Tenn. Comp. R. & Regs. 0780-01-05-.07, -.08, -.10 — Unfair Claims Settlement Practices
Rules of the Tennessee Department of Commerce and Insurance. Transcribed verbatim from the Cornell Legal Information Institute’s state regulations mirror of Chapter 0780-01-05 (Unfair Claims Settlement Practices), fetched directly at the three section URLs on 2026-08-08. Chapter 0780-01-05 contains sixteen rules; reproduced here are the three that govern the timing and the valuation of a first-party property claim. Each rule’s official caption appears in bold above its text, in the capitals used by the publisher, followed by the rule’s own Authority and administrative history notes as published.
Rule 0780-01-05-.07 — acknowledging a claim
FAILURE TO ACKNOWLEDGE PERTINENT COMMUNICATIONS
(1) Every insurer, upon receiving notification of a claim, shall, within thirty (30) days, acknowledge the receipt of such notice unless payment is made within that period of time. If an acknowledgement is made by means other than writing, an appropriate notation of the acknowledgement shall be made in the claim file of the insurer and dated.
(2) Pursuant to T.C.A. § 56-1-106, if the department makes a request for information from an insurer concerning a complaint filed against the insurer, the insurer must respond to the request within thirty (30) days from the date the request is received by the insurer.
(3) An appropriate reply shall be made within thirty (30) days on all other pertinent communications from a first party claimant which reasonably suggest that a response is expected.
(4) Every insurer, upon receiving notification of claim, shall promptly provide necessary claim forms, instructions and reasonable assistance so that first party claimants can comply with the policy conditions and the insurer’s reasonable requirements. Compliance with this paragraph within thirty (30) days of notification of a claim shall constitute compliance with paragraph 0780-01-05-.07(1).
Authority: T.C.A. §§ 56-1-106, 56-2-301, 56-8-101 through 56-8-120, 56-8-105, 56-8-108, and 56-8-110.
Original rules filed July 11, 2017; effective 10/9/2017.
Rule 0780-01-05-.08 — deciding and paying a claim
STANDARDS FOR PROMPT, FAIR AND EQUITABLE SETTLEMENTS APPLICABLE TO PROPERTY AND CASUALTY INSURERS
(1) Within sixty (60) days after receipt by the insurer of properly completed and executed proofs of loss and such information or documents required under the policy, the first party claimant shall be advised of the acceptance or denial of liability for the claim by the insurer. No insurer shall deny a claim without providing a basis for the denial. Upon request, any denial must be given to the first party claimant in writing and the claim file of the insurer shall contain documentation of the denial as required by rule 0780-01-05-.05.
(a) Where there is a reasonable basis supported by specific information available for review by the department that the first party claimant has fraudulently caused, contributed to, or misrepresented the loss, the insurer is relieved from the requirements of paragraph 0780-01-05-.08(1); provided, however, that the first party claimant shall be advised of the acceptance or denial of liability for the claim within a reasonable time for full investigation after receipt by the insurer of a properly completed and executed proof of loss.
(2) If the insurer needs more time to determine whether liability for a first party claim should be accepted or denied, it shall so notify the first party claimant within sixty (60) days after receipt of the proofs of loss and such information or documents required under the policy, giving the reasons more time is needed. If the investigation remains incomplete, the insurer shall, sixty (60) days from the initial notification and every sixty (60) days thereafter, send to the first party claimant a letter setting forth the reasons additional time is needed for investigation.
(a) Where there is a reasonable basis supported by specific information available for review by the department for suspecting that the first party claimant has fraudulently caused, contributed to, or misrepresented the loss, the insurer is relieved from the requirements of paragraph 0780-01-05-.08(2); provided, however, that the claimant shall be advised of the acceptance or denial of liability for the claim by the insurer within a reasonable time for full investigation after receipt by the insurer of a properly completed and executed proof of loss.
(3) The insurer shall, within thirty (30) days after concluding a coverage investigation, notify the first party claimant of the findings of the investigation. Paragraphs 0780-01-05-.08(1) and (2) shall apply at the time the notice of investigation closure is sent.
(4) Insurers shall not fail to settle first party claims on the basis that responsibility for payment should be assumed by others except as may otherwise be provided by policy provisions.
(5) Insurers shall give notice of an applicable statute of limitations to first party claimants at least thirty (30) days before the date on which such statute of limitations may expire.
(6) The insurer shall tender payment within thirty (30) days of affirmation of liability, if the amount of the claim is determined and not in dispute, unless the policyholder does not want payment within thirty (30) days.
(7) No insurer shall request or require any insured to submit to a polygraph examination unless authorized under the applicable insurance contracts and state law.
(8) If, after an insurer denies a claim in its entirety, the first party claimant objects in writing to such denial, the insurer shall notify the first party claimant in writing that he or she may file a complaint with the department, Consumer Insurance Services, 500 James Robertson Parkway, Nashville, Tennessee 37243, 1-800-342-4029, or may submit the complaint request for review electronically to that section’s complaint link for insurance complaints, currently found at: https://tn.gov/commerce/topic/commerce-file-a-complaint.
(9) An insurer shall notify a policyholder of his or her right to choose a vendor to complete repairs of damages covered under the policy, unless use of a specified vendor is provided pursuant to the terms of the policy. If a notice is made by means other than writing, an appropriate notation of the notice shall be made in the claim file of the insurer and dated.
(10) No insurer shall cancel a personal residential property policy in effect for sixty (60) days or more, if the sole reason for the cancellation of the policy is that a claim is pending with the insurer.
(11) Pursuant to T.C.A. § 56-7-113, no insurance company shall increase a premium or cancel a personal residential property policy solely on the basis of an inquiry or inquiries by an insured regarding the insured’s personal residential property policy or a loss under the policy.
Authority: T.C.A. §§ 56-2-201, 56-2-202, 56-2-301, 56-7-113, 56-8-101 through 56-8-120, 56-8-105, 56-8-108, and 56-8-110.
Original rules filed July 11, 2017; effective 10/9/2017.
Rule 0780-01-05-.10 — replacement cost, actual cash value, matching
STANDARDS FOR PROMPT, FAIR AND EQUITABLE SETTLEMENTS APPLICABLE TO FIRE AND EXTENDED COVERAGE TYPE POLICIES WITH REPLACEMENT COST COVERAGE
(1) When the policy provides for the adjustment and settlement of first party losses based on replacement cost, the following shall apply:
(a) When a loss requires repair or replacement of an item or part, any consequential physical damage incurred in making such repair or replacement not otherwise excluded by the policy, shall be included in the loss. The insured shall not have to pay for any cost except for betterment and any applicable deductible under the policy.
(b) When a loss requires replacement of items and the replaced items do not match in quality, color or size, the insurer shall replace items so as to conform to a reasonably uniform appearance according to the applicable policy provisions. This applies to interior and exterior losses. The insured shall not bear any cost over the applicable deductible, if any.
(2) Actual Cash Value:
(a) When the insurance policy provides for the adjustment and settlement of losses on an actual cash value basis on residential fire and extended coverage, the insurer shall determine actual cash value as follows: replacement cost of property at time of loss less depreciation, if any. Upon the insured’s request, the insurer shall provide a copy of the claim file worksheets detailing any and all deductions for depreciation.
(b) In cases in which the insured’s interest is limited because the property has nominal or no economic value, or a value disproportionate to replacement cost less depreciation, the determination of actual cash value as set forth above is not required. In such cases, the insurer shall provide, upon the insured’s request, a written explanation of the basis for limiting the amount of recovery along with the amount payable under the policy.
Authority: T.C.A. §§ 56-2-301, 56-8-101 through 56-8-120, 56-8-108, and 56-8-110.
Original rules filed July 11, 2017; effective 10/9/2017.
What each duty means when a claim is being slow-walked
The three rules above are the reason a Tennessee homeowner does not have to guess whether an insurer is taking too long. Each one attaches a number to a step that carriers otherwise describe as “in process.” Read them next to your own claim diary and the gaps become visible.
Acknowledgment and answered mail (.07)
The thirty-day acknowledgment clock in .07(1) starts when the insurer receives notification of a claim — the phone call or the online report — not when paperwork is finished. The rule lets an insurer satisfy it without writing, but then it has to make “an appropriate notation of the acknowledgement” in the claim file and date it. That matters: if nobody can show you an acknowledgment, ask for the dated claim-file entry the rule requires. Under .07(4), an insurer that promptly sends the claim forms, instructions, and reasonable assistance within thirty days has met .07(1) by doing so.
Paragraph .07(3) is the one most often forgotten. Any other pertinent communication from a first-party claimant that reasonably suggests a response is expected gets an appropriate reply within thirty days. Your emailed question about a denied line item is a pertinent communication. So is a request for the adjuster’s estimate. Date every message you send and keep the thread; silence past thirty days is a documented deviation from the rule, not a personality trait of your adjuster.
Paragraph .07(2) points a different direction. When the Department asks an insurer for information about a complaint filed against it, the insurer must answer the Department within thirty days. That is the practical force behind filing a Tennessee insurance complaint: it puts a deadline on a company that has been ignoring yours.
The decision, the extension letters, and the payment (.08)
The sixty-day decision clock in .08(1) runs from the insurer’s receipt of “properly completed and executed proofs of loss and such information or documents required under the policy.” That phrasing has a practical consequence. A claim that never gets a sworn proof of loss on file has no clean start date for the decision clock, so submitting one — completely, with the supporting documents the policy calls for — is what converts a vague delay into a measurable one.
A denial has to carry a reason. Under .08(1), no insurer may deny a claim without providing a basis for it, and on request the denial must be put in writing, with documentation kept in the claim file. Always make that request in writing. A denial you can read is a denial you can rebut.
If the insurer needs longer, .08(2) does not give it silence. It must tell you within the same sixty days why more time is needed, and then send a letter every sixty days after that, each one setting out the reasons the investigation is still open. Missing letters are the clearest evidence of a claim that has been shelved. Both .08(1)(a) and .08(2)(a) carve out an exception where there is a reasonable basis, supported by specific information available for review by the Department, to suspect the claimant caused, contributed to, or misrepresented the loss — but even then the rule still requires a decision “within a reasonable time for full investigation.”
Three more numbers sit in this rule. Under .08(3), findings must reach you within thirty days after the insurer concludes a coverage investigation. Under .08(6), payment is tendered within thirty days of affirmation of liability where the amount is determined and not in dispute. And under .08(5), the insurer must warn a first-party claimant at least thirty days before an applicable statute of limitations may expire. Do not organize your claim around that warning. Tennessee policies commonly shorten the time to sue by contract, so read your own “Suit Against Us” condition and calendar it yourself.
Read .08(9) before you accept a referral. The insurer must notify you of your right to choose a vendor to complete covered repairs unless the policy provides for a specified vendor. Read .08(10) and .08(11) before you decide a claim is too risky to report: an insurer may not cancel a personal residential policy in force sixty days or more solely because a claim is pending, and under T.C.A. § 56-7-113 it may not raise your premium or cancel solely because you made an inquiry.
Paragraph .08(8) closes the loop. Object in writing to a full denial and the insurer must tell you in writing that you may complain to Consumer Insurance Services — the rule prints the address, the phone number, and the complaint link inside the regulation itself.
Matching, actual cash value, and the depreciation worksheet (.10)
Rule .10 governs fire and extended coverage type policies with replacement cost coverage, and it holds the two provisions we cite most often in Tennessee.
The first is matching. Under .10(1)(b), when a loss requires replacement of items and the replaced items do not match in quality, color, or size, the insurer replaces items “so as to conform to a reasonably uniform appearance according to the applicable policy provisions.” It applies to interior and exterior losses, and the insured bears no cost over the applicable deductible. That is the answer to half a roof of new shingles beside a weathered slope, and to a run of new siding on one elevation. Note the qualifier the rule keeps — “according to the applicable policy provisions” — so the argument is built by reading the rule and your policy language together, not the rule alone.
Paragraph .10(1)(a) is its companion: consequential physical damage caused by making the repair or replacement, unless the policy otherwise excludes it, belongs in the loss, and the insured pays nothing except betterment and any applicable deductible. Interior damage caused while opening a wall to reach the covered repair is loss, not the homeowner’s problem.
The second provision is the depreciation worksheet. Under .10(2)(a), actual cash value on a residential fire and extended coverage settlement is replacement cost at the time of loss less depreciation, and “upon the insured’s request, the insurer shall provide a copy of the claim file worksheets detailing any and all deductions for depreciation.” Ask for it in writing on every actual cash value payment. Depreciation applied without a line-by-line worksheet is an assertion; the rule entitles you to the arithmetic. Once you have it, compare it against Lammert v. Auto-Owners, where the Tennessee Supreme Court held an insurer could not depreciate labor in calculating actual cash value under the policies at issue.
Who enforces this, and how it is actually used
These rules were promulgated under Tenn. Code Ann. §§ 56-8-101 through 56-8-120, the same chapter that contains the fifteen unfair claims practices in § 56-8-105. Enforcement belongs to the Commissioner. Courts applying Tennessee law have held there is no private right of action under § 56-8-105 (Lindsey v. Allstate Ins. Co., 34 F. Supp. 2d 636 (W.D. Tenn. 1999)), and Tenn. Code Ann. § 56-8-113 bars Tennessee Consumer Protection Act suits against insurers. No one sues “under” this chapter.
What a policyholder does instead is use the rule two ways. First, as a complaint: a documented breach of a numbered deadline is exactly what Consumer Insurance Services examines, and .07(2) gives the insurer thirty days to answer the Department. Second, as evidence: a missed sixty-day decision, absent extension letters, or a denial with no stated basis is proof of how the claim was handled, and that record supports a formal demand and the bad-faith penalty of up to twenty-five percent under Tenn. Code Ann. § 56-7-105.
Bringing that penalty suit is attorney work. Our work is the record that makes it possible — documenting the loss, preparing and filing the proof of loss, putting requests and objections in writing so the deadlines above have something to run from, pricing the repair properly, demanding the depreciation worksheet, and negotiating or invoking appraisal when the disagreement is about the amount of the loss. When a claim needs litigation, we refer it out. The plain-English walkthrough of these timelines is on the Tennessee claim settlement deadlines page, and the rest of the state’s claim law, in full text, is on the Tennessee claim-law page.
Related authorities
Tennessee
tn-code-56-8-105-unfair-claims-practices.md— Tenn. Code Ann. § 56-8-105 (15 unfair claims practices)tn-code-56-7-105-bad-faith-penalty.md— Tenn. Code Ann. § 56-7-105 (bad faith 25% penalty)tn-code-56-6-913-public-adjuster-fee-caps.md— Tenn. Code Ann. § 56-6-913 (public adjuster fee caps)tn-rule-0780-01-91-public-adjusters.md— Tenn. Comp. R. & Regs. ch. 0780-01-91 (public adjusters rule)tn-case-lammert-v-autoowners-2019-labor-depreciation.md— Lammert v. Auto-Owners (Tenn. 2019) (labor depreciation)tn-case-palmer-v-nationwide-1986-bad-faith-elements.md— Palmer v. Nationwide (Tenn. 1986) (bad faith elements)tn-case-merrimack-v-batts-2001-appraisal-scope.md— Merrimack v. Batts (Tenn. Ct. App. 2001) (appraisal)
Georgia
ga-reg-120-2-52-03-claim-handling-deadlines.md— Ga. Comp. R. & Regs. 120-2-52-.03 (claim-handling deadlines)ga-ocga-33-6-34-unfair-claims-settlement-practices.md— O.C.G.A. § 33-6-34 (unfair claims settlement practices)ga-ocga-33-4-6-bad-faith-penalty.md— O.C.G.A. § 33-4-6 (first-party bad faith penalty)
South Carolina
sc-code-38-59-20-improper-claim-practices.md— S.C. Code § 38-59-20 (improper claim practices)
Now you know the rule. Enforcing it against a carrier is a different job — and it's ours. A free, confidential case review by a licensed public adjuster takes three taps.
See if my case qualifies