How do I dispute an insurance claim settlement I disagree with?
If your insurer has offered a settlement you believe is too low or has wrongly denied your claim, the first step is to request a written explanation of how the amount was calculated. Insurers operating in Georgia are required by Ga. Comp. R. & Regs. 120-2-52-.03 to acknowledge your claim within 15 days, provide a coverage decision within 60 days, and pay an approved claim within 10 business days. Getting the reasoning in writing gives you something concrete to challenge.
What evidence supports a dispute with my insurance company?
Once you have the written explanation, gather documentation to support a higher value. For property claims under your homeowners insurance, independent repair estimates from licensed contractors are the most useful evidence. For auto claims, get your own appraisal from a qualified appraiser. For medical-related claims, obtain itemized bills and a written opinion from your treating provider. Document everything with dates and the name of each person you speak with.
For example, a Duluth homeowner who received a storm damage settlement of $8,000 hired an independent contractor who estimated $21,000 in repairs. The homeowner submitted that estimate with a formal written appeal and the insurer revised the settlement upward after reviewing the difference in scope.
How do I file a formal appeal with my insurance company?
Submit a written appeal to your insurer citing the specific reasons you disagree and attaching your supporting evidence. Most insurers have an internal appeal or reconsideration process. Reference the policy language, the specific coverage section you believe applies, and any estimate that contradicts the adjuster’s position. A low offer often comes down to how the loss was valued, so knowing the difference between actual cash value and replacement cost can help you frame the appeal. Keep a copy of everything you send and note the date you sent it.
What is the appraisal clause and how does it resolve valuation disputes?
If the internal appeal does not resolve the dispute, check your policy for an appraisal clause. Most Georgia homeowners and commercial property policies include one. Under the appraisal clause, each party hires their own licensed appraiser, and those two appraisers select a neutral umpire. The umpire’s decision on the value of the loss is typically binding. Our walkthrough of the Georgia appraisal process covers how it works step by step. For example, a Savannah property owner disputed a $45,000 settlement on a hurricane loss. Both parties invoked the appraisal clause, and the umpire awarded $72,000 after reviewing competing estimates, with the insurer paying the difference within 10 business days as required under Georgia regulations.
Can the Georgia Department of Insurance help with a disputed claim?
Yes. Filing a complaint with the Georgia Department of Insurance Consumer Services Division at oci.georgia.gov creates a regulatory record and can trigger a review of whether the insurer complied with Georgia’s claims handling rules. The DOI does not order an insurer to pay a higher amount, but a pattern of violations can result in regulatory action against the insurer. If you want help managing the appeal itself, our claims support can walk you through the documentation.
When does a claim dispute become a bad faith case under Georgia law?
Georgia’s bad faith statute, O.C.G.A. Section 33-4-6, applies when an insurer refuses to pay a covered claim without reasonable cause. If you send a written demand and the insurer does not pay within 60 days, a court can award the claim amount plus a penalty of up to 50 percent of the loss and reasonable attorney fees. Our explainer on insurance bad faith in Georgia covers the standard in more detail. Consulting with a licensed attorney who handles insurance disputes in Georgia is the appropriate step before sending a formal demand letter. A free coverage review can confirm whether your policy language supports your coverage position before you escalate.