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How Long Does It Take an Insurance Company to Pay Out a Claim?

Posted in Personal Injury on November 23, 2020

Most personal injury claimants want to expedite the insurance claims process as much as possible. They are dealing with expensive medical bills, property damage and lost wages, in most cases. They want to complete the insurance process and receive a check for benefits right away. Unfortunately, it is not always possible to speed up an insurance claim. Different companies have different ways of processing claims. However, each state has rules requiring insurance companies to respond to claims within a certain amount of time.

The Insurance Claims Process in Texas

After you file an injury claim with your insurance company or that of the at-fault party, you will have to wait for the company to assign a claims adjuster to get back to you. The adjuster may call you as soon as the day of your accident, or it may take several days. The amount of time you will wait depends on the company and the number of claims it is currently processing. It will also depend on the law in your state.

15 Days to Acknowledge Your Claim

In Texas, an insurance company legally has no more than 15 days from the date it receives your initial claim to issue a response. The insurance company must notify you within 15 days that it received your claim and has begun processing it. Typically, the insurance company will send you basic claims information and a Proof of Loss Form to fill out when it initially responds to your claim. You will need to fill out this form and submit it to continue the insurance process.

Approval or Denial Within 15 Days of Receiving Your Proof of Loss Form

It is important to wait until you fully understand your injuries and how long they will take to heal, as well as the cost of future treatments, before submitting your Proof of Loss Form and medical documentation. You should wait until your point of maximum medical improvement – the date a doctor believes you will heal as much as you ever will. Waiting until this point can delay your insurance claim, but it can be important if you wish to obtain full compensation for serious injuries. Once you submit your Proof of Loss Form, the insurance company legally has 15 days to review your information and either approve or deny your claim.

45 Days With a Valid Reason

The insurance company can extend the 15-day investigation period to 45 days if it gives you a valid reason. With an acceptable explanation, the insurance company can wait until 45 days after receiving your Proof of Loss Form to accept or deny benefits in Texas.

  • Further investigation needed
  • Inadequate medical documentation
  • Requests for more information
  • Liability dispute
  • Lack of insurance coverage available

If you believe the reason the insurance company gave you for extending its investigation is invalid or does not apply to your case, ask for an internal review. You may also wish to contact a lawyer about potential insurance bad faith. Delaying a claim without reason is a common example of bad faith, or an insurance company intentionally mishandling your claim to save money.

Can You Expedite an Insurance Claim?

The average insurance claim takes about three months to achieve a payout. If your case has complicating factors, however, it could take longer to resolve. Although most personal injury claims in Texas settle at the insurance stage, if your claim needs to go to trial, expect it to take one year or longer to receive a payout.
Hiring a personal injury lawyer to negotiate your insurance claim or injury lawsuit for you can expedite the claims process. Your lawyer can cut time off of your claim wherever possible, such as by submitting full information and documentation regarding your injuries right away. A lawyer can also help you take legal action if an insurance company is guilty of an unreasonable claim delay. A lawyer will let you know how long it will most likely take an insurance company to pay out your claim from the very beginning, so you know what to expect.