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§ 33-6-34 - Unfair claims settlement practices

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O.C.G.A.33-6-34 (2010) 33-6-34.Unfair claims settlement practices Anyof the following acts of an insurer when committed as provided in CodeSection 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)Failingto acknowledge with reasonable promptness pertinent communications withrespect to claims arising under its policies;(3)Failingto adopt and implement procedures for the prompt investigation andsettlement of claims arising under its policies;(4)Notattempting in good faith to effectuate prompt, fair, and equitablesettlement of claims submitted in which liability has become reasonablyclear;(5)Compelling insureds orbeneficiaries to institute suits to recover amounts due under itspolicies by offering substantially less than the amounts ultimatelyrecovered in suits brought by them;(6)Refusing to pay claims without conducting a reasonable investigation;(7)Whenrequested by the insured in writing, failing to affirm or deny coverageof claims within a reasonable time after having completed itsinvestigation related to such claim or claims;(8)Whenrequested by the insured in writing, making claims payments to aninsured or beneficiary without indicating the coverage under which eachpayment is being made;(9)Unreasonablydelaying the investigation or payment of claims by requiring both aformal proof of loss and subsequent verification that would result induplication of information and verification appearing in the formalproof of loss form; provided, however, this paragraph shall not precludean insurer from obtaining sworn statements if permitted under thepolicy;(10)When requested by theinsured in writing, failing in the case of claims denial or offers ofcompromise settlement to provide promptly a reasonable and accurateexplanation of the basis for such actions.In the case of claimsdenials, such denials shall be in writing;(11)Failingto provide forms necessary to file claims within 15 calendar days of arequest with reasonable explanations regarding their use;(12)Failingto adopt and implement reasonable standards to assure that the repairsof a repairer owned by the insurer are performed in a workmanlikemanner;(13)Indicating to a first-partyclaimant on a payment, draft check, or accompanying letter that saidpayment is final or a release of any claim unless the policy limit hasbeen paid or there has been a compromise settlement agreed to by thefirst-party claimant and the insurer as to coverage and amount payableunder the contract; and(14)Issuingchecks or drafts in partial settlement of a loss or claim under aspecific coverage which contain language which releases the insurer orits insured from its total liability.
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  • O.C.G.A. 33-6-34 (2010)
    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; and

    (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.

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