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The statute opens with the requirement that there be a “loss” covered by a policy.  Thus, the insured must prove that the loss for which payment sought is covered under the insurance policy at issue.  Where the claim is not covered, the insurer has no obligation to pay and there can be no bad faith.

The vast majority of cases applying O.C.G.A. § 33-4-6 involve the insurance company’s failure to pay a loss under “first-party” coverage.  First-party coverage includes claims involving only the insured and the insurer, such as payment for property damage to a home following a fire or the payment of benefits under a life or disability policy.

Leader Nat. Ins. Co. v. Kemp & Son

Although the law can guide a practitioner in interpreting the various component parts of an insurance policy, the ability to analyze a policy and render a competent coverage analysis requires certain practical considerations.  An opinion regarding coverage cannot be confidently given without consideration of all of the following:

Accurate Copy Of The Policy

Few insureds ever obtain, much less maintain, a complete and accurate copy of their policies.  Although a commercial broker will often maintain or be able to reconstruct a complete and accurate copy, many retail agents will, in response to a request for a copy of the policy, provide a declarations page and state-specific endorsements without all policy forms.

The rules of construction require the court to consider the policy as a whole, to give effect to each provision, and to interpret each provision to harmonize with each other. Additionally, a court should avoid an interpretation of a contract that renders portions of the language of the contract meaningless.

“[I]t is a cardinal rule of contract construction that a court should, if possible, construe a contract so as not to render any of its provisions meaningless and in a manner that gives effect to all of the contractual terms.” Pomerance, 288 Ga. App. at 494, 654 S.E.2d at 641.

A court may not construe an insurance policy in a way that renders a provision superfluous. York Ins. Co. v. Williams Seafood of Albany, Inc., 273 Ga. 710, 712, 544 S.E.2d 156, 157 (2001). This Court “must consider [the policy] as a whole, give effect to each provision, and interpret each provision to harmonize with each other.” S. Trust Ins. Co. v. Dr. T’s Nature Products Co., 261 Ga. App. 806, 807, 584 S.E.2d 34, 35-36 (2003).

Exclusions, Exceptions And Limitations

In contrast to the grant of coverage in an insurance policy, exceptions and exclusions to coverage must be narrowly and strictly construed against the insurer and liberally construed in favor of the insured to afford coverage.  A contract of insurance is construed most strongly against the insurer and liberally in favor of the insured, particularly where the insurer seeks to deny coverage based upon a policy exclusion. Exceptions, limitations and exclusions to insuring agreements require a narrow construction on the theory that the insurer, having affirmatively expressed coverage through broad promises, assumes a duty to define any limitations on that coverage in clear and explicit terms. Where an insurer grants coverage to an insured, any exclusions from coverage must be defined clearly and distinctly. Exclusions are strictly construed.

Ambiguities

The Reasonable Expectations Doctrine In Insurance Bad Faith

The plain meaning of an insurance policy is informed by the reasonable expectations of the insured.  “A contract of insurance should be strictly construed against the insurer and read in favor of coverage in accordance with the reasonable expectations of the insured.”   Insurance policies are contracts of adhesion, drawn by insurers, and should be construed as reasonably understood by an insured.  The test is not what the insurer intended its words to mean, but rather what a reasonable person in the insured’s position would understand them to mean.  “The policy should be read as a layman would read it and not as it might be analyzed by an insurance expert or an attorney.”

Richards v. Hanover Ins. Co.

Insurance Bad Faith And Common Law

In addition to the cause of action for bad-faith failure to pay that is grounded in statute, Georgia recognizes a cause of action for insurance bad faith that is grounded in the common law. As explained below, common-law bad faith is associated with a liability insurer’s fiduciary duty to protect its insured from the risks associated with litigation against the insured. In most cases, these risks include legal liability to the insured for damages the insured has allegedly caused to a third-party claimant. Succinctly stated, “[a]n insurance company may be liable for damages to its insured for failing to settle the claim of an injured person where the insurer is guilty of negligence, fraud, or bad faith in failing to compromise the claim.” The most common example of an insurance company’s liability for bad faith arises when the insurance company fails to take advantage of a reasonable opportunity to settle claims against its insured within policy limits.

Origins and the Smoot Trilogy

Because an insurance policy is a contract, any dispute implicating an insurer’s bad faith will involve the meaning of the words in the insurance policy.  This is true no matter the type of bad faith at issue.  Construction and interpretation of an insurance policy come into play in statutory bad-faith cases brought under O.C.G.A. § 33-4-6  as well as in bad-faith cases under the common law.  Below we will look at the types of bad faith insurance.

Types Of Bad Faith Insurance

1. Withholding Payment

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