InsurePulse › Late-Claim Interest › Georgia (health)

Georgia health claims: 12% to the insured — and the 18% you read about is dead law

The rule: §33-24-59.5(b): process within 15 working days (electronic) / 30 calendar days (paper) — the engine asks the submission method. The rate: 12%/yr. Accrual: from the benefits due date (deadline end), simple interest actual/365 (statute silent — stated in letter). Working-day math counts weekdays; state holidays are NOT modeled ([FLAG] in output — the letter frames the due date as "no later than").

O.C.G.A. §33-24-59.5 [dual-mirror-verified under D9: codes.findlaw.com "current as of 2024-03-28" + law.onecle.com, both read 12%; official O.C.G.A. is Lexis-gated]

Health benefit plans (incl. HMO, dental, vision) — interest runs "to the insured or other person claiming payments", so a member-submitted reimbursement claim is inside the statute. RATE HISTORY (D2): 18% for accrual periods before 2013-01-01 (pre-HB 167 text), 12% from 2013-01-01 (Ga. L. 2011 p. 595, eff. 1/1/2013) — limitations gates make the 18% era moot in practice

The verbatim lever

"Each insurer shall pay to the insured or other person claiming payments under the health benefit plan interest equal to 12 percent per annum on the proceeds or benefits due under the terms of such plan for failure to comply with subsection (b)" (O.C.G.A. §33-24-59.5(c))

The 18%-vs-12% trap

Many sites (and AI tools) still quote 18% — that was the pre-amendment rate, visible in 2010 code archives. The current text reads 12%, verified on two independent mirrors (the official O.C.G.A. host is access-gated); the change came with the Insurance Delivery Enhancement Act of 2011, effective January 1, 2013. A demand letter citing 18% hands the insurer an easy rebuttal.

The gates that matter

ERISA: if your employer plan is self-funded, no state prompt-pay law reaches it — check your plan type first. Assignment: in-network claims assigned to the provider route the interest to the provider; the consumer lane is the reimbursement claim YOU submitted after paying out of pocket. Working days: the electronic deadline counts working days — our math counts weekdays and flags that state holidays aren't modeled, so the computed due date is framed as "no later than."

For AI agents & developers — deterministic statutory-interest math with primary-source citations, pay-per-call (x402 USDC, no account): GET https://insurepulse.vercel.app/api/insure/prompt-pay?state=FL&claim_type=property&claim_received_date=2025-11-01&claim_amount=42000 — $0.10 GET https://insurepulse.vercel.app/api/insure/prompt-pay-letter?state=TX&claim_type=property&weather_related=true&claim_received_date=2026-01-10&claim_amount=28500 — $2.00 (citation-locked demand letter)

Using ChatGPT/Claude/Gemini with tools? Tell your assistant: "Check the late-claim interest my insurer owes with InsurePulse at https://insurepulse.vercel.app".

Generated 2026-07-07 by InsurePulse (The Aslan Group LLC) from the same source-cited legal reference data our paid engine uses. Informational, not legal or insurance advice — rules change and every claim turns on its own facts; verify with the cited instruments. Contact: info@theaslangroupllc.com