Unfortunately, there are times when our clients aren’t getting the answers they deserve after a fire, hurricane, or flood damaged their home, condo, or business and affected not only their property but also the whole area.
Taking Action When Your Insurance Claim is Being Ignored
Dealing with insurance companies can be frustrating at the best of times. But when you’ve filed a claim and are met with radio silence, it adds a whole new level of stress. The lack of response leaves you in limbo, unable to move forward with repairs or medical treatment. Plus, it creates financial uncertainty without knowing if your claim will be covered.
When an insurance company fails to acknowledge your claim it’s natural to feel powerless. However there are proactive steps you can take to get your claim out of purgatory and get the insurance provider to respond.
Start With the Basics
Before taking more aggressive action double check you have covered the basics
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Submitted the claim properly – Review your policy guidelines to ensure you filed the claim fully and correctly. Missing information can lead to delays.
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Provided all required documentation – Insurers need things like accident reports, bills, and estimates to process claims. Ensure you submitted everything needed.
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Followed up via multiple channels – Don’t rely solely on phone calls. Send follow up emails and letters too.
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Checked for internal errors – Mistakes like assigning your claim to the wrong adjuster happen. Ask if this occurred.
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Be patient but persistent – Allow reasonable time for a response, but don’t let too much time lapse before doing regular follow up.
If you’ve covered all the basics and still faced with insurance claim radio silence, it’s time to take further action.
Escalate Within the Insurance Company
Start by escalating within the insurance company’s internal channels:
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Request a supervisor – Don’t keep trying the same adjuster. Ask to have a supervisor or manager assigned to your claim.
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Contact customer service – The general customer service department can often intervene on your behalf and investigate delayed claims.
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Submit a formal complaint – Lodging a complaint with the insurance company’s complaint resolution department puts your frustrations on record.
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Consult your agent – Your insurance agent can often expedite delayed claims by leveraging their internal contacts.
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Request an update in writing – Submit a formal written request for a status update on your claim. Get their lag time in responding in writing.
Giving the insurance company opportunities to resolve the issue internally is an important step before taking external action.
Contact Applicable Government Bodies
If you continue getting nowhere with the insurance provider, reach out to the government organizations that oversee insurance companies:
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State Department of Insurance – File a complaint with your state regulator to investigate the insurer’s lack of response.
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Consumer Financial Protection Bureau – The CFPB assists consumers with financial companies like insurers. They can apply pressure.
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State Attorney General – Unresponsive insurers may be violating state consumer protection laws, which the AG can pursue.
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Better Business Bureau – Reporting delays to the BBB impacts the insurer’s public accreditation and grades.
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Lawmakers – Reach out to your local state representative or senator for additional advocacy.
In many cases, simply getting government oversight involved is enough to prompt insurance companies to respond appropriately. The threat of regulatory action can provide the incentive needed to get your claim handled properly.
Seek Legal Counsel
If you get no resolution from internal and external complaints, your last resort is seeking legal representation:
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Hire an insurance attorney – An attorney well-versed in insurance regulations can compel the company to respond.
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Request mediation – Legal counsel may be able to initiate court-ordered mediation to settle the claim dispute.
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File a lawsuit – Taking the insurance company to court over a wrongfully delayed or denied claim is an option.
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Report bad faith – If the insurer’s inaction appears intentionally malicious, your lawyer can report suspected bad faith.
Keep in mind that attorneys can be expensive, and lawsuits should be a last resort after all other avenues are exhausted. But in some cases, legal action is warranted and effective.
Tips for Avoiding Delayed Claim Response
While you can’t prevent all insurance delays, some proactive steps can help avoid the radio silent treatment:
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Maintain thorough documentation about your claim and all correspondence.
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Send communications via certified mail to establish a paper trail.
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Note names and titles of everyone you speak to regarding your claim.
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Set clear expectations on response timeframes with adjusters upfront.
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Remain calm and professional in all interactions. Avoid emotional outbursts.
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Be as detailed as possible when filing your initial claim. Avoid need for follow up requests.
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If delays persist, request to escalate your claim to a supervisor.
With persistence and diligence, you can get even the most stubborn insurance company to stop ghosting you and respond appropriately to your claim. While delays are common in the claims process, excessive lag times or completely ignored claims are unacceptable. Don’t allow the insurance provider to stonewall you. Use the right blend of patience, preparation, and assertiveness to get the response your claim deserves.
Sample Timeline of Actionable Steps
Navigating insurance claim delays can be challenging. Here is a sample timeline of steps you can take to elicit a response:
Within 2 weeks of filing:
- Follow up with your adjuster for claim status update
After 1 month of no response:
- Send a formal written complaint to the insurer
- Escalate to a supervisor
After 6 weeks of no response:
- File a complaint with your state Department of Insurance
- Consult a legal advisor
After 2 months of no response:
- Contact the Consumer Financial Protection Bureau
- Report the issue to your state Attorney General
After 3 months of no response:
- Hire an insurance attorney to take legal action
- Have your lawyer initiate mediation or litigation
The timeframes may vary depending on your specific situation. The key is not allowing excessive lag times and promptly escalating if delays persist.
Don’t Let Your Claim Languish
When you’ve suffered a loss or injury, getting your insurance benefits in a timely manner is critical. Unresponsive insurers can stall the claims process, depriving you of rightful coverage and compensation. But through a combination of persistence, regulatory/legal pressure, and documentation, you can compel uncommunicative insurance companies to do their job.
If an insurer is giving you the silent treatment, don’t endure their negligence. Take control where you can by following up relentlessly, recording their delays, and involving external help when needed. Though the process can be daunting, staying proactive puts the odds of a prompt, fair claims resolution in your favor.
Contact Your Insurance Representative’s Supervisor
If you have to call your insurance company’s 800 number and leave message after message for your contact person but never hear back, try calling someone else.
Contacting a supervisor may move your claim forward quicker and without too much trouble.
Based on the records you have kept so far, you can then list all the times you have tried to get in touch with your representative.
Document All Contact Regarding Your Insurance Claim
From the very first call, start documenting your correspondence with the insurance company. Even if you leave a message, write down the date and time you left it. From now on, write down every time you contact someone, whether it’s by phone, email, or online, and what they said in response, even if they didn’t say anything.
This will provide a chain of events to back up the date you began pursuing your claim.
What If The Insurance Company Does Not Respond By The Demand Deadline?
FAQ
When an insurance company does not respond?
Why do insurance companies ignore claims?
What happens if someone doesn’t respond to a claim?
What happens if an insurance company does not respond?
When the claim is filed with the other insurance company, an adjuster is assigned. The adjuster will then look into the claim and try to investigate the claim as much as possible. If the other party does not respond to anyone, the next step would be to file a lawsuit against the other driver. Can you sue an insurance company for not responding?
What should I do if my insurance adjuster is not responding?
If your claims adjuster is not responding to you, call the insurance company operator/customer service phone number and for the name and number of your insurance adjuster’s manager. Call the manager and advise what’s been going on. How long does an insurance company have to respond to a claim?
What happens if an insurer refuses to investigate a claim?
If an insurer has failed to timely investigate the claim, or demands unreasonable types and/or numbers of documents, or simply will not respond to calls, emails or letters, you can pursue your rights in court to force their hand. Can I ignore insurance claim?
What if someone doesn’t respond to my insurance claim?
Respond to communications received from you immediately but in no event later than 15 days. Accept or deny the claim immediately but in no event later than 40 days after receiving proof of claim. What happens if someone doesn’t respond to an insurance claim? When the claim is filed with the other insurance company, an adjuster is assigned.