An insurer that said it would cover the claim and then did not pay

Q: What does Georgia's bad-faith insurance statute require?

O.C.G.A. § 33-4-6 concerns a loss covered by a policy, a refusal to pay within 60 days after a demand by the policyholder, and a finding that the refusal was in bad faith. It is a first-party remedy against one's own insurer.

Q: Does a verbal assurance that a claim is covered bind an insurer?

An assurance is not a payment, and the statutory route is built around a written demand and the period that follows it. Any written confirmation of coverage is important evidence.

Q: What should a policyholder request when a claim was never paid?

The complete claim file, a statement of what was paid and to whom, and confirmation of whether a claim was opened at all, all in writing.

Question

My son was in an accident in 2022. The insurance we had at the time said they would cover it, and two years later we found out they never paid.

A. Jason Velez · Accepted Answer

A claim against your own insurer for failing to pay a covered loss is a different kind of claim, and Georgia has a specific provision for it. O.C.G.A. § 33-4-6(a) applies: 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… Three elements matter in that sentence. The loss has to be covered by the policy. There has to be a demand by the policyholder. And sixty days has to pass. This is a first-party remedy — it is for an insured against their own insurer, which is exactly the position here. The gap between being told it was covered and discovering it was not paid is the problem. An assurance is not a payment, and two years is long enough that other deadlines may also have moved. Establishing what actually happened on the file — whether the claim was opened, what was decided, and whether anything was ever sent — is the first step. A written demand matters because the statute is built around one. A phone call in 2022 is unlikely to satisfy it. ## What you can do 1. Ask the insurer in writing for the complete claim file and a statement of what was paid and to whom. 2. Find any letter or email in which coverage was confirmed — that is the key document. 3. Make a formal written demand for payment, and keep proof of the date it was sent. 4. Establish whether a claim was ever opened and what number it was given. 5. Speak to a Georgia attorney promptly, because the delay may have affected other deadlines. ⏱ Time limits apply. O.C.G.A. § 9-3-33 requires actions for injuries to the person to be brought within two years after the right of action accrues. Waiting also costs evidence — footage is overwritten and memories fade — so the practical deadline is usually much earlier than the legal one. A Georgia attorney can tell you quickly how the facts here line up, and most will look at a matter like this at no cost.

An insurer that said it would cover the claim and then did not pay

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