An insurance claim is the policyholder's written demand to the insurer for compensation of damage caused by an insured event — and the composition, timing and consequences of that demand are defined by the Civil Code of Georgia. The entire life cycle of a claim in Georgia, from notification to payment, is reflected in Articles 814, 820, 821, 826, 829 and 830 of the Code. Specialised ombudsman or agency procedural models characteristic of foreign insurance markets do not exist in the Georgian system — the page is carried entirely by the Georgian Civil Code.
The notification duty and the required records
The claim cycle begins with notification. Under Article 814 of the Civil Code, as soon as the policyholder learns of the occurrence of the insured event, the policyholder is obliged to notify the insurer. Thereafter the insurer may, after the insured event has occurred, demand from the policyholder any records that are necessary for establishing the insured event or the scope of the obligation. In practical terms this means that document preparation should begin at once: medical conclusions, invoices, payment documents and acts describing the event are precisely the material the insurer is legally entitled to request.
An important protection also exists. The insurer cannot rely on an agreement by which it is released from its obligation on the ground that the policyholder failed to perform the notification duty, where the insurer's interests are not thereby materially violated. Such a clause is effectively neutralised where a late or defective notification causes the insurer no real harm — for instance, where complete information about the event was available to it by another route. Drafting the claim therefore includes demonstrating that any notification defect was immaterial.
The form, scope and amount of compensation
Three fundamental parameters of compensation are fixed by the Code. Under Article 820, in damage insurance the insurer must compensate the damage in money — compensation by natural replacement or by provision of services is not envisaged by this norm. Under Article 821 the insurer compensates damage only within the limits of the insured sum — this is the ceiling defined in the contract, up to which the insurer's exposure runs. Finally, under Article 826 the insurer is not obliged to pay the policyholder an amount exceeding the damage incurred, even where the insured sum exceeds the insured value at the moment of the insured event. Damage is compensated according to its actual scope, and over-insurance brings the policyholder no additional recovery.
The policyholder's fault and the duty to mitigate
The most frequent ground for a claim's failure is fault. Under Article 829, the insurer is released from performing its obligation if the policyholder caused the event covered by the insurance deliberately or by gross negligence. A deliberately caused event strips the insurance of its purpose altogether, while gross negligence gives the insurer complete release — in both forms the fault must be established by the insurer, and it is here that the central disputed fact of the claim is born.
The second direction is the policyholder's active duty. Under Article 830, upon the occurrence of the event covered by the insurance the policyholder must, as far as possible, avert or reduce the damage and, in connection therewith, follow the insurer's instructions. Under the same article the insurer must compensate the costs incurred on its instruction. The practical conclusion is one-sided: mitigation measures must be documented, because the reimbursement of costs incurred on the insurer's instruction is guaranteed by law.
When the insurer must perform
Article 814 also fixes the moment of payment: the insurer must perform its obligation after the insured event has been established and the amount of compensation determined. This means that delay during the investigation is not in itself a breach — the insurer is entitled first to establish the event and quantify the damage. That right, however, cannot be converted into an instrument of indefinite inquiry: once the event is established and the amount determined, payment is already the insurer's duty, and its denial becomes the ground for escalating the claim to court.
Frequently asked questions
Below are the questions most frequently raised in connection with insurance claims.
In what form does the insurer compensate damage?
In money, under Article 820 of the Civil Code; compensation by natural replacement or services is not provided for by that norm.
Can compensation exceed the insured sum?
No — under Article 821 the insurer compensates damage only within the insured sum, and under Article 826 it is not obliged to pay more than the damage incurred even where the sum exceeds the insured value.
When is the insurer released from payment?
Under Article 829 — where the policyholder caused the insured event deliberately or by gross negligence; fault in these two forms must be proven by the insurer.
Is there a duty to mitigate the damage?
Yes — under Article 830 the policyholder must avert or reduce the damage as far as possible and follow the insurer's instructions; costs incurred on those instructions are borne by the insurer.
How We Help on Legal.ge
The Legal.ge team prepares insurance claims grounded in Articles 814, 820, 821, 826, 829 and 830 of the Civil Code: we establish the fact of performance of the notification duty, assemble the records the insurer may demand, analyse possible allegations of fault and defend the proper scope of compensation. Submit a request on this page — we will help prepare the claim and plan the court stage.