Georgia Claim Payment Timelines (Rule 120‑2‑52‑.03)

Georgia Claim Payment Timelines (Rule 120‑2‑52‑.03)

Overview
Does Georgia have payment timelines for insurance companies? Yes
Georgia Rule 120‑2‑52‑.03 establishes strict deadlines insurers must follow when acknowledging, investigating, and paying first‑party property damage claims. These timelines protect policyholders and ensure claims are handled promptly and fairly.

Key Information

1. Claim Acknowledgment — 15 Days Insurers must acknowledge receipt of a claim within 15 days, unless payment is made within that period. Acknowledgment may be verbal, but it must be documented in the claim file. Notification to an agent = notification to the insurer.

2. Proof of Loss Forms — 15 Days Within 15 days of receiving notice of a claim, insurers must provide:

  • Proof of loss forms (if required)

  • Reasonable explanation of how to complete them Providing these forms counts as acknowledgment of the claim.

3. Liability Decision Timelines

  • Motor vehicle policies: Insurer must affirm or deny liability within 15 days of receiving a completed proof of loss.

  • Fire or extended coverage policies: Insurer must affirm or deny liability within 60 days of receiving a completed proof of loss.

  • If no proof of loss is required: Insurer must complete a reasonable coverage investigation within 30 days of receiving the claim.

4. Payment Deadlines — 10 Days Once coverage is confirmed and the claim amount is determined and undisputed, payment must be issued within 10 days. If multiple coverages exist, insurers must pay undisputed portions within 10 days.

5. If More Time Is Needed If the insurer cannot meet the timelines above, it must notify the insured within 5 business days after the deadline passes. The notice must include:

  • Reason additional time is needed

  • Estimated time required Total time to accept or deny liability cannot exceed 60 days, unless the insurer is waiting on information requested from the insured.

6. Arbitration Option for Disputed Amounts If liability is affirmed but the amount payable is disputed, either party may request arbitration through the Georgia Insurance Commissioner.

  • Request must be in writing

  • Arbitration panel includes attorneys and licensed adjusters

  • Decision is binding for both parties. Costs are shared equally.

  • Any claim resolved under this Chapter is binding on both parties and satisfies any arbitration clause in the motor vehicle insurance policy, but it doesn’t take away or waive any other rights either party may have under common law.

7. Written Denial Requirements Insurers cannot deny a claim based on a policy provision unless the denial letter specifically cites the exact provision, condition, or exclusion. The denial must be in writing and documented in the claim file.

8. Repair Rights & Actual Cash Value Insurers must pay according to policy terms up to actual cash value for repair or replacement. The insured may choose any repair shop and pay the difference if their chosen shop is more expensive. Insurers cannot require use of a specific repair facility unless allowed by the policy.

Notes for Policyholders

If your insurer is missing deadlines, delaying payment, or failing to follow these standards, you may document the issue and consider filing a complaint with the Office of Insurance and Safety Fire Commissioner.