You have been in an accident. You know it’s not your fault. You are injured. You are going for treatment. You have hired an attorney. He or she has contacted the insurance company. Everything seems cut and dry. So, why is the case taking so long? Here are some of the factors that affect the timetable for your case:
(1) Liability Investigation
Even if it’s clear to you and the world that the other person is at fault, your insurance company and the other person’s insurance company will need to investigate the claim. I try to expedite that “investigation” by providing them with police reports or any other supporting information. They take the information, but still create reasons to delay like they need to speak to their insured which can take time. Eventually, they accept liability and things move forward, but that robotic investigation eats into the timeline.
(2) Your Course of Treatment
Although your attorney notifies the insurance company of his or her representation and acts as a protective liaison between you and the insurance companies, a full demand package is generally not presented to the insurance company until you are finished with your treatment. There are instances where a partial demand package is enough to settle a smaller policy limit where the injuries and treatment outweigh the available limits, but most cases require a full package. This means that if you go to treatment for six months, for example, your case remains open for at least that amount of time before a demand package can be sent. Just for clarification, your attorney is communicating with you and the insurance company throughout that time to inform them of your medical status which affects their reserve and makes it a little easier to negotiate when the time arises.
(3) Requesting Medical Records and Bills
In order to obtain your medical records, your attorney has had you sign a Medical Records Release to send to the various medical providers. It sounds easy enough to send the signed release with a request. But, the reality is that the medical providers are busy and sometimes have one person handling all of the requests and you find out they come into the office to work on those requests on one day per week. Usually, that day is the day that most holidays occur. (You think I’m kidding; I am not!) Another delay when requesting medical records occurs when the medical provider outsources its medical records and billing records requests to a third-party company. That company will receive the request from the provider, and they send your attorney a bill for copying the documents. It takes time for them to process the payment and they will mail the records to your attorney. Some providers are terrible at recordkeeping and never respond to the requests.
(4) Demand Sent, But Not Read
Thankfully, in this electronic age, attorneys can email or fax the Demand Packages. It sounds like that should expedite things, but it doesn’t always work that way. By the time the Demand has been sent, the insurance adjuster may have left the company, or your claim has been transferred to another insurance adjuster; or, in the worst-case scenario, your claim has not been reassigned and it remains in space until the new adjuster claims it. I always check with the company before sending the package. However, there have been times where I have been assured that the same adjuster is on the claim, only to find out the week after my inquiry, the adjuster has left the company.
(5) Demand Sent and Read by an Inexperienced or Difficult Insurance Adjuster
Customarily, your attorney will give the insurance company thirty days to respond to the Demand Package. Sometimes, the insurance company will assign an inexperienced adjuster with limited authority to handle your claim. The problem with that adjuster and their limited authority is that the adjuster will work within that limited authority when negotiating with you, despite the claim’s much higher value. It is extremely frustrating to spin my wheels negotiating with someone who is clearly ignoring the case value in favor of their limited authority. In a worse situation, the adjuster has the appropriate authority, but refuses to offer full value in hopes a less skilled attorney will accept the garbage offer. In both cases, there are ways to try to remedy the situation, but those ways, although necessary, can also increase the delay in resolving your case.
(6) Court and Discovery
People don’t realize that insurance companies are not required to settle cases, even if they appear to be cut and dry. They make voluntary offers to attempt to settle. The law states that a difference of opinion on value isn’t enough to penalize the insurance company unless the objective value abundantly exceeds their minimal offer. Sometimes insurance companies are willing to take their chances in court.
When court is the only option, you will be at the mercy of the Court’s timeline which can range from one to three years or more. Within that timeframe are court hearings, discovery requests, depositions, and trial. If your attorney has been fighting with the insurance company for months after you finish treatment, and suit is filed in court, your total wait time from accident to verdict could be three to four years. If your case is solid on liability and damages, your attorney and the insurance company could agree to arbitrate or mediate the case and resolve the case much more quickly than court, but it could take time to schedule those hearings as well. While in litigation, there is still a possibility of resolution, but it will still require time to do so.
(7) Don’t Worry!
All the explanations I have mentioned for delays for your case consider your case as a great case from the beginning, i.e., the fault is not disputed and your injuries and other consequences like medical bills and lost wages are related to the accident. Most cases follow a proper timeline and settle within a reasonable time following the end of your treatment. But, if you wonder why a case can take a long time, I hope I have educated you as to why. I try to fill in the time by communicating with the client so he or she understands the reason for the delay. Like anything in life, if everyone does their job correctly, resolutions are easily achieved. If one person in the chain of a claim doesn’t do their job correctly, time is wasted. Let’s hope your case is like most cases which resolve in a timely manner.