§ 9-11-118.Form of complaint for interpleader and declaratory relief

Chapter 11. Civil Practice Act · Article 10. Forms · Last amended 2006 · Last verified July 17, 2026

In one sentenceO.C.G.A. § 9-11-118 offers a sample complaint for an insurer facing competing claims to a life-insurance policy, alleging the policy’s lapse for nonpayment and the conflicting demands of three claimants, and asking the court to declare none of them entitled to recover, restrain separate lawsuits, and, if the policy was in force, require the claimants to interplead their rival claims.

Full Text of § 9-11-118

Text sizeJump to: (1) (2) (3) (4)

IN THE ______________________ COURT OF ______________________ COUNTY

A.B., STATE OF GEORGIA

Plaintiff ) ) v. ) ) Civil action C.D., E.F., and X.Y., ) File no.______________________ Defendants ) (Clerk will insert number.) ) COMPLAINT The defendant C.D., herein named, is a resident of______________________ (street), ______________________ (city), ______________________County, Georgia, and is subject to the jurisdiction of this court. (Add appropriate statement about domicile of remaining defendants.)

On or about June 1, 1965, plaintiff issued to G.H. a policy of life insurance whereby plaintiff promised to pay to K.L. as beneficiary the sum of $10,000.00 upon the death of G.H. The policy required the payment by G.H. of a stipulated premium on June 1, 1966, and annually thereafter as a condition precedent to its continuance in force.

No part of the premium due June 1, 1966, was ever paid and the policy ceased to have any force or effect after July 1, 1966.

Thereafter, on September 1, 1966, G.H. and K.L. died as the result of a collision between a locomotive and the automobile in which G.H. and K.L. were riding.

Defendant C.D. is the duly appointed and acting executor of the will of G.H., defendant E.F. is the duly appointed and acting executor of the will of K.L., and defendant X.Y. claims to have been duly designated as beneficiary of said policy in place of K.L.

Each of the defendants, C.D., E.F., and X.Y., is claiming that the above-mentioned policy was in full force and effect at the time of the death of G.H.; each of them is claiming to be the only person entitled to receive payment of the amount of the policy and has made demand for payment thereof.

By reason of these conflicting claims of the defendants, plaintiff is in great doubt as to which defendant is entitled to be paid the amount of the policy if it was in force at the time of death of G.H.

Wherefore, plaintiff demands that the court adjudge:

(1) That none of the defendants is entitled to recover from plaintiff the amount of said policy or any part thereof.

(2) That each of the defendants be restrained from instituting any action against plaintiff for the recovery of the amount of said policy or any part thereof.

(3) That, if the court shall determine that said policy was in force at the death of G.H., the defendants be required to interplead and settle between themselves their rights to the money due under said policy and that plaintiff be discharged from all liability in the premises except to the person whom the court shall adjudge entitled to the amount of said policy.

(4) That plaintiff recover its costs.

______________________ Attorney for plaintiff ______________________ Address

End

Plain-English Summary

An insurer squeezed between several people claiming the same death benefit does not have to wait to be sued three separate times. This form shows how the insurer can go to court first, laying every competing claim before a single judge to resolve at once.

Six numbered paragraphs tell the story: the policy issued and its premium requirement; the missed premium and resulting lapse; the deaths of the insured and the named beneficiary in a collision; three defendants each asserting a different role or claim — the executor of the insured’s estate, the executor of the beneficiary’s estate, and a person claiming to have been named a substitute beneficiary; each of them insisting the policy was in force and demanding payment; and the insurer’s resulting uncertainty about whom to pay.

The four-part demand blends more than one procedural device in a single complaint. It asks the court to declare that none of the claimants may recover from the insurer directly, to restrain each of them from filing a separate lawsuit, and — if the court finds the policy was in force — to require the claimants to interplead and settle their rival claims among themselves rather than against the insurer.

The section’s title reflects that combination: it draws on both interpleader, which forces competing claimants into one proceeding, and declaratory relief, which asks the court to determine the parties’ rights before further disputes arise.

Frequently Asked Questions

Why would an insurer file a complaint like this?

To resolve competing claims to the same policy proceeds in one action, instead of risking separate lawsuits from each claimant and inconsistent outcomes between them.

What caused the policy dispute in the sample complaint?

The required premium went unpaid, the policy lapsed, and yet three different people afterward claimed entitlement to the proceeds once the insured died.

What does the complaint ask the court to determine first?

Whether the policy was in force at the time of the insured’s death, since none of the claimants can recover from the insurer if it was not.

What happens if the court finds the policy was in force?

The complaint asks the court to require the claimants to interplead and settle their rival claims to the proceeds among themselves, discharging the insurer from further liability.

Does the complaint ask the court to stop the defendants from suing the insurer elsewhere?

Yes. It asks that each defendant be restrained from bringing a separate action against the plaintiff over the same proceeds.

Amendment History

Ga. L. 1966, p. 609, § 120; Ga. L. 1980, p. 649, § 13; Ga. L. 1984, p. 22, § 9; Ga. L. 2006, p. 72, § 9/SB 465.

Source & verification. Section text and amendment history are reproduced verbatim from the Official Code of Georgia Annotated, published by the Official Code of Georgia Annotated, Georgia Code Revision Commission. Last verified July 17, 2026. · Official source

Also known as: georgia form complaint interpleader life insuranceinsurance interpleader complaint sample georgiacompeting beneficiary claims lawsuit templategeorgia declaratory judgment interpleader complaint