One of the biggest challenges in injury claims, especially while trying to reach maximum medical improvement, is obtaining quick insurance coverage after an auto accident or other unfortunate incidents. This leaves many people wondering what to do if the insurance company delays your injury settlement?
Victims aim to reach maximum medical improvement as quickly as possible, but the process is both time-consuming and expensive.
Therefore, it’s crucial for victims of such incidents to know their options. Moreover, there are some red flags that might indicate that your insurance claim might get denied. Let’s discuss further on why the injury settlement negotiations are such a big issue.
Understanding Injury Claim Settlements
When you file an insurance claim after a car accident or personal injury, you expect the insurance company to handle your injury claim in a timely and fair manner.
Unfortunately, many auto insurance companies engage in delay tactics to minimize payouts and pressure claimants into accepting less than they deserve.
If you are facing unnecessary delays in your personal injury case, understanding your rights and legal options can help you hold the insurer accountable and secure the fair compensation you are entitled to.
Learning the Delay Tactics Used by Insurance Companies
Insurance providers are for-profit businesses, meaning their goal is to maximize profits by minimizing payouts. Common delay tactics insurance companies use include:
1. Requesting excessive documentation
Insurers may repeatedly ask for additional medical records, police reports, or other evidence, even when they already have sufficient information.
2. Slow responses
Insurance adjusters may take an unreasonably long time to respond to phone calls, emails, or submitted documents.
3. Questioning medical treatment
Some insurers delay the claims process by disputing the necessity of medical treatment or requiring an independent investigation
4. Claiming they are still investigating
Insurers may cite ongoing investigations to delay settlements, even when liability is clear.
5. Lowball settlement offers
Some companies intentionally offer less than a fair settlement, hoping claimants will accept out of frustration or financial necessity.
6. Misrepresenting policy terms
Adjusters may misinterpret or misstate insurance policy provisions to justify delays or deny claims.
Legal Protections Against Unjustified Insurance Delays
Each state has laws requiring insurance companies to process insurance disputes in good faith. When an insurer engages in delayed settlement without a valid reason, they may be acting in bad faith, which can lead to legal action.
Bad Faith Insurance Laws
Bad faith insurance laws protect policyholders from unfair claim denials and unnecessary delays. These laws vary by state, but generally, an insurer acts in bad faith if they:
- Fail to acknowledge and process claims promptly.
- Deny a valid claim without a reasonable explanation.
- Delay payments without justification.
Some states, such as California, have robust bad faith insurance laws under California Insurance Code §790.03(h), which prohibits unfair insurance claims process.
Similarly, Texas law under Texas Insurance Code §541.060 outlines prohibited insurer behaviors, including intentional injury claim delays.
Court Precedents on Insurance Delays
Several court cases have set precedents for holding insurers accountable for insurance disputes and unjustified delays:
1. Egan v. Mutual of Omaha Ins. Co., 24 Cal. 3d 809 (1979)
The California Supreme Court ruled that an insurer’s failure to reasonably investigate and process insurance claims process constituted bad faith, leading to punitive damages.
2. State Farm Mut. Auto Ins. Co. v. Campbell, 538 U.S. 408 (2003)
The U.S. Supreme Court ruled against an insurer for failing to fairly claim a car accident claim within insurance policy limits, highlighting insurers’ duty to act in good faith.
3. Johnson v. Progressive Insurance Co., 997 So.2d 207 (La. App. 2008)
The court ruled that the insurance company wrongfully denied a personal injury claim and unreasonably delayed the settlement, justifying legal action for fair compensation.
Steps to Take If Your Injury Settlement Is Delayed
If you suspect the insurance company is deliberately delaying your personal injury claim, take the following steps:
1. Keep Detailed Records
Maintain a record of all interactions with the insurance provider, including:
- Phone calls (dates, times, and content of discussions).
- Emails and letters sent or received.
- Documents submitted, such as medical bills, police reports, and medical evaluations.
2. Follow Up Regularly
Do not wait passively for the insurance company to respond. Follow up regularly with phone calls and emails. Always document your attempts to communicate.
3. Demand a Reasonable Timeline
If your claim is delayed, send a written demand letter outlining a reasonable deadline for resolution. Clearly outline the details of your car accident claim, the documentation provided, and your expectation for a quick settlement.
4. Consult a Personal Injury Attorney
A personal injury attorney can:
- Assess your case to determine if the insurance company delays violate bad faith laws.
- Negotiate with the insurer on your behalf.
- File a legal action if necessary to force a fair settlement.
Many experienced lawyers offer a free consultation, allowing you to discuss your case without upfront costs.
5. File a Complaint with the State Insurance Commission
Every state has an insurance regulatory body that oversees insurer conduct. If you experience insurance disputes, file a complaint with your state’s insurance commission. For example:
- California Department of Insurance – Accepts complaints against insurers violating insurance policy settlement laws.
- Texas Department of Insurance – Investigates reports of insurance claim delays.
6. Consider Legal Action
If your injury claim is delayed settlement without valid reason, you may have grounds for a bad faith lawsuit. A successful lawsuit can result in:
- Payment of the original insurance claim amount.
- Additional damages for financial losses caused by insurance disputes.
- Punitive damages to penalize the insurance provider for wrongful conduct.
How a Personal Injury Lawyer Can Help
A skilled lawyer can help you navigate the insurance claims process, ensuring you receive fair compensation for your medical expenses, lost wages, and property damage. They can:
- Gather detailed records, including medical attention, treatment plan, and full extent of injuries.
- Draft a demand letter outlining your injury claim and expected appropriate settlement.
- Engage in settlement negotiations with the insurance provider.
- Initiate legal action if the insurer accountable fails to claim fairly.
Conclusion
If the insurance company delays your injury settlement, you have legal options to seek compensation and hold the insurer accountable.
By gathering evidence, maintaining detailed records, and consulting an experienced lawyer at Bourassa Law Group, you can challenge bad faith tactics and secure the fair compensation you deserve.
Don’t let an insurance company use delay tactics—know your rights, act decisively, and pursue legal action if necessary to ensure a fair settlement in your personal injury case.
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