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29. Georgia Property and Casualty Law

Georgia Claims Practices and Consumer Protection

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Unfair claims practices (O.C.G.A. §§ 33-6-30 through 33-6-37)

A claim follows the policy’s own steps: notice, proof of loss, the adjuster’s investigation, appraisal and payment. Georgia adds rules that sit outside the policy and govern how the insurer behaves while it handles the claim. They come from three places: regulatory standards the Commissioner enforces, statutory penalties a court can add when an insurer refuses in bad faith to pay, and the consumer’s access to the Commissioner’s office. Georgia’s privacy statute, covered later on this page, governs the information gathered along the way.

What the Act covers (O.C.G.A. §§ 33-6-30 through 33-6-32)

Article 2 of Chapter 6 of the Insurance Code is the Unfair Claims Settlement Practices Act (O.C.G.A. § 33-6-30). It sets standards “for the investigation and disposition of claims arising under policies or certificates of insurance issued to residents of Georgia,” and it does not cover claims involving workers’ compensation, fidelity, or surety insurance (O.C.G.A. §§ 33-6-31, 33-6-32(3)). Workers’ compensation claims follow their own timetable under Title 34.

Definitions
Insured
The party named on a policy or certificate, or the person the contract defines as having legal rights to its benefits (O.C.G.A. § 33-6-32(1)).
Person
Any individual or entity engaged in the business of insurance, including agents, brokers, counselors and adjusters (O.C.G.A. § 33-6-32(2)).

The listed practices are described as acts of an insurer (O.C.G.A. §§ 33-6-33, 33-6-34), but the Commissioner’s enforcement power reaches “any person” engaged in an unfair claims settlement practice, and “person” includes the agents and adjusters who handle claims (O.C.G.A. §§ 33-6-32(2), 33-6-35(a)).

When a claims practice becomes a violation (O.C.G.A. § 33-6-33)

An act on Georgia’s list is an improper claims settlement practice when it:

  1. Is committed flagrantly and in conscious disregard of the Insurance Code or its rules, or
  2. Has been committed with such frequency as to indicate a general business practice (O.C.G.A. § 33-6-33).

The test separates an honest slip from a deliberate act or a pattern. An adjuster who misplaces one letter and answers it late has not, by that alone, violated the Act. A company whose files show that letters routinely go unanswered has. A single act can also qualify if it is flagrant and in conscious disregard of the law, such as an adjuster knowingly telling a claimant that a policy lapsed when it did not.

The unfair claims settlement practices (O.C.G.A. § 33-6-34)

Georgia lists sixteen acts. They fall into a few groups.

  • Honesty and communication. Knowingly misrepresenting relevant facts or policy provisions relating to the coverages at issue; failing to acknowledge pertinent communications about claims with reasonable promptness (O.C.G.A. § 33-6-34(1), (2)).
  • Investigation. Failing to adopt and implement procedures for prompt investigation and settlement; refusing to pay claims without a reasonable investigation; delaying a claim by requiring both a formal proof of loss and a later verification that duplicates it, although sworn statements may still be taken if the policy permits (O.C.G.A. § 33-6-34(3), (6), (9)).
  • Settlement. Not attempting in good faith a prompt, fair and equitable settlement once liability has become reasonably clear; compelling insureds to sue by offering substantially less than they ultimately recover (O.C.G.A. § 33-6-34(4), (5)). An insurer that routinely offers half of documented repair costs, expecting that only some homeowners will sue for the rest, is the kind of pattern paragraph (5) describes.
  • Payment documents. Telling a first-party claimant on a check or accompanying letter that a payment is final or a release, unless the policy limit has been paid or a compromise settlement has been agreed; issuing a partial-settlement check with language releasing the insurer or its insured from total liability (O.C.G.A. § 33-6-34(13), (14)). An advance paid to a homeowner for emergency repairs may not be labeled final unless one of those conditions is met.
  • Repairs. Failing to adopt reasonable standards to assure that a repairer the insurer owns works in a workmanlike manner (O.C.G.A. § 33-6-34(12)).
  • Health claims. The last two paragraphs concern surprise billing and emergency services (O.C.G.A. § 33-6-34(15), (16)).

Three duties arise when the insured requests them in writing: to affirm or deny coverage within a reasonable time after completing the investigation, to indicate the coverage under which each payment is made, and to promptly give a reasonable and accurate explanation of the basis for a denial or a compromise offer (O.C.G.A. § 33-6-34(7), (8), (10)). Paragraph (10) adds that claim denials shall be in writing.

Sidenote
Know this: the 15 calendar days and the written request

Outside the health-claim paragraphs, the Act’s one fixed deadline is for claim forms: an insurer that fails to provide the forms needed to file a claim, with reasonable explanations, within 15 calendar days of a request commits an unfair practice (O.C.G.A. § 33-6-34(11)). The coverage decision, payment explanation and explanation of a denial are owed “when requested by the insured in writing.” A producer helping a client with a slow claim should put the client’s questions to the insurer in writing.

Enforcement and no private lawsuit (O.C.G.A. §§ 33-6-35 through 33-6-37)

When the Commissioner has reason to believe a person is engaging in an unfair claims settlement practice and a proceeding would serve the public interest, the Commissioner serves a statement of charges and a notice of hearing (O.C.G.A. § 33-6-35(a)). The unfair trade practices procedure applies (O.C.G.A. § 33-6-35(b)): the hearing is set no less than 15 days after service, the person charged may show cause, and others may intervene for good cause (O.C.G.A. § 33-6-7(a), (b)).

A violation leads to written findings and a cease and desist order. The Commissioner may add a monetary penalty for each violation, with a higher maximum where the person knew or reasonably should have known of the violation, and in that case may also suspend or revoke the person’s license (O.C.G.A. § 33-6-8(a)). Violating a cease and desist order while it is in effect can bring a further penalty, license suspension or revocation (O.C.G.A. § 33-6-9). The person charged may seek review by petition, and the Commissioner’s findings of fact are final if sustained by substantial evidence (O.C.G.A. § 33-6-10(a)). The Commissioner may adopt rules under the Act and, in extraordinary circumstances, temporarily suspend them (O.C.G.A. § 33-6-36).

The Act creates no private cause of action (O.C.G.A. § 33-6-37). A claimant cannot sue “for violating the Act”; the claimant’s own routes are a suit on the policy, the bad-faith statutes below, and a complaint to the Commissioner.

Other claim-handling rules (O.C.G.A. §§ 33-24-40, 33-24-41.2, 33-24-46, 33-6-4)

  • No waiver by handling the claim. Acknowledging notice of a loss, furnishing forms, investigating and negotiating do not waive any policy provision or defense (O.C.G.A. § 33-24-40). An insurer can respond promptly without conceding coverage.
  • Notice of settlement payments. When an insurer pays $5,000 or more to settle a natural person’s third-party liability claim through the claimant’s attorney or other representative, it must give the claimant written notice at the same time (O.C.G.A. § 33-24-41.2(a)). Only the Commissioner may act on a missing notice, and it does not undo the settlement (O.C.G.A. § 33-24-41.2(b)).
  • A question is not a claim. Under a residential property policy, a report of loss or a question about coverage does not by itself establish a claim against the policy (O.C.G.A. § 33-24-46(b)(1)). A homeowner can ask whether hail damage is covered without that call counting as a claim.
  • Innocent co-insureds. No one may fail to pay an innocent first-party claimant’s loss, to the extent of that claimant’s interest in the property, when the loss was caused by the intentional act of an insured against whom a family violence or sexual assault complaint is brought for that act (O.C.G.A. § 33-6-4(b)(15)(G)).

Fair and equitable settlement of auto physical damage claims (Ga. Comp. R. & Regs. r. 120-2-52)

The Commissioner’s rule on first-party property damage claims under personal private passenger auto policies sets specific deadlines for “the expeditious and efficient settlement” of those claims (Ga. Comp. R. & Regs. r. 120-2-52-.02). These are the insured’s own claims for damage to or theft of the insured vehicle, such as collision and other-than-collision claims.

Claim deadlines (Ga. Comp. R. & Regs. r. 120-2-52-.03)

Step Deadline Rule
Acknowledge the claim Within 15 days of notice, unless payment is made in that time. Notice to the insurer’s agent is notice to the insurer. r. 120-2-52-.03(1)
Send proof of loss forms, if used Within 15 days, with explanations; sending them counts as the acknowledgment r. 120-2-52-.03(2)
Affirm or deny liability Within 15 days of receiving the completed proof of loss; if none is required, the coverage investigation takes place within 30 days of receiving the claim r. 120-2-52-.03(3)
Need more time Notify the claimant within 5 business days after the deadline passes, with the reason and an estimate. Total time may not exceed 60 days from notice of the claim unless the file documents requested information not yet submitted. r. 120-2-52-.03(5)
Pay Within 10 days after coverage is confirmed and the full amount is determined and undisputed r. 120-2-52-.03(4)

The same paragraph that sets the 15-day auto deadline states 60 days after the completed proof of loss for losses under fire or extended coverage type policies (r. 120-2-52-.03(3)).

Denials, repairs and arbitration (Ga. Comp. R. & Regs. r. 120-2-52-.03, -.04)

  • Denials based on a specific provision, condition or exclusion must cite it and be given to the insured in writing (r. 120-2-52-.03(7)).
  • Choice of shop. The insurer pays up to actual cash value to repair or replace, less the deductible. The insured may choose the repair shop and pays any difference if it costs more than the insurer’s shop; unless the policy permits, the insurer may not require a particular repairer when the work can be done elsewhere at the same cost (r. 120-2-52-.03(8)).
  • Higher estimates. The insured may have a copy of the insurer’s estimate, which must allow repairs restoring preaccident quality, safety, function and appearance. If the insured shows with a written estimate that necessary repairs cost more, the insurer must respond within 15 days by naming a shop that will do the work for its estimate or paying the difference (r. 120-2-52-.04(1)).
  • Betterment and depreciation. Deductions must be documented and itemized. A deduction for wear and tear or rust is limited to $1,000, and all such deductions together to 20% of the vehicle’s market value before the loss (r. 120-2-52-.04(2)). The insurer may not require the insured to authorize non-original-manufacturer aftermarket crash parts in the repair (r. 120-2-52-.05(5)).
  • Arbitration. Once liability is accepted but the amount is disputed, either side may ask the Commissioner in writing for arbitration. Where the Commissioner has set up a panel, three arbitrators hear the case, including at least one attorney and one licensed adjuster; the result binds both parties, and they share the cost equally (r. 120-2-52-.03(6)).

For a total loss, the insurer either pays the cost of a comparable automobile, with taxes and transfer fees, measured by methods the rule lists, such as comparable cars available within 50 miles of the county seat where the car was principally garaged, or offers a comparable replacement vehicle, which the insured may reject (r. 120-2-52-.06).

Bad-faith penalties (O.C.G.A. §§ 33-4-6 and 33-4-7)

The Unfair Claims Settlement Practices Act lets the Commissioner discipline insurers but gives the claimant nothing. Georgia’s bad-faith statutes do the opposite: a court may add a penalty and attorney’s fees to what the insurer owes. Each statute has precise conditions, and a claimant who misses one loses the penalty.

Refusal to pay a covered loss (O.C.G.A. § 33-4-6)

This first-party statute protects the holder of the policy. The penalty applies when (O.C.G.A. § 33-4-6(a)):

  1. The loss is covered by the policy,
  2. The holder has made a demand for payment,
  3. The insurer has refused to pay within 60 days after the demand, and
  4. A finding has been made that the refusal was in bad faith.

The insurer then owes, in addition to the loss, not more than 50 percent of its liability for the loss or $5,000, whichever is greater, plus all reasonable attorney’s fees. Paying after the 60 days does not end the bad-faith action, and an expert’s opinion cannot alone decide bad faith on summary judgment or directed verdict. The jury sets the attorney’s fees on competent expert evidence of the reasonable value of the lawyer’s services, and the trial court may correct a fee verdict it finds greatly excessive or inadequate (O.C.G.A. § 33-4-6(a)). Within 20 days of filing suit, the plaintiff mails the Commissioner a copy of the demand and complaint by first-class mail (O.C.G.A. § 33-4-6(b)).

Third-party property damage under auto liability policies (O.C.G.A. § 33-4-7)

This statute protects a claimant against the auto liability insurer of the person who caused the damage, and only for property damage. The insurer has an affirmative duty to adjust the loss fairly and promptly, to investigate and evaluate it reasonably, and, where liability is reasonably clear, to make a good faith effort to settle (O.C.G.A. § 33-4-7(a)). It breaches the duty when, liability being reasonably clear, it offers in bad faith less than the amount reasonably owed (O.C.G.A. § 33-4-7(b)). The claimant recovers the penalty only if (O.C.G.A. § 33-4-7(c)):

  • The claimant or attorney delivered a demand letter by statutory overnight delivery or certified mail, return receipt requested, offering to settle for an amount certain;
  • The insurer refused or declined within 60 days of receiving it; and
  • The claimant ultimately recovers at least the amount demanded.

The insurer is an unnamed party, not disclosed to the jury, until a verdict reaches the demand; the trial then resumes to decide bad faith (O.C.G.A. § 33-4-7(d)). Late payment does not end the action (O.C.G.A. § 33-4-7(e)), and the plaintiff mails the Commissioner the demand and complaint within 20 days of suing (O.C.G.A. § 33-4-7(g)).

Comparing the penalties

Uninsured motorist coverage carries its own penalty (O.C.G.A. § 33-7-11(j)), covered in Georgia Auto Insurance Law.

O.C.G.A. § 33-4-6 O.C.G.A. § 33-4-7 O.C.G.A. § 33-7-11(j)
Protects Holder of the policy Third-party claimant UM insured
Loss Any covered loss Property damage under a motor vehicle liability policy Loss covered by UM
Trigger Refusal to pay within 60 days of demand, found in bad faith Demand for an amount certain refused for 60 days; recovery at least the demand Refusal to pay within 60 days of demand, found in bad faith
Maximum penalty Greater of 50% of the insurer’s liability or $5,000 Greater of 50% of the insured’s liability or $5,000 Greater of 25% of the recovery or $25,000
Also Reasonable attorney’s fees Reasonable attorney’s fees Attorney’s fees; decided in a separate action after judgment against the uninsured motorist
Sidenote
Exam point: "whichever is greater"

The dollar amount sets a floor under the maximum penalty. On a $60,000 covered loss, 50 percent is $30,000, greater than $5,000, so the penalty may reach $30,000. On a $6,000 loss, 50 percent is $3,000, so the $5,000 figure controls (O.C.G.A. § 33-4-6(a)). Attorney’s fees come on top.

Insurance Information and Privacy Protection (O.C.G.A. Title 33, Chapter 39)

Underwriting and claims run on personal information: driving records, prior losses, credit-based information, medical records after an injury. Chapter 39, Georgia’s version of the NAIC Insurance Information and Privacy Protection Model Act, sets standards for collecting, using and disclosing it, lets people see and dispute what is held about them, and entitles applicants and policyholders to the reasons for an adverse underwriting decision (O.C.G.A. § 33-39-1).

Who and what the chapter covers (O.C.G.A. §§ 33-39-2, 33-39-3)

For property and casualty insurance, the chapter binds insurers, agents and insurance-support organizations dealing with policies delivered, issued for delivery or renewed in Georgia (O.C.G.A. § 33-39-2(a)(2)). “Agent” includes brokers, counselors, adjusters and service representatives (O.C.G.A. § 33-39-3(3)). An insurance transaction is one for insurance primarily for personal, family or household needs (O.C.G.A. § 33-39-3(13)), so the chapter concerns personal lines.

Definitions
Personal information
Individually identifiable information from which judgments can be made about a person’s character, habits, finances, occupation, credit, health or other characteristics; a name, address and age alone is not (O.C.G.A. § 33-39-3(19)).
Privileged information
Individually identifiable information relating to a claim or a civil or criminal proceeding, collected in connection with or in reasonable anticipation of it (O.C.G.A. § 33-39-3(22)).
Adverse underwriting decision
For individually underwritten property or casualty coverage: a declination; a termination (a cancellation or nonrenewal for a reason other than nonpayment); an agent’s failure to apply to a specific insurer the agent represents when the applicant asks; placement with a residual market mechanism or an unauthorized insurer; or a higher rate based on information that differs from what the applicant furnished (O.C.G.A. § 33-39-3(1)(A), (24)).

Collecting information (O.C.G.A. §§ 33-39-4 through 33-39-8)

  • Pretext interviews, in which the interviewer pretends to be someone else or hides the interview’s purpose, are prohibited. The one exception is a claim investigation, questioning a source with no privileged relationship to the person, when specific information available for the Commissioner’s review gives a reasonable basis for suspecting criminal activity, fraud, material misrepresentation or material nondisclosure (O.C.G.A. §§ 33-39-3(21), 33-39-4).
  • Notice of information practices. A written notice goes to applicants no later than delivery of the policy, or when collection begins if information will come from sources other than the applicant or public records, and to policyholders by the renewal date unless practices are unchanged and sharing complies with the chapter (O.C.G.A. § 33-39-5(a)). An abbreviated notice may be used if it tells the person that information may come from others and may be disclosed without authorization, that rights of access and correction exist, and that the full notice is available on request (O.C.G.A. § 33-39-5(c)).
  • Marketing questions must be clearly identified (O.C.G.A. § 33-39-6).
  • Authorizations for others to release information must be plain, dated and specific, and may last no longer than one year from signing for a property or casualty application (thirty months for life, health or disability) or the duration of a non-health claim (O.C.G.A. § 33-39-7).
  • Investigative consumer reports. The person must be told that he or she may ask to be interviewed and may receive a copy (O.C.G.A. § 33-39-8(a)).

Access, correction and adverse decisions (O.C.G.A. §§ 33-39-9 through 33-39-13)

Access. On a written request with proper identification, the holder has 30 business days to describe the recorded personal information, let the person see and copy it, and identify those to whom it was disclosed within the prior two years (O.C.G.A. § 33-39-9(a)). The right covers personal information; privileged information gathered for a claim or lawsuit is a separate category and is not personal information (O.C.G.A. § 33-39-3(19), (22)).

Correction. Within 30 business days of a written request, the holder corrects, amends or deletes the information or explains its refusal and the person’s right to file a statement of disagreement (O.C.G.A. § 33-39-10(a)). Corrections go to designated recipients from the prior two years and to support organizations that systematically received the information within seven years (O.C.G.A. § 33-39-10(b)). A statement of disagreement is filed with the disputed information and accompanies it in any later disclosure (O.C.G.A. § 33-39-10(c), (d)).

Adverse underwriting decisions. The insurer or agent gives the specific reasons in writing, or says they are available on written request, with a summary of these rights (O.C.G.A. § 33-39-11(a)). A request made within 90 business days must be answered within 21 business days with the reasons, the supporting items of information and the institutional sources, though specific items of privileged information may be withheld on a reasonable suspicion of fraud or similar misconduct based on specific information available for the Commissioner’s review (O.C.G.A. § 33-39-11(b)). Rescissions, class-wide withdrawals and an agent’s placement of a declined or canceled client with another market the client accepts are not adverse decisions, but the specific reasons are still owed (O.C.G.A. § 33-39-3(1)(B)).

Past decisions. An insurer or agent may ask about a previous adverse decision or residual market coverage only if it also asks why (O.C.G.A. § 33-39-12), and may not base an adverse decision on the mere fact of either, though it may act on further information from the earlier insurer (O.C.G.A. § 33-39-13(a)). For personal auto, it may not base an adverse decision solely on the fact that the applicant has never bought auto insurance or was not covered during some period immediately before applying (O.C.G.A. § 33-39-13(b)).

Sidenote
Pitfall: declining is not the only adverse decision

An insurer’s placement of a personal-lines risk in a residual market, or a higher rate charged because a report contradicts what the applicant said, is an adverse underwriting decision just as a declination is, with the same right to the specific reasons (O.C.G.A. §§ 33-39-3(1)(A)(iv), 33-39-11).

Disclosure limits and remedies (O.C.G.A. §§ 33-39-14 through 33-39-23; Ga. Comp. R. & Regs. r. 120-2-87)

Personal or privileged information may be disclosed only as the statute allows (O.C.G.A. § 33-39-14). Common property and casualty examples are disclosure with the person’s written authorization (one presented by a non-insurer must be dated, signed and obtained one year or less before); to another insurer, agent (an adjuster acting for the insurer is one) or insurance-support organization, limited to what it reasonably needs to perform its function in the transaction or to detect fraud or misrepresentation; to any other contractor performing a function for the insurer, if it agrees not to pass the information on; to a regulator or law enforcement; for marketing, only without medical, privileged or character information and after the person was given a chance to refuse; and to a mortgagee or lienholder, limited to what protects its interest (O.C.G.A. § 33-39-14(1)–(3), (5), (6), (11), (18)).

The Commissioner may investigate (O.C.G.A. § 33-39-15), serve charges with a hearing set no less than 30 days after service, with a copy to the person whose rights were allegedly violated (O.C.G.A. § 33-39-16(a), (d)), and issue a cease and desist order (O.C.G.A. § 33-39-18). A knowing violation may bring a penalty for each violation up to an aggregate cap; violating a cease and desist order may bring larger fines or license suspension or revocation (O.C.G.A. § 33-39-19). Review is by petition to the Superior Court of Fulton County within 30 days (O.C.G.A. § 33-39-20(a)).

The individual may obtain equitable relief for denied access, correction or explanation rights and actual damages, and no more, for a wrongful disclosure; the court may award costs and attorney’s fees to the prevailing party, and suit must come within two years of discovery. There is no other remedy (O.C.G.A. § 33-39-21). In turn, no suit for defamation, invasion of privacy or negligence lies against anyone who discloses information as the chapter allows or furnishes it to an insurer, agent or support organization, unless the information was false and furnished with malice or willful intent to injure (O.C.G.A. § 33-39-22). Obtaining information from an insurer, agent or support organization under false pretenses is a misdemeanor (O.C.G.A. § 33-39-23). The Commissioner’s rule implements the chapter together with the Gramm-Leach-Bliley Act and requires compliance with federal standards wherever they are stricter (Ga. Comp. R. & Regs. r. 120-2-87-.01, -.04).

Consumer complaints to the Commissioner (Ga. Comp. R. & Regs. r. 120-2-2-.65)

A Georgia consumer unhappy with a claim can take it to the Office of the Commissioner. The Commissioner’s rules describe how the claims and investigation staff work a complaint (Ga. Comp. R. & Regs. r. 120-2-2-.65):

  • Action begins with a written complaint or a personal visit; a record is made of the complainant, the party complained against and the problem, and the complaint goes to the best-qualified investigator.
  • The investigator gathers the claimant’s statement, available medical data and the policy to determine whether a legitimate claim was denied, and in fire and casualty claims reviews the loss estimates to see whether an offer rests on a legitimate estimate.
  • Investigation is made regardless of the amount, and the policyholder is told the staff’s view.
  • Misrepresentation or another unfair trade practice is referred to the Commissioner to be stopped.
  • The staff does not actively take part in third-party claims unless bad faith is obvious on the face of the complaint.

Behind the process stands the Commissioner’s power to investigate anyone in the business of insurance (O.C.G.A. § 33-6-6(a)). Complaints reach producers and adjusters too, and when a licensee is examined over a complaint the Commissioner finds unjustified, the office bears the examination’s cost (O.C.G.A. § 33-2-15(a)).

Specific disputes also have their own routes to the Commissioner, each with its own deadline:

Situation Route to the Commissioner Citation
Auto physical damage claim, liability accepted, amount disputed Written request for arbitration r. 120-2-52-.03(6)
Personal auto policy canceled or nonrenewed Request review within 15 days of receiving the notice; policy stays in force during the review O.C.G.A. § 33-24-45(o)
Decision of the FAIR Plan or a participating insurer Appeal within 30 days O.C.G.A. § 33-33-7
Bad-faith suit filed Plaintiff mails the demand and complaint within 20 days O.C.G.A. §§ 33-4-6(b), 33-4-7(g)

Lesson summary

  • The Unfair Claims Settlement Practices Act (O.C.G.A. §§ 33-6-30 through 33-6-37) excludes workers’ compensation, fidelity and surety, reaches agents and adjusters, and is violated when a listed act is flagrant and in conscious disregard of the law or frequent enough to be a general business practice.
  • Claim forms are due within 15 calendar days of a request; a coverage decision, a payment explanation and the basis for a denial are owed on the insured’s written request; the Act gives claimants no private lawsuit.
  • Rule 120-2-52 sets auto physical damage deadlines: acknowledge within 15 days, decide within 15 days of the proof of loss and within 60 days of notice unless requested information is missing, and pay within 10 days once the amount is determined and undisputed.
  • O.C.G.A. § 33-4-6 adds up to the greater of 50 percent of the insurer’s liability or $5,000, plus attorney’s fees, when an insurer refuses in bad faith to pay a covered loss within 60 days of the policyholder’s demand.
  • O.C.G.A. § 33-4-7 applies the same formula to third-party auto property damage claims, but only after a demand for an amount certain goes unaccepted for 60 days and the claimant recovers at least the demand.
  • Georgia’s privacy chapter governs personal-lines information: one-year authorizations, access and correction within 30 business days, and specific reasons for adverse underwriting decisions, including residual market placements.
  • The Commissioner’s office investigates complaints regardless of amount, and auto claim arbitration, auto cancellation review within 15 days and FAIR Plan appeals within 30 days give specific disputes their own routes.

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Georgia Claims Practices and Consumer Protection

Unfair claims practices (O.C.G.A. §§ 33-6-30 through 33-6-37)

A claim follows the policy’s own steps: notice, proof of loss, the adjuster’s investigation, appraisal and payment. Georgia adds rules that sit outside the policy and govern how the insurer behaves while it handles the claim. They come from three places: regulatory standards the Commissioner enforces, statutory penalties a court can add when an insurer refuses in bad faith to pay, and the consumer’s access to the Commissioner’s office. Georgia’s privacy statute, covered later on this page, governs the information gathered along the way.

What the Act covers (O.C.G.A. §§ 33-6-30 through 33-6-32)

Article 2 of Chapter 6 of the Insurance Code is the Unfair Claims Settlement Practices Act (O.C.G.A. § 33-6-30). It sets standards “for the investigation and disposition of claims arising under policies or certificates of insurance issued to residents of Georgia,” and it does not cover claims involving workers’ compensation, fidelity, or surety insurance (O.C.G.A. §§ 33-6-31, 33-6-32(3)). Workers’ compensation claims follow their own timetable under Title 34.

Definitions
Insured
The party named on a policy or certificate, or the person the contract defines as having legal rights to its benefits (O.C.G.A. § 33-6-32(1)).
Person
Any individual or entity engaged in the business of insurance, including agents, brokers, counselors and adjusters (O.C.G.A. § 33-6-32(2)).

The listed practices are described as acts of an insurer (O.C.G.A. §§ 33-6-33, 33-6-34), but the Commissioner’s enforcement power reaches “any person” engaged in an unfair claims settlement practice, and “person” includes the agents and adjusters who handle claims (O.C.G.A. §§ 33-6-32(2), 33-6-35(a)).

When a claims practice becomes a violation (O.C.G.A. § 33-6-33)

An act on Georgia’s list is an improper claims settlement practice when it:

  1. Is committed flagrantly and in conscious disregard of the Insurance Code or its rules, or
  2. Has been committed with such frequency as to indicate a general business practice (O.C.G.A. § 33-6-33).

The test separates an honest slip from a deliberate act or a pattern. An adjuster who misplaces one letter and answers it late has not, by that alone, violated the Act. A company whose files show that letters routinely go unanswered has. A single act can also qualify if it is flagrant and in conscious disregard of the law, such as an adjuster knowingly telling a claimant that a policy lapsed when it did not.

The unfair claims settlement practices (O.C.G.A. § 33-6-34)

Georgia lists sixteen acts. They fall into a few groups.

  • Honesty and communication. Knowingly misrepresenting relevant facts or policy provisions relating to the coverages at issue; failing to acknowledge pertinent communications about claims with reasonable promptness (O.C.G.A. § 33-6-34(1), (2)).
  • Investigation. Failing to adopt and implement procedures for prompt investigation and settlement; refusing to pay claims without a reasonable investigation; delaying a claim by requiring both a formal proof of loss and a later verification that duplicates it, although sworn statements may still be taken if the policy permits (O.C.G.A. § 33-6-34(3), (6), (9)).
  • Settlement. Not attempting in good faith a prompt, fair and equitable settlement once liability has become reasonably clear; compelling insureds to sue by offering substantially less than they ultimately recover (O.C.G.A. § 33-6-34(4), (5)). An insurer that routinely offers half of documented repair costs, expecting that only some homeowners will sue for the rest, is the kind of pattern paragraph (5) describes.
  • Payment documents. Telling a first-party claimant on a check or accompanying letter that a payment is final or a release, unless the policy limit has been paid or a compromise settlement has been agreed; issuing a partial-settlement check with language releasing the insurer or its insured from total liability (O.C.G.A. § 33-6-34(13), (14)). An advance paid to a homeowner for emergency repairs may not be labeled final unless one of those conditions is met.
  • Repairs. Failing to adopt reasonable standards to assure that a repairer the insurer owns works in a workmanlike manner (O.C.G.A. § 33-6-34(12)).
  • Health claims. The last two paragraphs concern surprise billing and emergency services (O.C.G.A. § 33-6-34(15), (16)).

Three duties arise when the insured requests them in writing: to affirm or deny coverage within a reasonable time after completing the investigation, to indicate the coverage under which each payment is made, and to promptly give a reasonable and accurate explanation of the basis for a denial or a compromise offer (O.C.G.A. § 33-6-34(7), (8), (10)). Paragraph (10) adds that claim denials shall be in writing.

Sidenote
Know this: the 15 calendar days and the written request

Outside the health-claim paragraphs, the Act’s one fixed deadline is for claim forms: an insurer that fails to provide the forms needed to file a claim, with reasonable explanations, within 15 calendar days of a request commits an unfair practice (O.C.G.A. § 33-6-34(11)). The coverage decision, payment explanation and explanation of a denial are owed “when requested by the insured in writing.” A producer helping a client with a slow claim should put the client’s questions to the insurer in writing.

Enforcement and no private lawsuit (O.C.G.A. §§ 33-6-35 through 33-6-37)

When the Commissioner has reason to believe a person is engaging in an unfair claims settlement practice and a proceeding would serve the public interest, the Commissioner serves a statement of charges and a notice of hearing (O.C.G.A. § 33-6-35(a)). The unfair trade practices procedure applies (O.C.G.A. § 33-6-35(b)): the hearing is set no less than 15 days after service, the person charged may show cause, and others may intervene for good cause (O.C.G.A. § 33-6-7(a), (b)).

A violation leads to written findings and a cease and desist order. The Commissioner may add a monetary penalty for each violation, with a higher maximum where the person knew or reasonably should have known of the violation, and in that case may also suspend or revoke the person’s license (O.C.G.A. § 33-6-8(a)). Violating a cease and desist order while it is in effect can bring a further penalty, license suspension or revocation (O.C.G.A. § 33-6-9). The person charged may seek review by petition, and the Commissioner’s findings of fact are final if sustained by substantial evidence (O.C.G.A. § 33-6-10(a)). The Commissioner may adopt rules under the Act and, in extraordinary circumstances, temporarily suspend them (O.C.G.A. § 33-6-36).

The Act creates no private cause of action (O.C.G.A. § 33-6-37). A claimant cannot sue “for violating the Act”; the claimant’s own routes are a suit on the policy, the bad-faith statutes below, and a complaint to the Commissioner.

Other claim-handling rules (O.C.G.A. §§ 33-24-40, 33-24-41.2, 33-24-46, 33-6-4)

  • No waiver by handling the claim. Acknowledging notice of a loss, furnishing forms, investigating and negotiating do not waive any policy provision or defense (O.C.G.A. § 33-24-40). An insurer can respond promptly without conceding coverage.
  • Notice of settlement payments. When an insurer pays $5,000 or more to settle a natural person’s third-party liability claim through the claimant’s attorney or other representative, it must give the claimant written notice at the same time (O.C.G.A. § 33-24-41.2(a)). Only the Commissioner may act on a missing notice, and it does not undo the settlement (O.C.G.A. § 33-24-41.2(b)).
  • A question is not a claim. Under a residential property policy, a report of loss or a question about coverage does not by itself establish a claim against the policy (O.C.G.A. § 33-24-46(b)(1)). A homeowner can ask whether hail damage is covered without that call counting as a claim.
  • Innocent co-insureds. No one may fail to pay an innocent first-party claimant’s loss, to the extent of that claimant’s interest in the property, when the loss was caused by the intentional act of an insured against whom a family violence or sexual assault complaint is brought for that act (O.C.G.A. § 33-6-4(b)(15)(G)).

Fair and equitable settlement of auto physical damage claims (Ga. Comp. R. & Regs. r. 120-2-52)

The Commissioner’s rule on first-party property damage claims under personal private passenger auto policies sets specific deadlines for “the expeditious and efficient settlement” of those claims (Ga. Comp. R. & Regs. r. 120-2-52-.02). These are the insured’s own claims for damage to or theft of the insured vehicle, such as collision and other-than-collision claims.

Claim deadlines (Ga. Comp. R. & Regs. r. 120-2-52-.03)

Step Deadline Rule
Acknowledge the claim Within 15 days of notice, unless payment is made in that time. Notice to the insurer’s agent is notice to the insurer. r. 120-2-52-.03(1)
Send proof of loss forms, if used Within 15 days, with explanations; sending them counts as the acknowledgment r. 120-2-52-.03(2)
Affirm or deny liability Within 15 days of receiving the completed proof of loss; if none is required, the coverage investigation takes place within 30 days of receiving the claim r. 120-2-52-.03(3)
Need more time Notify the claimant within 5 business days after the deadline passes, with the reason and an estimate. Total time may not exceed 60 days from notice of the claim unless the file documents requested information not yet submitted. r. 120-2-52-.03(5)
Pay Within 10 days after coverage is confirmed and the full amount is determined and undisputed r. 120-2-52-.03(4)

The same paragraph that sets the 15-day auto deadline states 60 days after the completed proof of loss for losses under fire or extended coverage type policies (r. 120-2-52-.03(3)).

Denials, repairs and arbitration (Ga. Comp. R. & Regs. r. 120-2-52-.03, -.04)

  • Denials based on a specific provision, condition or exclusion must cite it and be given to the insured in writing (r. 120-2-52-.03(7)).
  • Choice of shop. The insurer pays up to actual cash value to repair or replace, less the deductible. The insured may choose the repair shop and pays any difference if it costs more than the insurer’s shop; unless the policy permits, the insurer may not require a particular repairer when the work can be done elsewhere at the same cost (r. 120-2-52-.03(8)).
  • Higher estimates. The insured may have a copy of the insurer’s estimate, which must allow repairs restoring preaccident quality, safety, function and appearance. If the insured shows with a written estimate that necessary repairs cost more, the insurer must respond within 15 days by naming a shop that will do the work for its estimate or paying the difference (r. 120-2-52-.04(1)).
  • Betterment and depreciation. Deductions must be documented and itemized. A deduction for wear and tear or rust is limited to $1,000, and all such deductions together to 20% of the vehicle’s market value before the loss (r. 120-2-52-.04(2)). The insurer may not require the insured to authorize non-original-manufacturer aftermarket crash parts in the repair (r. 120-2-52-.05(5)).
  • Arbitration. Once liability is accepted but the amount is disputed, either side may ask the Commissioner in writing for arbitration. Where the Commissioner has set up a panel, three arbitrators hear the case, including at least one attorney and one licensed adjuster; the result binds both parties, and they share the cost equally (r. 120-2-52-.03(6)).

For a total loss, the insurer either pays the cost of a comparable automobile, with taxes and transfer fees, measured by methods the rule lists, such as comparable cars available within 50 miles of the county seat where the car was principally garaged, or offers a comparable replacement vehicle, which the insured may reject (r. 120-2-52-.06).

Bad-faith penalties (O.C.G.A. §§ 33-4-6 and 33-4-7)

The Unfair Claims Settlement Practices Act lets the Commissioner discipline insurers but gives the claimant nothing. Georgia’s bad-faith statutes do the opposite: a court may add a penalty and attorney’s fees to what the insurer owes. Each statute has precise conditions, and a claimant who misses one loses the penalty.

Refusal to pay a covered loss (O.C.G.A. § 33-4-6)

This first-party statute protects the holder of the policy. The penalty applies when (O.C.G.A. § 33-4-6(a)):

  1. The loss is covered by the policy,
  2. The holder has made a demand for payment,
  3. The insurer has refused to pay within 60 days after the demand, and
  4. A finding has been made that the refusal was in bad faith.

The insurer then owes, in addition to the loss, not more than 50 percent of its liability for the loss or $5,000, whichever is greater, plus all reasonable attorney’s fees. Paying after the 60 days does not end the bad-faith action, and an expert’s opinion cannot alone decide bad faith on summary judgment or directed verdict. The jury sets the attorney’s fees on competent expert evidence of the reasonable value of the lawyer’s services, and the trial court may correct a fee verdict it finds greatly excessive or inadequate (O.C.G.A. § 33-4-6(a)). Within 20 days of filing suit, the plaintiff mails the Commissioner a copy of the demand and complaint by first-class mail (O.C.G.A. § 33-4-6(b)).

Third-party property damage under auto liability policies (O.C.G.A. § 33-4-7)

This statute protects a claimant against the auto liability insurer of the person who caused the damage, and only for property damage. The insurer has an affirmative duty to adjust the loss fairly and promptly, to investigate and evaluate it reasonably, and, where liability is reasonably clear, to make a good faith effort to settle (O.C.G.A. § 33-4-7(a)). It breaches the duty when, liability being reasonably clear, it offers in bad faith less than the amount reasonably owed (O.C.G.A. § 33-4-7(b)). The claimant recovers the penalty only if (O.C.G.A. § 33-4-7(c)):

  • The claimant or attorney delivered a demand letter by statutory overnight delivery or certified mail, return receipt requested, offering to settle for an amount certain;
  • The insurer refused or declined within 60 days of receiving it; and
  • The claimant ultimately recovers at least the amount demanded.

The insurer is an unnamed party, not disclosed to the jury, until a verdict reaches the demand; the trial then resumes to decide bad faith (O.C.G.A. § 33-4-7(d)). Late payment does not end the action (O.C.G.A. § 33-4-7(e)), and the plaintiff mails the Commissioner the demand and complaint within 20 days of suing (O.C.G.A. § 33-4-7(g)).

Comparing the penalties

Uninsured motorist coverage carries its own penalty (O.C.G.A. § 33-7-11(j)), covered in Georgia Auto Insurance Law.

O.C.G.A. § 33-4-6 O.C.G.A. § 33-4-7 O.C.G.A. § 33-7-11(j)
Protects Holder of the policy Third-party claimant UM insured
Loss Any covered loss Property damage under a motor vehicle liability policy Loss covered by UM
Trigger Refusal to pay within 60 days of demand, found in bad faith Demand for an amount certain refused for 60 days; recovery at least the demand Refusal to pay within 60 days of demand, found in bad faith
Maximum penalty Greater of 50% of the insurer’s liability or $5,000 Greater of 50% of the insured’s liability or $5,000 Greater of 25% of the recovery or $25,000
Also Reasonable attorney’s fees Reasonable attorney’s fees Attorney’s fees; decided in a separate action after judgment against the uninsured motorist
Sidenote
Exam point: "whichever is greater"

The dollar amount sets a floor under the maximum penalty. On a $60,000 covered loss, 50 percent is $30,000, greater than $5,000, so the penalty may reach $30,000. On a $6,000 loss, 50 percent is $3,000, so the $5,000 figure controls (O.C.G.A. § 33-4-6(a)). Attorney’s fees come on top.

Insurance Information and Privacy Protection (O.C.G.A. Title 33, Chapter 39)

Underwriting and claims run on personal information: driving records, prior losses, credit-based information, medical records after an injury. Chapter 39, Georgia’s version of the NAIC Insurance Information and Privacy Protection Model Act, sets standards for collecting, using and disclosing it, lets people see and dispute what is held about them, and entitles applicants and policyholders to the reasons for an adverse underwriting decision (O.C.G.A. § 33-39-1).

Who and what the chapter covers (O.C.G.A. §§ 33-39-2, 33-39-3)

For property and casualty insurance, the chapter binds insurers, agents and insurance-support organizations dealing with policies delivered, issued for delivery or renewed in Georgia (O.C.G.A. § 33-39-2(a)(2)). “Agent” includes brokers, counselors, adjusters and service representatives (O.C.G.A. § 33-39-3(3)). An insurance transaction is one for insurance primarily for personal, family or household needs (O.C.G.A. § 33-39-3(13)), so the chapter concerns personal lines.

Definitions
Personal information
Individually identifiable information from which judgments can be made about a person’s character, habits, finances, occupation, credit, health or other characteristics; a name, address and age alone is not (O.C.G.A. § 33-39-3(19)).
Privileged information
Individually identifiable information relating to a claim or a civil or criminal proceeding, collected in connection with or in reasonable anticipation of it (O.C.G.A. § 33-39-3(22)).
Adverse underwriting decision
For individually underwritten property or casualty coverage: a declination; a termination (a cancellation or nonrenewal for a reason other than nonpayment); an agent’s failure to apply to a specific insurer the agent represents when the applicant asks; placement with a residual market mechanism or an unauthorized insurer; or a higher rate based on information that differs from what the applicant furnished (O.C.G.A. § 33-39-3(1)(A), (24)).

Collecting information (O.C.G.A. §§ 33-39-4 through 33-39-8)

  • Pretext interviews, in which the interviewer pretends to be someone else or hides the interview’s purpose, are prohibited. The one exception is a claim investigation, questioning a source with no privileged relationship to the person, when specific information available for the Commissioner’s review gives a reasonable basis for suspecting criminal activity, fraud, material misrepresentation or material nondisclosure (O.C.G.A. §§ 33-39-3(21), 33-39-4).
  • Notice of information practices. A written notice goes to applicants no later than delivery of the policy, or when collection begins if information will come from sources other than the applicant or public records, and to policyholders by the renewal date unless practices are unchanged and sharing complies with the chapter (O.C.G.A. § 33-39-5(a)). An abbreviated notice may be used if it tells the person that information may come from others and may be disclosed without authorization, that rights of access and correction exist, and that the full notice is available on request (O.C.G.A. § 33-39-5(c)).
  • Marketing questions must be clearly identified (O.C.G.A. § 33-39-6).
  • Authorizations for others to release information must be plain, dated and specific, and may last no longer than one year from signing for a property or casualty application (thirty months for life, health or disability) or the duration of a non-health claim (O.C.G.A. § 33-39-7).
  • Investigative consumer reports. The person must be told that he or she may ask to be interviewed and may receive a copy (O.C.G.A. § 33-39-8(a)).

Access, correction and adverse decisions (O.C.G.A. §§ 33-39-9 through 33-39-13)

Access. On a written request with proper identification, the holder has 30 business days to describe the recorded personal information, let the person see and copy it, and identify those to whom it was disclosed within the prior two years (O.C.G.A. § 33-39-9(a)). The right covers personal information; privileged information gathered for a claim or lawsuit is a separate category and is not personal information (O.C.G.A. § 33-39-3(19), (22)).

Correction. Within 30 business days of a written request, the holder corrects, amends or deletes the information or explains its refusal and the person’s right to file a statement of disagreement (O.C.G.A. § 33-39-10(a)). Corrections go to designated recipients from the prior two years and to support organizations that systematically received the information within seven years (O.C.G.A. § 33-39-10(b)). A statement of disagreement is filed with the disputed information and accompanies it in any later disclosure (O.C.G.A. § 33-39-10(c), (d)).

Adverse underwriting decisions. The insurer or agent gives the specific reasons in writing, or says they are available on written request, with a summary of these rights (O.C.G.A. § 33-39-11(a)). A request made within 90 business days must be answered within 21 business days with the reasons, the supporting items of information and the institutional sources, though specific items of privileged information may be withheld on a reasonable suspicion of fraud or similar misconduct based on specific information available for the Commissioner’s review (O.C.G.A. § 33-39-11(b)). Rescissions, class-wide withdrawals and an agent’s placement of a declined or canceled client with another market the client accepts are not adverse decisions, but the specific reasons are still owed (O.C.G.A. § 33-39-3(1)(B)).

Past decisions. An insurer or agent may ask about a previous adverse decision or residual market coverage only if it also asks why (O.C.G.A. § 33-39-12), and may not base an adverse decision on the mere fact of either, though it may act on further information from the earlier insurer (O.C.G.A. § 33-39-13(a)). For personal auto, it may not base an adverse decision solely on the fact that the applicant has never bought auto insurance or was not covered during some period immediately before applying (O.C.G.A. § 33-39-13(b)).

Sidenote
Pitfall: declining is not the only adverse decision

An insurer’s placement of a personal-lines risk in a residual market, or a higher rate charged because a report contradicts what the applicant said, is an adverse underwriting decision just as a declination is, with the same right to the specific reasons (O.C.G.A. §§ 33-39-3(1)(A)(iv), 33-39-11).

Disclosure limits and remedies (O.C.G.A. §§ 33-39-14 through 33-39-23; Ga. Comp. R. & Regs. r. 120-2-87)

Personal or privileged information may be disclosed only as the statute allows (O.C.G.A. § 33-39-14). Common property and casualty examples are disclosure with the person’s written authorization (one presented by a non-insurer must be dated, signed and obtained one year or less before); to another insurer, agent (an adjuster acting for the insurer is one) or insurance-support organization, limited to what it reasonably needs to perform its function in the transaction or to detect fraud or misrepresentation; to any other contractor performing a function for the insurer, if it agrees not to pass the information on; to a regulator or law enforcement; for marketing, only without medical, privileged or character information and after the person was given a chance to refuse; and to a mortgagee or lienholder, limited to what protects its interest (O.C.G.A. § 33-39-14(1)–(3), (5), (6), (11), (18)).

The Commissioner may investigate (O.C.G.A. § 33-39-15), serve charges with a hearing set no less than 30 days after service, with a copy to the person whose rights were allegedly violated (O.C.G.A. § 33-39-16(a), (d)), and issue a cease and desist order (O.C.G.A. § 33-39-18). A knowing violation may bring a penalty for each violation up to an aggregate cap; violating a cease and desist order may bring larger fines or license suspension or revocation (O.C.G.A. § 33-39-19). Review is by petition to the Superior Court of Fulton County within 30 days (O.C.G.A. § 33-39-20(a)).

The individual may obtain equitable relief for denied access, correction or explanation rights and actual damages, and no more, for a wrongful disclosure; the court may award costs and attorney’s fees to the prevailing party, and suit must come within two years of discovery. There is no other remedy (O.C.G.A. § 33-39-21). In turn, no suit for defamation, invasion of privacy or negligence lies against anyone who discloses information as the chapter allows or furnishes it to an insurer, agent or support organization, unless the information was false and furnished with malice or willful intent to injure (O.C.G.A. § 33-39-22). Obtaining information from an insurer, agent or support organization under false pretenses is a misdemeanor (O.C.G.A. § 33-39-23). The Commissioner’s rule implements the chapter together with the Gramm-Leach-Bliley Act and requires compliance with federal standards wherever they are stricter (Ga. Comp. R. & Regs. r. 120-2-87-.01, -.04).

Consumer complaints to the Commissioner (Ga. Comp. R. & Regs. r. 120-2-2-.65)

A Georgia consumer unhappy with a claim can take it to the Office of the Commissioner. The Commissioner’s rules describe how the claims and investigation staff work a complaint (Ga. Comp. R. & Regs. r. 120-2-2-.65):

  • Action begins with a written complaint or a personal visit; a record is made of the complainant, the party complained against and the problem, and the complaint goes to the best-qualified investigator.
  • The investigator gathers the claimant’s statement, available medical data and the policy to determine whether a legitimate claim was denied, and in fire and casualty claims reviews the loss estimates to see whether an offer rests on a legitimate estimate.
  • Investigation is made regardless of the amount, and the policyholder is told the staff’s view.
  • Misrepresentation or another unfair trade practice is referred to the Commissioner to be stopped.
  • The staff does not actively take part in third-party claims unless bad faith is obvious on the face of the complaint.

Behind the process stands the Commissioner’s power to investigate anyone in the business of insurance (O.C.G.A. § 33-6-6(a)). Complaints reach producers and adjusters too, and when a licensee is examined over a complaint the Commissioner finds unjustified, the office bears the examination’s cost (O.C.G.A. § 33-2-15(a)).

Specific disputes also have their own routes to the Commissioner, each with its own deadline:

Situation Route to the Commissioner Citation
Auto physical damage claim, liability accepted, amount disputed Written request for arbitration r. 120-2-52-.03(6)
Personal auto policy canceled or nonrenewed Request review within 15 days of receiving the notice; policy stays in force during the review O.C.G.A. § 33-24-45(o)
Decision of the FAIR Plan or a participating insurer Appeal within 30 days O.C.G.A. § 33-33-7
Bad-faith suit filed Plaintiff mails the demand and complaint within 20 days O.C.G.A. §§ 33-4-6(b), 33-4-7(g)

Lesson summary

  • The Unfair Claims Settlement Practices Act (O.C.G.A. §§ 33-6-30 through 33-6-37) excludes workers’ compensation, fidelity and surety, reaches agents and adjusters, and is violated when a listed act is flagrant and in conscious disregard of the law or frequent enough to be a general business practice.
  • Claim forms are due within 15 calendar days of a request; a coverage decision, a payment explanation and the basis for a denial are owed on the insured’s written request; the Act gives claimants no private lawsuit.
  • Rule 120-2-52 sets auto physical damage deadlines: acknowledge within 15 days, decide within 15 days of the proof of loss and within 60 days of notice unless requested information is missing, and pay within 10 days once the amount is determined and undisputed.
  • O.C.G.A. § 33-4-6 adds up to the greater of 50 percent of the insurer’s liability or $5,000, plus attorney’s fees, when an insurer refuses in bad faith to pay a covered loss within 60 days of the policyholder’s demand.
  • O.C.G.A. § 33-4-7 applies the same formula to third-party auto property damage claims, but only after a demand for an amount certain goes unaccepted for 60 days and the claimant recovers at least the demand.
  • Georgia’s privacy chapter governs personal-lines information: one-year authorizations, access and correction within 30 business days, and specific reasons for adverse underwriting decisions, including residual market placements.
  • The Commissioner’s office investigates complaints regardless of amount, and auto claim arbitration, auto cancellation review within 15 days and FAIR Plan appeals within 30 days give specific disputes their own routes.

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