The amount of time an insurance company has to pay a claim varies from state to state, but in all cases, they have a legal obligation to handle their claims in a fair and efficient manner.
Insurance companies are encouraged to act promptly to investigate cases and make determinations. Once they decide to cover an insurance claim, they need to do so within a reasonable timeframe. Some states have statutes that outline how long insurers have to complete each step of this process, while others leave the amount of time more ambiguous.
Time Limits on the Insurance Claims Process in Pennsylvania
While some states say the insurance company has a “reasonable time” to handle a claim, Pennsylvania law puts specific limits on how long the insurance company has to complete each step of the process, which includes:
Receipt of Your Claim
The insurance company has ten working days from the date you submitted your claim to either:
- Acknowledge they received your claim; or
- Make a payment in your case.
Accept or Deny Your Claim
When filing a claim based on your own insurance policy, the insurer has 15 working days after getting your claim and supporting information to:
- Accept your claim and offer you compensation; or
- Deny your claim; or
- Notify you in writing that they need more time
Completing an Investigation
When the insurance company must conduct a full investigation related to your claim—most common with claims filed based on someone else’s liability policy – it may take longer to learn of the insurance company’s decision. In general, the insurer must complete an investigation within 30 days of receiving your claim.
If they cannot complete their investigation within 30 days, they will need to explain in writing why they need more time. The insurance company will need to send you a case update every 45 days after this initial letter. If this drags on unnecessarily, your attorney may be able to get a decision sooner. Insurance companies must handle claims in a professional and efficient manner or risk bad faith accusations.
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Understanding the Insurance Claims Process
In general, navigating the steps of an insurance claim is somewhat easier when you file a claim based on your own insurance coverage. While you still need to prove your losses and expenses, the insurance company can often send an adjuster over to review and value your claim based on their appraisal.
A full investigation can be conducted by the insurance company or by your lawyer to:
- Identify the liable party
- Collect evidence to prove negligence
- Document your expenses and losses related to the incident or accident
It can take several weeks or longer for the insurance company to finish their investigation and extend an offer. Pennsylvania law requires them to keep you updated throughout this process.
What to Do I the Insurer Delays Your Claim
Insurance companies cannot force delays or hold your payment for several months without a good reason. An unscrupulous insurance adjuster may try to withhold payment to manipulate you into accepting a lower offer. If you suspect this is happening to you, the insurance company can be held liable for damages.
If the insurance company is not meeting their deadlines or keeping you informed, you may be able to pursue legal action against them. A Pittsburgh personal injury lawyer on our team can help you get to the bottom of any unnecessary delays or fight an unreasonable denial on your behalf.
Types of Damages You Can Recover From the Insurance Company
When you file a claim with the insurance company, you can request reimbursement for two types of damages: economic and non-economic.
These types of losses hold a fixed, monetary value. We can prove their worth by using bills, receipts, and invoices. Some of them might include:
- Past and future medical care: If your injuries called for your hospital stay, surgeries, medications, or follow-up appointments
- Lost earnings: If you had to skip work due to your injuries
- Future diminished earning capacity: If you cannot return to work or have to opt for a lower-paying one
- Damaged property: If you were in an auto accident and your car was damaged, totaled, or needed to be towed
Accidents of any type can affect our physical and emotional states, and the resulting damages should be accounted for in your claim.
Non-economic damages can include:
- Pain and suffering: If your injuries caused you debilitating pain
- Mental anguish: If the accident has taken a toll on your mental health
- Lost quality of life: If you are unable to enjoy the regular activities you used to do
You are not limited to pursue the damages listed here. Your lawyer can look at how the incident affected you in all areas of your life and price each loss accordingly.
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Hire a Pittsburgh Personal Injury Lawyer at Berger and Green Today
We encourage you to reach out to Berger and Green after any Pittsburgh-area personal injury accident. We can ensure you understand the full value of your accident-related expenses and losses. Do not settle for less than you deserve. We can also protect your right to compensation, handling all communication with the insurer, fight for the compensation you deserve, and file a lawsuit if necessary.
Call us today at 412-661-1400 for your complimentary case evaluation. Discuss your case with a member of our team and learn more about how we can help you. We operate on a no-win, no-fee payment structure.