(For Effective Date, See note.) Unfair Claims Settlement Practices

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  2. Georgia Code
  3. Insurance
  4. Unfair Trade Practices
  5. Unfair Claims Settlement Practices
  6. (For Effective Date, See note.) Unfair Claims Settlement Practices

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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. (For effective date, see note.) 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. (For effective date, see note.) 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; and
  15. (For effective date, see note.) Failure to comply with any insurer requirement in Chapter 20E of Title 33, the "Surprise Billing Consumer Protection Act," including the failure to pay a resolution organization as required under Code Section 33-20E-16.

(Code 1981, §33-6-34, enacted by Ga. L. 1992, p. 3048, § 9; Ga. L. 2020, p. 210, § 2/HB 888.)

Code Commission notes.

- Pursuant to Code Section 28-9-5, in 1992, "first-party" was substituted for "first party" in two places in paragraph (13).

RESEARCH REFERENCES

ALR.

- What constitutes bad faith on part of insurer rendering it liable for statutory penalty imposed for bad faith in failure to pay, or delay in paying, insured's claim - Particular conduct of insurer, 115 A.L.R.5th 589.

What constitutes bad faith on part of insurer rendering it liable for statutory penalty imposed for bad faith in failure to pay, or delay in paying, insured's claim - Particular grounds for denial of claim: matters relating to policy, 116 A.L.R.5th 247.


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