party, shall cause to be made a record of all the evidence and all the proceedings had at the hearing. In case of a refusal of any person to comply with any subpoena issued under this Code section or to testify with respect to any matter concerning which he may be lawfully interrogated, the Superior Court of Fulton County or the superior court of the county where the party resides, on application of the Commissioner, may issue an order requiring the person to comply with the subpoena and to testify; and any failure to obey any order of the court may be punished by the court as a contempt thereof.
(e) Statements of charges, notices, orders, and other processes of the Commissioner under this article may be served by anyone duly authorized by the Commissioner either in the manner provided by law for service of process in civil actions or by registering or certifying and mailing a copy of the statement, notice, order, or other process to the person affected by it at the person’s residence or principal office or place of business. The verified return by the person so serving the statement, notice, order, or other process, which return sets forth the manner of the service, shall be proof of the same; and the return post card receipt for the statement, notice, order, or other process, which receipt is registered or certified and mailed as provided in this Code section, shall be proof of the service of the same.
Georgia Code § 33-6-8 — Issuance of cease and desist orders; issuance of orders providing for other relief; change in orders; date on which orders appealable.
(a) If, after the hearing provided for in Code Section 33-6-7, the Commissioner shall determine that the person charged has engaged in an unfair method of competition or an unfair or deceptive act or practice, he shall reduce his findings to writing and shall issue and cause to be served upon the person charged with the violation a copy of the findings and an order requiring such person to cease and desist from engaging in the method of competition, act, or practice; and, if the act or practice is a violation of Code Sections 33-6-4 and 33-6-5, the Commissioner may at his discretion order any one or more of the following:
(1) Payment of a monetary penalty of not more than $1,000.00 for each and every act or violation, unless the person knew or reasonably should have known he was in violation of this article, in which case the penalty shall be not more than $5,000.00 for each and every act or violation;
(2) Suspension or revocation of the person’s license, if he knew or reasonably should have known he was in violation of this article; or
(3) Any other relief as is reasonable and appropriate.
(b) The Commissioner may, at any time before the serving of a copy of the petition for review filed in the Superior Court of Fulton County upon him or her, as provided for in Code Section 33-6-11, or after the expiration of the time allowed by law for the serving of the petition for review, if no petition for review has been thus served, amend or set aside in whole or in part any order issued by the Commissioner under this Code section whenever in the Commissioner’s opinion the facts and circumstances surrounding the case have so changed as to require the action or if the public interest shall so require. No change of an order in a manner unfavorable to the person charged or to the parties at interest shall be made except after notice and opportunity for hearing. The date of the Commissioner’s last order shall be the point of time from which it may be reviewed by appeal.
Georgia Code § 33-6-9 — Penalties for violations of cease and desist orders.
After notice and hearing and upon order of the Commissioner, any person who violates a cease and desist order under Code Section 33-6-8, while the order is in effect may, at the discretion of the Commissioner, be subject to any one or more of the following:
(1) A monetary penalty of not more than $10,000.00 for each and every act or violation;
(2) Suspension or revocation of such person’s license; or
(3) Any other relief as is reasonable and appropriate.
Georgia Code § 33-6-32 — Definitions.
As used in [Georgia Code §§ 33-6-30 through 33-6-37], the term:
(1) “Insured” means the party named on a policy or certificate or as defined in the contract as the person with legal rights to the benefits provided by such policy or certificate.
(2) “Person” means an individual, corporation, association, partnership, reciprocal exchange, interinsurer, Lloyd’s insurer, fraternal benefit society, and any other legal entity engaged in the business of insurance, including but not limited to agents, brokers, counselors, and adjusters.
(3) “Policy” or “certificate” means any contract of insurance; indemnity; medical, health, or hospital service; or annuity issued by an insurer. “Policy” or “certificate” shall not mean contracts for workers’ compensation, fidelity, or surety insurance.
Georgia Code § 33-6-33 — When claims settlement practice improper.
It is an improper claims settlement practice for any domestic, foreign, or alien insurer transacting business in Georgia to commit any act provided in Code Section 33-6-34 if such act:
(1) Is committed flagrantly and in conscious disregard of this title or any rule or regulation promulgated pursuant to this title; or
(2) Has been committed with such frequency so as to indicate a general business practice to engage in such conduct.
Georgia Code § 33-6-34 — Unfair claims settlement practices.
Any of the following acts of an insurer when committed as provided in Code Section 33-6-33 shall constitute an unfair claims settlement practice:
1) Knowingly misrepresenting to claimants and insureds relevant facts or policy provisions relating to coverages at issue;
(2) Failing to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies;
(3) Failing to adopt and implement procedures for the prompt investigation and settlement of claims arising under its policies;
(4) Not attempting in good faith to effectuate prompt, fair, and equitable settlement of claims submitted in which liability has become reasonably clear;
(5) Compelling insureds or beneficiaries to institute suits to recover amounts due under its policies by offering substantially less than the amounts ultimately recovered in suits brought by them;
(6) Refusing to pay claims without conducting a reasonable investigation;
(7) When requested by the insured in writing, failing to affirm or deny coverage of claims within a reasonable time after having completed its investigation related to such claim or claims;
(8) When requested by the insured in writing, making claims payments to an insured or beneficiary without indicating the coverage under which each payment is being made;
(9) Unreasonably delaying the investigation or payment of claims by requiring both a formal proof of loss and subsequent verification that would result in duplication of information and verification appearing in the formal proof of loss form; provided, however, this paragraph shall not preclude an insurer from obtaining sworn statements if permitted under the policy;
(10) When requested by the insured in writing, failing in the case of claims denial or offers of compromise settlement to provide promptly a reasonable and accurate explanation of the basis for such actions. In the case of claims denials, such denials shall be in writing;
(11) Failing to provide forms necessary to file claims within 15 calendar days of a request with reasonable explanations regarding their use;
(12) Failing to adopt and implement reasonable standards to assure that the repairs of a repairer owned by the insurer are performed in a workmanlike manner;
(13) Indicating to a first-party claimant on a payment, draft check, or accompanying letter that said payment is final or a release of any claim unless the policy limit has been paid or there has been a compromise settlement agreed to by the first-party claimant and the insurer as to coverage and amount payable under the contract;
(14) Issuing checks or drafts in partial settlement of a loss or claim under a specific coverage which contain language which releases the insurer or its insured from its total liability;
(15) Failure to comply with any insurer requirement in Chapter 20E of this title, the “Surprise Billing Consumer Protection Act,” including:
(A) The failure to designate whether the healthcare plan is subject to the exclusive jurisdiction of the Employee Retirement Income Security Act of 1974, 29 U.S.C. Sec. 1001, et seq.;
(B) The failure to directly pay the provider or facility within 15 working days for electronic claims or 30 calendar days for paper claims any moneys due under Code Section 33-20E-4 or 33-20E-5; or
(C) The failure to pay a resolution organization as required under Code Section 33-20E-16; and
(16) Failure to comply with any insurer requirement relating to emergency services or care in Article 4 of Chapter 11 of Title 31, Article 1 of Chapter 20A of this title, Chapter 20E of this title, Chapter 21A of this title, Code Section 33-24-59.27, and Chapter 30 of this title.
Georgia Code § 33-6-35 — Notice of hearing; hearing procedures; cease and desist orders; penalties; judicial review; intervenors.
(a) Whenever the Commissioner has reason to believe that any person has engaged or is engaging in this state in any unfair claims settlement practice and has reason to believe that a proceeding with respect to such unfair claims settlement practice would be in the public interest, the Commissioner shall serve upon such person a statement of the charges in that respect and a notice of hearing in the same manner as provided in Code Section 33-6-7.
(b) The provisions of Code Sections 33-6-7 through 33-6-11, relating to hearings, cease and desist orders, penalties, judicial review, intervenors, and other matters in connection with violations of Article 1 of this chapter shall be applicable to violations of [Georgia Code §§ 33-6-30 through 33-6-37].
Georgia Code § 33-6-37 — Private cause of action not created or implied.
Nothing contained in [Georgia Code §§ 33-6-30 through 33-6-37] shall be construed to create or imply a private cause of action for a violation of this article.
Georgia Code § 33-4-6 — Liability of insurer for damages and attorney’s fees; notice to Commissioner and consumers’ insurance advocate.
Bad Faith
(a) In the event of a loss which is covered by a policy of insurance and the refusal of the insurer to pay the same within 60 days after a demand has been made by the holder of the policy and a finding has been made that such refusal was in bad faith, the insurer shall be liable to pay such holder, in addition to the loss, not more than 50 percent of the liability of the insurer for the loss or $5,000.00, whichever is greater, and all reasonable attorney’s fees for the prosecution of the action against the insurer. The action for bad faith shall not be abated by payment after the 60 day period nor shall the testimony or opinion of an expert witness be the sole basis for a summary judgment or directed verdict on the issue of bad faith. The amount of any reasonable attorney’s fees shall be determined by the trial jury and shall be included in any judgment which is rendered in the action; provided, however, that the attorney’s fees shall be fixed on the basis of competent expert evidence as to the reasonable value of the services based on the time spent and legal and factual issues involved in accordance with prevailing fees in the locality where the action is pending; provided, further, that the trial court shall have the discretion, if it finds the jury verdict fixing attorney’s fees to be greatly excessive or inadequate, to review and amend the portion of the verdict fixing attorney’s fees without the necessity of disapproving the entire verdict. The limitations contained in this Code section in reference to the amount of attorney’s fees are not controlling as to the fees which may be agreed upon by the plaintiff and the plaintiff’s attorney for the services of the attorney in the action against the insurer.
(b) In any action brought pursuant to subsection (a) of this Code section, and within 20 days of bringing such action, the plaintiff shall, in addition to service of process in accordance with Code Section 9-11-4, mail to the Commissioner of Insurance a copy of the demand and complaint by first-class mail. Failure to comply with this subsection may be cured by delivering same.
Georgia Code § 33-24-8 — Admissibility in evidence of applications in actions between insurer and insured.
As to kinds of insurance other than life insurance, no application for insurance signed by or on behalf of the insured shall be admissible in evidence in any action between the insured and the insurer arising out of the policy applied for if the insurer, at expiration of 30 days after receipt by the insurer of written demand by or on behalf of the insured for a copy of the application, has failed to furnish to the insured a copy of the application reproduced by any legible means.
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