How Long Does an Insurance Company Have to Investigate a Claim?

As is with a great many things, the amount of time an insurance company will have to pay a claim will vary from state to state, but in all cases, they are legally obligated to handle every claim efficiently and properly.

All insurance companies are encouraged to act promptly to investigate cases and make determinations. When they have decided to cover a claim they must do so within a reasonable timeframe.

You may find that some states have statutes that give timeframes for how long an insurer has to complete each step of the claim process. Other states may leave the amount of time for the process being more ambiguous. 

What Happens When You File a Claim: The Process

Whatever state you live in it is good to understand the insurance claims process when you make a claim. Navigating the steps of insurance claims is easier when you file a claim based on your insurance coverage, while you still need to prove your losses and expenses, the insurance company will often send an adjuster to review and value your claim. This is based on their appraisal.

A full investigation can be conducted by the insurance company, or by your lawyer, depending on the situation to do a few things, these can be; identifying the liable party, collect any evidence to prove negligence, or documenting your expenses and losses that are related to whatever incident or accident has taken place.

This is a process that can take some time, a few weeks or more for the company to complete the investigation, and then extend an offer to you.

Note that a claims adjustor is usually assigned to your case, and as this person is an employee of the insurance company they will be working to pay you in a reasonable amount of time, so long as your claim is legitimate, or to avoid paying you if your claim is not so legitimate.

It is also worth noting that this person may contact your or your attorney (depending on the situation) for details and to confit information from the original insurance claim. If there was a serious accident they may request a copy of the police report or contact witnesses, or even visit the scene of the incident, this does depend on the individual situation and the severity of the case, as well as the state that you live in.

In this case, the adjuster may ask for images from the scene of the incident to inspect them for damages. Hence it is always useful to take photos, if able, at the scene of the accident. This means taking photos of the affected (your vehicle) and any others involved in the accident.

Do I need a lawyer?

When dealing with insurance, you may wonder if you need to deal with a lawyer. This depends on the individual case and circumstances. In a simple claim, or a minor incident you may not need to consult anyone.

However, if you are dealing with a claim that involved a serious injury, or if there is a delay in the insurance company processing your claim then you should consider getting legal help.

Many attorneys will not charge for an initial consultation that helps you decide if you need them or wish to hire them. So even if you decide not to hire then a phone call with them like this can always help you prepare for talking to the claims adjuster who will probably be asking you similar questions. So if nothing else, it can be good practice.

What to do in the event of your claim being delayed?

It is wise to be educated on how these situations work. Insurance companies cannot force a delay or withhold payment for several months without any good reason.

An unscrupulous insurance adjuster may try to withhold payment to get to you accept a lower offer. If you feel that this may be the case then you may need to consider legal help as the insurance company can be held liable for damages.

If the insurance company does not meet their deadlines, or if they are not keeping you informed of proceedings, then you may be able to pursue legal action against them.

This is an event in which case you will want to hire a lawyer, as they can get to the bottom of any unnecessary delays, or perhaps fight an unreasonable denial of payment on your behalf.

Amount of Time It Takes to Investigate

The amount of time an insurer is allowed to investigate a claim varies by state. As with many legal actions in the United States, every state has different rules and laws for proceedings. Let us look into some examples of them. If you are curious about the insurance investigation proceedings in your state, check the rules for your state.

Washington, DC: Washington, DC doesn’t have a specific number of says in which a car insurance company must complete its investigation of any accident. The law in this state simply states that an Insurer must implement reasonable standards for prompt investigation. Many insurance companies in the District of Columbia will take around 30 to 45 days to complete their investigations and answer. If a company needs more time to investigate then they are honor-bound to inform the claimant of the reason why.

Virginia: In Virginia, most insurance companies will take 45 days to complete their investigations and issue a written response upon receiving claims. Some insurance companies may take longer if the case has any complex elements or unique problems, or in the possibility that the agent may have to conduct more extensive research to assess the claim. Once again the insurance company has to keep the claimant informed of the status of the case, in writing, especially if the company is anticipating a need for an investigation that exceeds 45 days.

To Summarize

How long an insurance company has to investigate a claim varies by which state you live in and the overall nature of the claim. Nonetheless, if the time exceeds expectations you will be informed and should be informed of the proceedings throughout.

You should have regular contact with the claims adjuster as they investigate your claim regardless of state. Check your state’s rules on the period of investigation to find out if your state has a time limit.