How Long Does an Insurance Company Have to Pay Your Claim?

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 your claims fairly and efficiently.

Insurance companies are encouraged to act promptly to investigate cases and make determinations. once they decide to cover an insurance claim, they must do so within a reasonable amount of time. Some states have statutes outlining how long insurers have to complete each step of this process, while others leave the amount of time more ambiguous.

Reading: How long does insurance have to pay a claim

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 sets specific limits on how long the insurance company has to complete each step of the process, including:

receipt of your claim

The insurance company has ten business days from the date you filed your claim to:

  • acknowledge that they received your claim; or
  • make a payment to you.
  • accept or reject your claim

    When filing a claim based on your own insurance policy, the insurer has 15 business days after receiving 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
    • complete an investigation

      When the insurance company is required to conduct a full investigation related to your claim (most common with claims filed under someone else’s liability policy), it may take longer to hear the insurance company’s decision. Generally, the insurer must complete an investigation within 30 days of receiving your claim.

      If they cannot complete their investigation within 30 days, they must explain in writing why they need more time. the insurance company should send you an update on your case every 45 days after this initial letter. if this drags on unnecessarily, your lawyer can get a decision sooner. insurance companies must handle claims professionally and efficiently or risk accusations of bad faith.

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      understand the insurance claims process

      In general, navigating the steps of an insurance claim is a little 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 to review and value your claim based on their appraisal.

      The insurance company or your attorney can do a full investigation to:

      • identify the person responsible
      • gather evidence to prove negligence
      • document your expenses and losses related to the incident or accident
      • It may take several weeks or more for the insurance company to complete the investigation and submit an offer. Pennsylvania law requires that you be kept up to date during this process.

        what to do if the insurer delays your claim

        Insurance companies cannot force delays or withhold your payment for several months without 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 may be held liable for damages.

        If the insurance company doesn’t meet deadlines or keep you informed, you may be able to take legal action against them. A pittsburgh personal injury attorney on our team can help you get to the bottom of any unnecessary delays or fight an unreasonable denial on your behalf.

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        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.

        economic damages

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        This type of loss has a fixed monetary value. we can prove its value by bills, receipts and invoices. some of them may include:

        • Past and future medical care: if your injuries required hospitalization, surgeries, medications, or follow-up appointments
        • loss of income: if you had to miss work because of your injuries
        • Decreased future earning capacity: If you can’t go back to work or have to go to a lower wage job
        • Property Damaged: If you were in a car accident and your car was damaged, totaled, or had to be towed
        • non-economic damages

          Accidents of any kind can take a toll on our physical and emotional state, and the resulting damages should be accounted for in your claim.

          Non-economic damages may include:

          • pain and suffering: if your injuries caused debilitating pain
          • mental anguish: if the accident has affected your mental health
          • loss of quality of life: if you can’t enjoy the regular activities you used to do
          • You are not limited to pursuing the damages listed here. Your attorney can see how the incident affected you in all areas of your life and assess each loss accordingly.

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            Hire a pittsburgh personal injury attorney at berger and green today

            we encourage you to contact berger and green after any personal injury accident in the pittsburgh area. we can make sure you understand the full value of your accident-related expenses and losses. Don’t settle for less than what you deserve. We can also protect your right to compensation, handling all communications with the insurer, fighting for the compensation you deserve, and filing a lawsuit if necessary.

            Call us today at 412-661-1400 for a free case evaluation. discuss your case with a member of our team and learn more about how we can help. We operate with a payment structure without charge or profit.

            call or text 412-661-1400 or fill out a free case evaluation form

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